Association Between Coronavirus Disease 2019 and Acute Complicated Diverticulitis

Area of Science:

• Gastroenterology
• Infectious Diseases
• Surgical Gastroenterology

Background:

• Gastrointestinal symptoms are recognized manifestations of coronavirus disease 2019 (COVID-19).
• The co-occurrence of COVID-19 and first-time acute diverticulitis suggests overlapping pathophysiology.
• This study investigates the association between COVID-19 and acute diverticulitis in a tertiary care setting.

Purpose of the Study:

• To characterize the association between COVID-19 infection and the development of first-time acute diverticulitis.
• To analyze complication rates and treatment outcomes in COVID-19-positive patients with acute diverticulitis.
• To assess the impact of COVID-19 vaccination status and disease severity on diverticulitis outcomes.

Main Methods:

• Retrospective analysis of 81 patients diagnosed with COVID-19 who developed acute diverticulitis within 30 days (2020-2022).
• COVID-19 diagnosis via PCR; acute diverticulitis diagnosis via CT scan.
• Exclusion of patients with a prior history of acute diverticulitis; data collection on patient characteristics, comorbidities, and disease course.

Main Results:

• A median of 13 days elapsed between COVID-19 diagnosis and acute diverticulitis onset.
• The overall complication rate for acute diverticulitis was 59.3%, with intestinal perforation (39.5%) being most common.
• Patients diagnosed with acute diverticulitis concurrently with COVID-19 showed significantly higher rates of intestinal perforation, peritonitis, and emergent surgery.

Conclusions:

• First-time acute diverticulitis within 30 days of COVID-19 infection is associated with a high complication rate, primarily intestinal perforation.
• Concurrent diagnosis of acute diverticulitis and COVID-19 significantly increases complication and emergent surgical intervention risks.
• Increased clinical vigilance and monitoring are recommended for patients developing diverticulitis shortly after COVID-19 infection due to high complication rates.