ABSTRACT
The ongoing pandemic of SARS-CoV-2 calls for rapid and cost-effective methods to accurately identify infected individuals. The vast majority of patient samples is assessed for viral RNA presence by RT-qPCR. Our biomedical research institute, in collaboration between partner hospitals and an accredited clinical diagnostic laboratory, established a diagnostic testing pipeline that has reported on more than 252,000 RT-qPCR results since its commencement at the beginning of April 2020. However, due to ongoing demand and competition for critical resources, alternative testing strategies were sought. In this work, we present a clinically-validated procedure for high-throughput SARSCoV-2 detection by RT-LAMP in 25 minutes that is robust, reliable, repeatable, sensitive, specific, and inexpensive © 2021. Buck MD et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited
ABSTRACT
Purpose/Background: The global pandemic due to COVID-19 has had numerous health and economic consequences but the impact on patients with colorectal conditions such as diverticulitis is unknown. We sought to determine the effect of COVID-19 limitations on patients with diverticular conditions. Methods/Interventions: We analyzed records from the Premier hospital inpatient files from 1/1/2019 through 6/30/2020 accounting for 586 hospitals. Admissions and surgical procedures for patients with diverticular disease were compared for the first six months of 2019 as compared to the first six months of 2020 during the COVID-19 pandemic. Types of procedures, presence of abscess, and adverse events were compared during the two periods as well as the development of respiratory complications such as pneumonia or pulmonary failure. All analyses were performed with SAS 9.4 and p value of less than 0.05 was considered significant. Results/Outcome(s): Admissions for diverticulitis declined by 25% in 2020 from a total of 20,717 patients in the first six months of 2019. Despite the net decline in admissions, the proportion of urgent diverticular disease cases rose significantly in April 2020 to 59.2% from an average of 36.9% in 2019 (p<0.05). In addition, although diverticular abscess comprised 55.1% of all admissions in 2019, the proportion of abscess cases rose to 69.4% in April 2020. As a consequence, 38% of all procedures in the spring of 2020 resulted in a stoma, which was 29% higher than in 2019. In addition, laparoscopy was used in 43% of all procedures in 2019, yet only 34% of cases in April 2020. Postoperative complications such as organ space infections and sepsis were significantly higher in April 2020 but not other infectious complications such as urinary tract infections. Most importantly, pneumonia complications were similar in 2019 (1.6%) as they were in 2020 (1.8%) (p=0.5). Although respiratory failure rates grew in April 2020, further stratification of data for surgical technique and presence of abscess, revealed no significant differences between the two time periods. Conclusions/Discussion: National data reveal that a large number of patients with diverticular disease avoided the hospital in 2020 likely leading to increased disease severity as reflected by proportionately higher diverticular abscess case rates. The increases in diverticular abscess procedures coincided with higher rates of organ space infections and proportionately more ostomy procedures but no increase in respiratory complications. These data indicate that surgery for diverticulitis in the setting of the COVID pandemic can be safely performed without additional increase in respiratory consequences.