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contribution to medical research, with 2120 publications in this time. However, there is a propensity for low-evidence work and disproportionately fewer higher-level publications such as RCTs, systematic reviews and meta-analyses, highlighting an area of improvement. The top 5% of authors account for 41% of the total publications and are responsible for significantly more high-level evidence studies. Quantitative analysis demonstrates that thoracoabdominal aortic pathologies and peripheral arterial disease are the most popular topics, while there has been an increasing number of publications on endovascular and hybrid surgery in keeping with the trend in clinical practice. This information allows for improved identification of top contributing authors to vascular surgery research and can be used in resource allocation for future research projects or identification of research gaps. The novel severe acute respiratory syndrome coronavirus-2 (coronavirus disease 2019 [COVID-19]) pandemic is responsible for more than 500,000 deaths in the United States and nearly 3 million worldwide, profoundly altering the landscape of health care delivery. Aggressive public health measures were instituted and hospital efforts became directed at COVID-19–related concerns. Consequently, routine surgical practice was virtually halted, resulting in billions of dollars in hospital losses as pandemic costs escalated. Navigating an uncertain new landscape of scarce resource allocation, exposure risk, role redeployment, and significant practice pattern changes has been challenging. Furthermore, the overall effect on the financial viability of the health care system and vascular surgical practices is yet to be elucidated. This review explores the economic and clinical implications of COVID-19 on the practice of vascular surgery in addition to the health care system as a whole. The severe acute respiratory syndrome coronavirus-2 (coronavirus disease 2019 [COVID-19]) was first identified in December 2019 in Wuhan, China, before spreading to the United States and starting a rapid national breakout by March 2020 To date, this has resulted in nearly 3 million global deaths and more than 500,000 deaths in the United States In the wake of patients deferring hospital exposure and diversion of health care resources to emergent care, demand for non–COVID-19 care plummeted, resulting in US hospitals collectively losing approximately $50 billion per month during the peak months of the pandemic Furthermore, the deferral of usual care in addition to COVID-19–related sequelae has significantly impacted the health of vascular surgery patients. Herein, we describe the effects of COVID-19 on health care and specifically vascular surgery from a systems, economic, and clinical care perspective, as well as offer insights into the ongoing recovery phase of the pandemic. Common resource databases were used and searched to identify current literature on the subject of financial sequelae from the COVID-19 pandemic. Search terms included economic, financial, health systems, and clinical impact from COVID-19. We reviewed the identified articles and the most representative of these works were included in order to provide a thorough review for the purpose of this article. This review was intended to be a contemporary perspective of the known economic, health systems, and clinical implications of the COVID-19 pandemic encompassing the most up-to-date information, with known limitations due to the available data and the ongoing nature of this health crisis. The global pandemic of COVID-19 has led to unprecedented public health challenges due to the severity of the disease, the breadth of its impact, and the rapidity of its infectious spread. Within a few weeks, the COVID-19 public health emergency (PHE) overwhelmed current health care resources, especially in densely populated cities, forcing clinicians to make very difficult triage decisions about the types of care and interventions offered to patients during a time of resource scarcity. Not surprisingly, these effects transcend national borders onto the global scale—a recent report by the CovidSurg Collaborative projected that 28.4 million operations worldwide would be
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