Background The novel coronavirus disease 2019 (COVID-19) pandemic has resulted in fewer emergency presentations of many acute medical and surgical conditions. The purpose of this study was to assess the severity of disease at presentation and quantify the change in number of presentations during this period. Methods This retrospective study includes all patients diagnosed with acute diverticulitis on abdominopelvic computerised tomography (CT) between March 1, 2020 and June 30, 2020, compared to the same period in 2019. Follow up scans on the index admission were excluded. Hinchey grade was assessed for all CT scans. Inflammatory markers were analysed, along with outcome measures including length of stay and mortality. Results Acute diverticulitis was diagnosed in 52 CT scans in the acute pandemic period – a decrease of 51.4%. Average age at presentation was unchanged (63.3 ± 14.3 vs. 62.8 ± 13.8, P = .848). The number of Hinchey II, III and IV presentations were significantly higher in the acute pandemic period (28.8% vs. 11.2%, P = .005) and significantly more emergency operations were carried out (7.69% vs. .93%, P = .04). Mortality was not significantly increased, nor were serum levels of C-reactive protein, white cell count and lactate. Discussion During the COVID-19 pandemic, fewer patients presented and were diagnosed with acute diverticulitis. A significantly greater proportion presented at a more advanced stage and required emergency surgery, suggesting late presentation. Our findings support the need for maintaining acute surgical services and the provision of early radiological and surgical input in patients presenting with signs and symptoms of acute diverticulitis in future pandemics.

To support the global restart of elective surgery, data from an international prospective cohort study of 8492 patients (69 countries) was analysed using artificial intelligence (machine learning techniques) to develop a predictive score for mortality in surgical patients with SARS-CoV-2. We found that patient rather than operation factors were the best predictors and used these to create the COVIDsurg Mortality Score (https://covidsurgrisk.app). Our data demonstrates that it is safe to restart a wide range of surgical services for selected patients.

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Aims During a non-obstetric admission, there is minimal awareness amongst other specialties regarding the need to reassess venous thromboembolism (VTE) prophylaxis requirements. The primary aim of this study was to review whether perinatal patients are accurately assessed for VTE risk factors during non-obstetric admissions and being prescribed appropriate thromboprophylaxis upon discharge. Methods Data collection was carried out by retrospectively identifying all admissions of pregnant women in hospital under a non-obstetric team over a period of six months. Patients were scored according to their individual risk factors related to pregnancy and the admission. Comparison was made between the recommended and actual prophylaxis given. Results 152 patients were included in the study. Only 13 women received appropriate VTE management whilst 35 patients were deemed high-risk and did not receive prophylaxis. VTE assessment was not documented in nearly 60% of patients. 68% of patients were found to be at intermediate risk. Conclusion Reassessment for risk of VTE in antenatal and postnatal patients is poorly documented when managed by non-obstetric led teams. Women with both established and transient risk factors for VTE are not receiving appropriate thromboprophylaxis. Raised awareness of this specific problem is required amongst non-obstetric teams. Key Statement Appropriate thromboprophylaxis is vital at the point of admission of a pregnant patient to hospital as this is associated with an 18-fold increased risk of VTE. Further improvements need to be made in order to educate non-obstetric teams caring for obstetric patients regarding the importance of VTE risk assessment.