The Immediate, Hospital-Level Impact of Stay-at-Home Order on Diverticulitis Burden

Soriano, Celine; Kaplan, Jennifer A.; Law, Joanna K.; Williams, Barbara; Blackmore, C. Craig; Simianu, Vlad V.

doi:10.1007/s11605-020-04798-x

Cited by 6 publications

(11 citation statements)

References 6 publications

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“…Overall, admissions for acute diverticulitis decreased by 56%, from 749 in pre-lockdown to 332 during lockdown. A higher percentage reduction (up to 67%) was observed in the largest series[ 11 , 12 , 14 , 16 , 17 ]. A 4%-8% decrease in the rate of uncomplicated diverticulitis (defined as localized diverticular inflammation without any abscess or perforation) was also noted during the lockdown phase in the three studies from United States.…”

Section: Resultsmentioning

confidence: 91%

“…A 4%-8% decrease in the rate of uncomplicated diverticulitis (defined as localized diverticular inflammation without any abscess or perforation) was also noted during the lockdown phase in the three studies from United States. [ 11 , 16 , 17 ]…”

Section: Resultsmentioning

confidence: 99%

“…However, most studies showed a substantial decrease in the number of overall admissions between the pre-lockdown and lockdown phases. Some authors noticed how this trend was at odds with that observed in the pre-pandemic period, as it had been increasing in recent years[ 11 , 16 ].…”

Section: Discussionmentioning

confidence: 99%

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What paradigm shifts occurred in the management of acute diverticulitis during the COVID-19 pandemic? A scoping review

Gallo¹,

Ortenzi²,

Grossi³

et al. 2021

WJCC

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BACKGROUND Acute colonic diverticulitis (ACD) is common in Western countries, with its prevalence increasing throughout the world. As a result of the coronavirus disease 2019 (COVID-19), elective surgery and in-patients’ visits have been cancelled or postponed worldwide. AIM To systematically explore the impact of the pandemic in the management of ACD. METHODS MEDLINE, Embase, Scopus, MedxRiv, and the Cochrane Library databases were searched to 22 December 2020. Studies which reported on the management of patients with ACD during the COVID-19 pandemic were eligible. For cross sectional studies, outcomes of interest included the number of hospital admission for ACD, as well as key features of disease severity (complicated or not) across two time periods (pre- and during lockdown). RESULTS A total of 69 papers were inspected, and 21 were eligible for inclusion. Ten papers were cross sectional studies from seven world countries; six were case reports; three were qualitative studies, and two review articles. A 56% overall decrease in admissions for ACD was observed during lockdown, peaking 67% in the largest series. A 4%-8% decrease in the rate of uncomplicated diverticulitis was also noted during the lockdown phase. An initial non-operative management was recommended for complicated diverticulitis, and encouraged to an out-of-hospital regimen. Despite initial concerns on the use of laparoscopy for Hinchey 3 and 4 patients to avoid aerosolized contamination, societal bodies have progressively mitigated their initial recommendations as actual risks are yet to be ascertained. CONCLUSION During the COVID-19 pandemic, fewer patients presented and were diagnosed with ACD. Such decline may have likely affected the spectrum of uncomplicated disease. Established outpatient management and follow up for selected cases may unburden healthcare resources in time of crisis.

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Section: Resultsmentioning

confidence: 91%

Section: Resultsmentioning

confidence: 99%

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What paradigm shifts occurred in the management of acute diverticulitis during the COVID-19 pandemic? A scoping review

Gallo¹,

Ortenzi²,

Grossi³

et al. 2021

WJCC

View full text Add to dashboard Cite

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“…The initial search produced 135 potentially relevant articles. After 85 articles were screened for relevance of titles and abstracts, 50 full text articles were further assessed for eligibility and 25 were excluded ( Supplementary Table S1 ); thus, 25 trials were included in the review [ 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 ]. Their characteristics are reported in Table 1 , Table 2 , Table 3 and Table 4 .…”

Section: Resultsmentioning

confidence: 99%

“…For these reasons, some patients presented late with more severe conditions. An analysis performed on patients with diverticulitis who were evaluated at Virginia Mason Medical Center (Seattle, WA, USA) showed a shift to lower outpatient and increased inpatient and Emergency Department attendance ( p < 0.01) [ 19 ]. At the same time, the incidence of associated abscesses more than doubled compared to the incidence of abscesses during non-COVID periods (11.7% vs. 4.4%, p < 0.01) [ 36 ], and the incidence of peritonitis (Hinchey III and IV) was significantly higher (28.8% vs. 11.2%, p = 0.005) [ 22 ].…”

Section: Resultsmentioning

confidence: 99%

The Management of Acute Colonic Diverticulitis in the COVID-19 Era: A Scoping Review

et al. 2021

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Background and Objective: During the COVID-19 pandemic, health systems worldwide made major changes to their organization, delaying diagnosis and treatment across a broad spectrum of pathologies. Concerning surgery, there was an evident reduction in all elective and emergency activities, particularly for benign pathologies such as acute diverticulitis, for which we have identified a reduction in emergency room presentation with mild forms and an increase with more severe forms. The aim of our review was to discover new data on emergency presentation for patients with acute diverticulitis during the Covid-19 pandemic and their current management, and to define a better methodology for surgical decision-making. Method: We conducted a scoping review on 25 trials, analyzing five points: reduced hospital access for patients with diverticulitis, the preferred treatment for non-complicated diverticulitis, the role of CT scanning in primary evaluation and percutaneous drainage as a treatment, and changes in surgical decision-making and preferred treatment strategies for complicated diverticulitis. Results: We found a decrease in emergency access for patients with diverticular disease, with an increased incidence of complicated diverticulitis. The preferred treatment was conservative for non-complicated forms and in patients with COVID-related pneumonia, percutaneous drainage for abscess, or with surgery delayed or reserved for diffuse peritonitis or sepsis. Conclusion: During the COVID-19 pandemic we observed an increased number of complicated forms of diverticulitis, while the total number decreased, possibly due to delay in hospital or ambulatory presentation because of the fear of contracting COVID-19. We observed a greater tendency to treat these more severe forms by conservative means or drainage. When surgery was necessary, there was a preference for an open approach or a delayed operation.

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Impact of the first COVID-19 surge on the outcomes of diverticulitis

Aulet

Spencer²,

Abelson³

et al. 2022

Surgery in Practice and Science

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The Immediate, Hospital-Level Impact of Stay-at-Home Order on Diverticulitis Burden

Cited by 6 publications

References 6 publications

What paradigm shifts occurred in the management of acute diverticulitis during the COVID-19 pandemic? A scoping review

What paradigm shifts occurred in the management of acute diverticulitis during the COVID-19 pandemic? A scoping review

The Management of Acute Colonic Diverticulitis in the COVID-19 Era: A Scoping Review

Impact of the first COVID-19 surge on the outcomes of diverticulitis

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