ABSTRACT
Background and aim: Telemedicine has become a fundamental tool in the management of inflammatory bowel diseases and its role has mainly emerged due to the current COVID-19 pandemic.“Vicini di Salute” is a home telemonitoring project, born to support the management of patients affected by chronic diseases, such as Ulcerative Colitis (UC). The primary aims were to assess (1) the degree of involvement of UC patients, (2) the clinical disease course and the adherence to therapy and (3) the impact of the UC on health status. The secondary aim was to evaluate the degree of patient satisfaction. Materials and methods: The study design was to prospectively enrol twenty adult UC patients with quiescent or mild to moderate disease. They received a tablet for 6 months through which questionnaires about adherence to therapy and UC-related symptoms were periodically administered. The health-related quality of life was assessed through the Short Inflammatory Bowel Disease Questionnaire (SIBDQ). The Satisfaction Questionnaire was sent at the baseline and then every three months. Patients also received educational and motivational messages related to bowel disease. Results: Patients received the tablets in June 2020 and all of them completed the study. Demographics and clinical characteristics of the participants are shown in Table 1. Eighty percent of patients regularly used the device and more than 95% answered all questionnaires at least once. The compilation rate was inversely proportional to the frequency of administration (from 54% of the weekly ones up to 80% of the quarterly Satisfaction Questionnaires). Thirteen patients completed at least two questionnaires on UC-related symptoms per month. Among them, 31% maintained clinical remission, 38% achieved clinical remission, 15% had persistent disease activity and 16% experienced disease flare. Based on treatment adherence questionnaires, therapy was regularly assumed in 89%, it was not spontaneously changed in 70% and it was interrupted for well-being in 2%. The mean SIBDQ score was 49±15. Participants reported a mean degree of satisfaction of 8,5 of 10. (table presented) Conclusions: This study was the first in Italy to be focused on telemedicine in UC patients. It showed a high involvement rate and it represented an important tool to assess the clinical disease course and the adherence to therapy, improving the overall management of patients. Based on our experience, telemedicine could become a promising method in the management of UC patients in clinical practice.
ABSTRACT
Aims This is a prospective observational web-based survey aimed to assess the impact of SARS-CoV-2 pandemic onGastroenterology Units in Italy. Methods All members of the Italian Society of Gastroenterology (SIGE) were invited to answer a 39-point multiple-choiceweb-based survey between March 30 thand April 7 th2020. Results Data of 121 hospitals from all 20 Italian regions were analyzed. Overall, 10.7 % of Gastroenterology divisions havebeen converted to COVID Units. Outpatients consultations, endoscopic and ultrasound procedures were limited to urgenciesand oncology indications in 85.1 %, 96.2 % and 72.2 % of Units, respectively, and 46.7 % of Units suspended the screeningfor colorectal cancer.In order to guarantee the ordinary follow-up of outpatients, 83/121 (68.6 %) divisions activated aremote consultancy service (63.9 % by phone, 31.3 % by email, 4.8 % by video). Overall, 112/121 (92.6 %) GI Units issued and followed a specific protocol for the management of patients with suspectedor confirmed SARS-CoV-2 infection. The 72.2 % of the staff received proper training for the use of personal protective equipment, although 45.5 % did not havesufficient devices for an adequate replacement. With regard to PPE availability, N95/FFP2-3 masks were available in 91/121 (75.2 %), surgical masks in 115/121 (95.0 %),gloves in 117/121 (96.7 %), disposable gown in 100/121 (82.6 %), hairnet in 104/121 (85.9 %), goggles in 78/121 (64.5 %)and boots in 57/121 (47.1 %) of divisions. Finally, in 41/121 GI divisions (33.9 %) there was at least one healthcare professional who got infected, in a total of 132subjects, of which 121/132 from divisions not-converted to COVID Units and 75/132 from high-prevalence areas. Conclusions Substantial changes of practice and reduction of procedures have been recorded in the entire country duringthe first wave of the pandemic. The long-term impact of such modifications is difficult to estimate but potentially very riskyfor many digestive diseases.
ABSTRACT
The involvement of gastrointestinal system in SARS-CoV2 related disease, COVID-19, is increasingly recognized. COVID-19 associated pancreatic injury has been suggested, but its correlation with pancreatic disease is still unclear. In this case report, we describe the detection of SARS-CoV2 RNA in a pancreatic pseudocyst fluid sample collected from a patient with SARS-CoV2 associated pneumonia and a pancreatic pseudocyst developed as a complication of an acute edematous pancreatitis. The detection of SARS-CoV2 within the pancreatic collection arise the question of whether this virus has a tropism for pancreatic tissue and whether it plays a role in pancreatic diseases occurrence.