Is common variable immunodeficiency associated with diverticulitis? A matched cohort study

Abstract

Background The aim of this study was to evaluate the likelihood of acute diverticulitis and its severity in patients with common variable immunodeficiency (CVID) compared to matched controls among those who presented to the emergency room and underwent computed tomography (CT) imaging for abdominal pain.

Methods This was a multicenter, retrospective study comparing adult patients with a diagnosis of CVID, who had CT imaging for abdominal pain between the years 2015-2024, to a control cohort of adult patients without CVID. Mann-Whitney U and chi-square tests were performed to compare baseline characteristics between cases and controls. Mantel-Haenszel tests and conditional logistic regression were used to evaluate associations between CVID, diverticulitis and selected variables.

Results A total of 1392 patients were included in the analysis (696 with CVID and 696 without CVID). Of these patients, 72% were female, 96% were white, their median age was 57 years, and their median body mass index was 27.8 kg/m2. CVID was associated with lower odds of diverticulitis (odds ratio [OR] 0.41, 95% confidence interval 0.27-0.63; P<0.001). There was no difference between the rates of complicated diverticulitis. Among patients with CVID who were diagnosed with diverticulitis, 51.4% (vs. 45%, OR 1.27, 95%CI 0.57-2.81; P=0.563) required inpatient treatment, 22.9% required surgical intervention (vs. 16.5%, OR 1.50, 95%CI 1.50 (0.56-4.04); P=0.418), and 31.4% (vs. 24.1%, OR 1.45, 95%CI 0.60-3.49; P=0.411) had recurrent diverticulitis.

Conclusion Patients with CVID presenting to the emergency department have lower odds of acute diverticulitis among those who underwent CT imaging for abdominal pain.

Keywords Common variable immunodeficiency, diverticulitis, abdominal pain

Ann Gastroenterol 2026; 39 (5): 614-618