Impact of the COVID-19 Pandemic on the Management of Acute Colonic Diverticulitis: A Retrospective Observational Study

TL;DR

The study found that hospital admissions for acute colonic diverticulitis dropped during the pandemic, with more use of radiological drainage but no decline in care quality.

Contribution

This study provides new insights into how the pandemic affected the management and hospitalization trends of acute colonic diverticulitis.

Findings

Hospital admissions for ACD decreased by 17.87% during the pandemic.

Radiological drainage was used more frequently during the pandemic compared to pre-COVID times.

CRP levels were higher during the pandemic, suggesting delayed care-seeking behavior.

Abstract

Introduction

Acute colonic diverticulitis (ACD) is a frequent gastrointestinal disease, with its rising incidence and hospitalizations contributing to increased healthcare costs. The COVID-19 pandemic significantly impacted healthcare delivery, leading to shifts in hospital admissions and management strategies for various conditions, including ACD. This study aims to assess the changes in hospital admission rates for ACD before and during the COVID-19 pandemic. Secondary outcomes include the differences in patient demographics, management approaches, and follow-up data between the two periods.

Methods

A retrospective observational study was conducted on patients admitted with ACD between January 1, 2017, and May 5, 2023. Patients were divided into two groups: the pre-COVID group (PCG, January 2017 to March 2020) and the COVID group (CG, March 2020 to May 2023). Data collected included patient characteristics, laboratory findings, disease severity, imaging, treatment strategies, and the 90-day follow-up outcomes. Statistical analyses were used to compare the two groups.

Results

A total of 428 patients were included in the study (235 in PCG, 193 in CG), with a 17.87% decline in hospital admissions for ACD during the pandemic. While the demographic characteristics were largely comparable, previous abdominal surgery was more frequent in PCG (p=0.006). Management strategies shifted, with the increased use of radiological drainage in CG (p=0.034), though surgical intervention rates remained stable. CRP levels were significantly higher in CG (p=0.010), suggesting a possible delay in care-seeking.

Conclusion

The COVID-19 pandemic led to a reduction in ACD-related hospital admissions, with an increased use of radiologic drainage. Overall care quality remained consistent, emphasizing the healthcare system's resilience during crises.