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Original Article
- Infection
- How the COVID-19 pandemic affected the severity and clinical presentation of diverticulitis
- Sara S. Soliman, Rolando H. Rolandelli, Grace C. Chang, Amanda K. Nemecz, Zoltan H. Nemeth
- Intest Res 2023;21(4):493-499. Published online October 26, 2023
- DOI: https://doi.org/10.5217/ir.2022.00042
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Abstract
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ePub - Background/Aims
Single-institution studies showed that patients presented with more severe diverticulitis and underwent more emergency operations during the coronavirus disease 2019 (COVID-19) pandemic. Therefore, we studied this trend using nationwide data from the American College of Surgeons National Surgical Quality Improvement Program database.
Methods
Patients (n = 23,383) who underwent a colectomy for diverticulitis in 2018 (control year) and 2020 (pandemic year) were selected. We compared these groups for differences in disease severity, comorbidities, perioperative factors, and complications.
Results
During the pandemic, colonic operations for diverticulitis decreased by 13.14%, but the rates of emergency operations (17.31% vs. 20.04%, P< 0.001) and cases with a known abscess/perforation (50.11% vs. 54.55%, P< 0.001) increased. Likewise, the prevalence of comorbidities, such as congestive heart failure, acute renal failure, systemic inflammatory response syndrome, and septic shock, were higher during the pandemic (P< 0.05). During this same period, significantly more patients were classified under American Society of Anesthesiologists classes 3, 4, and 5, suggesting their preoperative health states were more severe and life-threatening. Correspondingly, the average operation time was longer (P< 0.001) and complications, such as organ space surgical site infection, wound disruption, pneumonia, acute renal failure, septic shock, and myocardial infarction, increased (P< 0.05) during the pandemic.
Conclusions
During the pandemic, surgical volume decreased, but the clinical presentation of diverticulitis became more severe. Due to resource reallocation and possibly patient fear of seeking medical attention, diverticulitis was likely underdiagnosed, and cases that would have been elective became emergent. This underscores the importance of monitoring patients at risk for diverticulitis and intervening when criteria for surgery are met. -
Citations
Citations to this article as recorded by
- Where Are We Now? An Update on Colectomies for Diverticulitis in the Wake of the COVID-19 Pandemic
Benjamin Gallant, Andrew Hu, HyukJoo Hwang, Kaitlyn Oldewurtel, Allison Crawford, Justin Maykel, Thomas Peponis, Paul Sturrock, Karim Alavi, Tess Aulet
The American Surgeon™.2026;[Epub] CrossRef - Impact of the COVID-19 Pandemic on the Management of Acute Colonic Diverticulitis: A Retrospective Observational Study
Manuela Mastronardi , Aurora Bertini, Margherita Sandano, Paola Germani, Marina Troian, Nicolò de Manzini, Alan Biloslavo
Cureus.2025;[Epub] CrossRef - Analyzing the switch from laparoscopic to robotic surgery for diverticular disease: a comparative cohort study
Rahul Bhome, Ramprasad Rajebhosale, Rachel Smyth, Estelle Martin, Matthew Tutton, Subash P. Vasudevan
Journal of Robotic Surgery.2025;[Epub] CrossRef - Surgical and non-operative treatment of acute complicated diverticulitis in a COVID hospital
A. E. Tyagunov, N. A. Shcherbakov, R. R. Akhmedov, N. S. Donchenko, B. K. Laipanov, Z. M. Alieva, E. A. Stradymov, A. V. Tavadov, A. T. Mirzoyan, D. D. Fyodorov, A. A. Tyagunov, A. V. Sazhin
Koloproktologia.2024; 23(2): 108. CrossRef
- Where Are We Now? An Update on Colectomies for Diverticulitis in the Wake of the COVID-19 Pandemic
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