Systematic Reviews
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 16, 2021; 9(23): 6759-6767
Published online Aug 16, 2021. doi: 10.12998/wjcc.v9.i23.6759
What paradigm shifts occurred in the management of acute diverticulitis during the COVID-19 pandemic? A scoping review
Gaetano Gallo, Monica Ortenzi, Ugo Grossi, Gian Luca Di Tanna, Francesco Pata, Mario Guerrieri, Giuseppe Sammarco, Salomone Di Saverio
Gaetano Gallo, Department of Medical and Surgical Sciences, University of Catanzaro, Catanzaro 88011, Italy
Monica Ortenzi, Mario Guerrieri, Department of General and Emergency Surgery, Polytechnic University of Marche, Ancona 60121, Italy
Ugo Grossi, 2nd Surgery Unit, Regional Hospital Treviso, DISCOG, University of Padua, Treviso 31100, Italy
Gian Luca Di Tanna, The George Institute for Global Health, University of New South Wales, Sydney 2050, NSW, Australia
Francesco Pata, Department of General Surgery, Ospedale Nicola Giannettasio, Corigliano-Rossano 87064, Italy
Francesco Pata, La Sapienza University, Roma 00185, Italy
Giuseppe Sammarco, Department of Health Sciences, University "Magna Graecia" Medical School, University of Catanzaro, Catanzaro 88100, Italy
Salomone Di Saverio, Department of General Surgery, University of Insubria, University Hospital of Varese, Varese 21100, Italy
Author contributions: Gallo G, Ortenzi M, and Grossi U designed and performed the research; Ortenzi M, Grossi U, and Di Tanna GL analyzed the data; Gallo G, Ortenzi M, Grossi U, and Pata F wrote the paper; Guerrieri M, Sammarco G, and Di Saverio S supervised the paper; all authors read and approved the final manuscript.
Conflict-of-interest statement: The authors declare that they have no conflict of interest, and no funding from any organization for the submitted work.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Gaetano Gallo, MD, Academic Research, Surgeon, Department of Medical and Surgical Sciences, University of Catanzaro, Viale Europa, Catanzaro 88011, Italy. gaethedoctor@alice.it
Received: February 2, 2021
Peer-review started: February 7, 2021
First decision: March 6, 2021
Revised: April 15, 2021
Accepted: July 7, 2021
Article in press: July 7, 2021
Published online: August 16, 2021
ARTICLE HIGHLIGHTS
Research background

Acute diverticulitis represents a common cause of surgical admission in emergency settings.

Research motivation

The pandemic has had an impact on the rate of admission and treatment for acute diverticulitis. The aim of this review is to map the research done in this area.

Research objectives

The main objective of this review was to systematically explore the impact of the coronavirus disease 2019 (COVID-19) pandemic on the rate of admission and treatment for acute diverticulitis.

Research methods

We searched five electronic databases from December 1, 2019 to December 22, 2020, for studies that reported on the management of patients with acute diverticulitis during the COVID-19 pandemic. Quantitative, qualitative and mixed-method studies were included in order to consider different aspects of measuring treatment burden. Overallproportions were estimated from the weighted mean of percentages measured in each study. Data were expressed using descriptive statistics, including proportions and averages.

Research results

The review demonstrated an overall decrease in admissions for acute complicated diverticulitis (ACD) during the pandemic peak and consequent lockdown, peaking 67% in the largest series. A reduction in the rate of uncomplicated diverticulitis was observed as well. The pandemic outbreak produced a major shift towards non-operative and out-of-hospital management of ACD.

Research conclusions

During the COVID-19 pandemic, there was a reduction in the rate of both complicated and uncomplicated diverticulitis. The pandemic outbreak may have unburdened healthcare resources in time of crisis as a result of a switch towards non-operative treatment and clinical follow-up in selected patients with diverticular disease.

Research perspectives

Whether the pandemic has had an impact on the rate of admission and treatment for acute diverticulitis has not yet been systematically explored. Besides offering a general overview of the changes in epidemiology and management of acute diverticulitis that occurred during the pandemic, the review will inform on changes in the management of this disease in the likely forecast that severe acute respiratory syndrome coronavirus 2 will become a chronic problem to deal with.