ABSTRACT
Background and Aim: Since the emergence of COVID-19, tele-rheumatology care has presented as an appealing alternative way for accessing health care. The efficacy of tele-care needs to be evaluated in our setting. This study aimed at assessing the agreement between the tele-visit and the face-to- face clinic-based visit. Methodology: We prospectively recruited patients with rheumatoid arthritis;who were following up in the out-patient department clinics between December 2021 and May 2022. Each patient underwent disease activity assessment by means of disease activity score 28-c- reactive protein (DAS28-CRP) and disease activity score28-erythrocyte sedimentation rate (DAS28-ESR). Within two weeks from the face-to- face visit, we virtually assessed their disease activity, through a telephone-based interview, by applying Routine Assessment of Patient Index Data 3 (RAPID3) score, collecting data on demographics and inquiring about satisfaction with the tele-visit. Disease activity scores were categorized into remission or low disease activity, and moderate to high disease activity. Result(s): In our study, 78 patients were recruited and completed the two-points interview. A total of 62(79.49%) of the participants were female;mean age of 54.73 +/- 13.71 years. Seropositivity for rheumatoid factor and/or anti-citrullinated peptide was found in 51(83.61%) participants. 27% of patients with RAPID3 had remission or low disease activity. While this was 71% and 33% for DAS28-CRP and DAS28-ESR, respectively. Moderate to high disease activity percentage of 73%, 29% and 67% were found in RAPID3, DAS28-CRP and DAS28-ESR, respectively. Furthermore, the correlations of RAPID 3 were relatively moderate but significant with DAS28-CRP (r = 0.6, P-value < 0.001) and DAS28-ESR (r = 0.4, P-value = 0.001), respectively. Satisfaction rates with the tele-visit were at odds with other reported publications. Conclusion(s): Tele-rheumatology assessment of disease activity for patients with rheumatoid arthritis appears to be feasible in our setting. Further studies should aim at assessing patients' satisfaction and the recently implemented video-based tele-clinics.
ABSTRACT
Background: The severity of lung involvement associated with SARS-CoV-2 infection levels from lack of symptoms or slight pneumonia (in 81%) to excessive disease-associated hypoxia (seen in 14%), a critical disease associated with shock, respiration failure, and multi-organ failure (in 5%) or death (2.3%). Aim: This work aims to determine the prevalence of clinical and radiological manifestations among children and adolescents COVID-19 patients. Materials and Methods: A systematic search was performed over different medical databases to identify Pediatrics studies, which studied the outcome of COVID-19 infection in children and adolescents. Using the meta-analysis process, either with fixed or random-effects models, we conducted a meta-analysis on the prevalence of clinical manifestations (e.g., fever, nasal congestion, cough, dyspnea, abdominal pain, diarrhea, and critical cases), as primary outcomes, and on radiological manifestations (e.g., CT involvement - ground-glass opacities), as a secondary outcome. Pooled prevalence of abdominal pain=9.6%, pooled prevalence of critical cases=7.7%. Results: Eight studies were identified involving 682 patients. The meta-analysis process revealed a pooled prevalence of fever=61.1%, a pooled prevalence of nasal congestion=8%, pooled prevalence of cough=49.7%, pooled prevalence of dyspnea=21.4%, pooled prevalence of diarrhea=13.3%, pooled prevalence of critical cases=7.7%. Concerning the secondary outcome measures, the pooled prevalence of CT involvement=41.6%. Conclusion: To conclude, COVID-19 disease cause different manifestations in children such as fever and respiratory symptoms such as cough and dyspnea, organizing pneumonia and decreased pulmonary function.