Evaluation of factors associated with trust in telemedicine in patients with inflammatory bowel disease during COVID-19 pandemic: a multicenter cross-sectional survey.

OBJECTIVE: Telemedicine (TM) has had a powerful impact in recent years, particularly on managing chronic diseases such as inflammatory bowel disease (IBD). Knowing patients' expectations and concerns is essential to increase their confidence in this mode of medical care. PATIENTS AND METHODS: We interviewed a large cohort of IBD patients enrolled at two Italian tertiary referral centers to investigate their trust in TM. RESULTS: A total of 376 patients completed the survey and were included in the study: 293 (77.9%) considered TM valuable for managing their disease, and 307 (85%) wanted to have TM service at their center. However, only 99 patients (26.3%) believed that TM guarantees the same level of care as the in-person visit. Among the socio-demographic variables, those independently associated with trust in TM were the higher education qualification (p=0.02) and the level of competence in information and communication technologies (ICT) (p=0.03). CONCLUSIONS: Our findings highlighted the importance of equipping IBD patients with basic ICT skills to utilize TM services and increase their confidence in ICT with the help of caregivers. Additionally, to improve the perceived value of TM, it will be helpful to use additional tools such as telemonitoring of disease activity using patients' reported outcomes or remote measurement of fecal calprotectin.

Willingness and hesitancy to the telemedicine in patients with inflammatory bowel disease during COVID-19 outbreak. Preliminary results of a survey in an Italian IBD Center

Background: Telemedicine is becoming a necessary tool for chronic disease management. Thanks to the wide diffusion of devices connecting to the World Wide Web, a large part of the population are now able to access to telemedicine services.Telemedicine is becoming a necessary tool for chronic disease management. Thanks to the wide diffusion of devices connecting to the World Wide Web, a large part of the population are now able to access to telemedicine services. The aim of this survey was to explore the willingness and hesitancy of patients with inflammatory bowel disease (IBD) to the use of telemedicine during COVD-19 outbreak. Methods: A paper-and-pencil questionnaire was proposed to all consecutive patients observed at our tertiary IBD center in San Giovanni Rotondo (Italy) from February to May 2021. The survey investigated 20 items that can be grouped into 5 areas: socio-demographic data, clinical data, informatics competence, devices and network utilized for the internet connection, attitude to the telemedicine, and the impact of COVID-19 pandemic. Results: A total of 156 patients completed the questionnaire (100 males). One hundred forthy-three patients (91.7%) were under 65 years and only 15 (9.6%) were graduates. Forthy-seven patients (30%) were single, 101 married (65%). Eighteen patients (11.5%) felt they had no IT skills. Eight patients (5.1%) had a previous experience of telemedicine. One hundred twenty-three patients (78.8%) consider the support of telemedicine useful for the management of their pathology and 134 (85.9%) would like the Center where they are followed up to have the possibility of offering a telemedicine service. One hundred three patients (66.0%) would like to have a teleconsultation with figures other than the Gastroenterologist. Ninety-seven patients (62.2%) agree that the ongoing coronavirus pandemic has a major impact on the need to implement telemedicine. Regarding the confidence with telemedicine, 106 patients (67.9%) were partially or totally agreeing telemedicine can properly resolve health problems, and 98 (62.8%) agree that technologies guarantee the privacy of the health data. One hundred twenty-five patients (80%) agree that telemedicine should be developed independently of the pandemic, however only 48 patients (31%) believe that telemedicine guarantee the same level of assistance of visit in presence. Conclusion: Italian IBD patients showed a positive attitude towards telemedicine and consider that useful for the management of their disease. The majority of patients would like the center where they are followed up offering a telemedicine service, regardless of the ongoing pandemic. However only one third of patients believe that telemedicine can offer the same level of assistance of in-presence visit.

Telemedicine in IBD patients: Results of a national survey of the Italian IBD patients' association (AMICI Onlus)

Background: Telemedicine is one of the major changes that clinicians have encountered over the past decade;in particular during the COVID-19 pandemic, televisits were rapidly implemented to guarantee patients' assistance, with the intention of Health Care Providers (HCPs) to continue to use them beyond the pandemic. The aim of our national survey was to evaluate the current usage of telemedicine for IBD patients from their perspective, investigating patients' impressions about telemedicine and factors affecting them through a Machine Learning (ML) analysis. Methods: In March 2021, the Italian IBD patients' association (AMICI Onlus) distributed to their members -through its mailing list and on social media platforms -an anonymous online questionnaire investigating the use of telemedicine. Socio-demographic and IBD characteristics were collected;the usage, patients' satisfaction and trust of telemedicine were assessed through Likert scales. ML tools -Decision Trees (DT) and Random Forest (RF) -were applied to identify the determinants of patient's perceptions about telemedicine;the produced RF ranking displays two indicators: %IncMSE and IncNodePurity. Results: Nine hundred and seventy-eight IBD patients (women 58.9%) from every Italian region completed the questionnaire. Among the respondents, 87 (8.9%) personally had a telemedicine experience;153 reported that their Centre performed a telemedicine service during the COVID-19 pandemic (24.2% televisits, 39.2% e-mails, 24.8% phone-calls, 3.9 % dedicated website, 7.9% others). Overall, 707 (72.3%) would trust a telemedicine service, 760 (77.7%) would like to have it also with another HCP (e.g., nutritionist, psychologist) and 778/961 (81%) would like to use telemedicine in the future (17 did not answer to this specific question);792 (81%) stated they thought useful to have the possibility to use telemedicine and 847 (86.6%) would like their Centre to offer them this facility. Considering this last question as the output at the DT, the variable which have been found to influence the most this patients' willingness is patient's perception of the usefulness of telemedicine in treating their disease, since it represented the root of the tree explaining the results. The RF rankings confirmed that this variable influenced the most patients' perception with the highest levels of %IncMSE and IncNodePurity(Figure 1). Conclusion: The practice of telemedicine in the management of IBD patients has not been very relevant throughout Italy so far (less than 10%), but more than four every five respondents would like to use telemedicine. Machine learning analysis shows that the perceived usefulness of telemedicine service is the key point for patients who would like it was a part of usual clinical practice.

IMPACT OF A SARS-COV2 INFECTION IN PATIENTS WITH CELIAC DISEASE

Objective. No data are available on the effects of SARS-CoV2 infection in patients with celiac disease (CD) in terms of development of related symptoms and antibodies. We aimed to investigate the impact of SARS-CoV2 infection in CD. Design. During lockdown (March-May 2020), celiac patients living in Milano were interviewed about the development of COVID-19 resembling symptoms, adherence to an anti-virus lifestyle and gluten-free diet (GFD), and were asked to reply to a stress questionnaire. The development of anti SARSCoV2 IgG and IgA (anti RBD and N proteins) and the expression of duodenal ACE2 receptor were also investigated. Whenever available, duodenal histology, anti-tissue transglutaminase IgA (tTGA), immunologic comorbidities and GFD adherence were analyzed as possible risk factors. Results. 362 celiac patients have been interviewed and 42 (11%) reported COVID-19 resembling symptoms. The presence of symptoms was not influenced by positivity of tTGA, presence of duodenal atrophy or adherence to GFD. 37% of symptomatic patients showed anti SARS-CoV2 Immunoglobulins (Ig). Globally, 18% of celiac patients had anti SARS-CoV2 Ig vs 25% of non-celiac controls (p=0.18). Levels of anti RBD IgG/IgA and anti N IgG did not differ from non-celiac controls. Celiac patients had significantly lower levels of anti N IgA. ACE2 receptor was detected in the non-atrophic duodenal mucosa of celiac patients;atrophy was associated with a weaker expression of ACE2 receptor. Conclusion. CD patients show an anti SARS-CoV2 Ig positivity/profile similar to non-celiac controls, except for anti-N IgA. Main celiac biomarkers and adherence to the GFD do not influence the development of different antibody profiles.

TELEMEDICINE IN GASTROENTEROLOGY: A STUDY ON FEASIBILITY AND PATIENTS’ TRUST DURING COVID-19 PANDEMIC

Background and Aim Telehealth includes both health care delivery (often identified as telemedicine) in terms of disease diagnosis or treatment and several other services, such as prevention, education and public health promotion.1 During the recent COVID-19 pandemic, worldwide telemedicine has enabled many patients with chronic diseases to get access to remote assistance, since it has emerged as the ideal solution to overcome the restrictions to perform regular non-urgent follow-up visits to chronic patients and to continue patients’ assistance. Some positive reports on the use of telemedicine in gastroenterology among healthcare providers and patients have been published, but a patient’s trust perspective about video-consultations has been missing to date.2-5 Our study aimed at ascertaining our gastroenterological patients’ trust in video-consultations during the COVID-19 pandemic. Material and Methods At our Gastroenterology Unit in Milan (Italy), which is a tertiary referral center for Inflammatory Bowel Diseases (IBD) and Celiac Disease (CeD), telemedicine was used in place of on-site follow-up visits scheduled but not provided during the COVID-19 pandemic: all IBD and CeD outpatients received a phone call, while video-consultations were performed to patients with mild-to-moderate symptoms, with bio-umoral alterations or as needed for those patients who requested it. The patient’s trust in telemedicine was assessed through an adapted version of the PAtient Trust Assessment Tool (PATAT) question-naire.6 The primary endpoint was expressed as a percentage greater than 75% of patients giving a score of at least 4 out of 5 in a Likert Scale for three selected key statements about telemedicine.Results One hundred eighty-eight out of 218 scheduled (86.2%) video-consultations were performed. Among the 188 visits, 163 (86.7%) questionnaires were compiled. The primary endpoint of trust in the telemedicine service was achieved in 95.2%, 89.7% and 87.3% of the respondents for the three selected key statements (trust the service, its capability to solve clinical problems, ease to use).Conclusion During the COVID-19 pandemic our results showed that most of our IBD and CeD patients accepted and trusted video-consultations as an alternative to the traditional in-person examination.References: 1) Ray Dorsey E et al. N. Engl. J. Med. 2016;375:154–161. 2) Lauren A. G., Raymond K. Current Gastroenterology Reports (2020) 22: 12 3) De Jong, M. J. et al. Clinical Gastroenterology and Hepatology 2020;18:1744–1752 4) Lees CW et al. Gastroenterology. 2020 Sep;159(3):805-808.e1. 5) Allocca M et al. Clin Gastroenterol Hepatol 2020;18:1882–1883. 6) Velsen, L. V. et al, H. Int. J. Med. Inform 2017;97:52–58.(Figure presented)

Functional Gastrointestinal And Somatoform Symptoms Five Months After Sars-Cov-2 Infection: A Controlled Cohort Study

Background and aim: Gastrointestinal infections represent a risk factor for functional gastrointestinal and somatoform extraintesti-nal disorders. We investigated the prevalence and relative risk (RR) of gastrointestinal and somatoform symptoms five months after SARS-CoV-2 infection compared with a control cohort. Materials and methods: 378 subjects, age range 18-60 years, were stu-died. 177 SARS-CoV-2 infected patients and 201 controls responded to an online questionnaire about symptoms and signs during the acute phase of the infection and after 4.8±0.3 months. 13 and 18 patients were respectively excluded because of a previous gastrointestinal dise-ase. Presence and severity of gastrointestinal symptoms, somatization, anxiety and depression were recorded with a structured standardized questionnaire, including the Structured Assessment of Gastrointestinal Symptoms (SAGIS) questionnaire, the Symptom Check List (SCL)-12 for somatization and the Hospital Anxiety and Depression Scale (HADS). Stool form through Bristol Stool scale and a yes/no question summari-zing the Rome IV criteria for Irritable Bowel Syndrome (IBS) were also recorded. Any association between exposure to infection and symp-toms was evaluated by calculating crude and adjusted RR values and score differences with 95% confidence intervals (CI). Results: Fever, dyspnea, loss of smell/taste/weight, diarrhea, myal-gia, arthralgia and asthenia were reported by more than 40% of patients during the acute phase. Abdominal pain/discomfort, diar-rhea/incontinence and gastroesophageal reflux disease/regurgita-tion symptoms persisted after SARS-CoV-2 infection, but with very low severity;the relative increase on the mean score of each domain was minimal (score difference up to +0.16). Compared with con-trols, adjusted RRs for loose stools, chronic fatigue and somatization were increased after infection: 1.88 (95% CI 0.99–3.54), 2.24 (95% CI 1.48–3.37), 3.62 (95% CI 1.01–6.23) respectively. The prevalence of IBS and HADS scores tended to be greater in patients than in con-trols. Gastrointestinal sequelae were greater in patients with diar-rhea during the acute phase. Conclusions: Mild gastroenterological symptoms persist five months after SARS-CoV-2 infection, in particular in patients report-ing diarrhea in the acute phase. Infected patients are at increased risk of chronic fatigue and somatoform disorders, thus supporting the hypothesis that both functional gastrointestinal and somato-form disorders may have a common biological orig

COVID-19 VACCINE: A SURVEY ON HESITANCY IN PATIENTS WITH CELIAC DISEASE

Background and aim: COVID-19 vaccination campaign represents the most relevant way to overcome the pandemic. COVID-19 vac-cines have been developed at the fastest known pace yet;such a fast production has led to concerns among general population wor-ldwide about safety and efficacy of COVID-19 vaccines. Specifically, patients affected by chronic illnesses, such as Celiac Disease (CeD), may have greater apprehension. The immune status of CeD patients has been studied in literature, however the actual risk of infections is not clear, depending on various factors such as suboptimal nutri-tional status. Information on vaccine hesitancy plays a pivotal role in the development of an efficient vaccine campaign. In our study, we aimed at evaluating COVID-19 vaccine hesitancy among CeD patients, its reasons and determinants. Materials and methods: An anonymous validated questionnaire formulated on the EUSurvey web platform was sent to a mailing list of CeD patients followed at our “Celiac Center” of Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico of Milan. The questions focused on socio-demographic data, disease-related and lifestyle data, attitude to vaccinations in general and predisposition to the COVID-19 vaccine. Hesitancy was defined by a negative answer to the question “Would You accept to get vaccinated tomorrow against COVID-19?”. Among the hesitant, COVID-19 vaccine refusing patients were defined as those who answered negatively to the fol-lowing question: “Would You eventually accept it in the future when more data is available?”. We evaluated the reasons and the factors associated (determinants) to hesitancy, by calculating Adjusted Odds Ratio (AdjOR) with 95% confidence intervals (CI). Results: The questionnaire was sent to 346 patients with a response rate of 29.8% (103). Among the respondents, 25.2% of patients were hesitant, with a total refusal rate of 4.8%. The main reason was the fear of adverse events (68.2%). Among the hesitant patients, 23% declared that their opinion was influenced by CeD. A positive atti-tude towards general vaccinations, a perceived good knowledge about COVID-19 and related vaccines and the adherence to GFD were determinants significantly associated to vaccine willingness (respective AdjOR of 16.48, 95% C.I. 3.34–81.31;6.50, 95% C.I. 1.44–29.22;12.71, 95% C.I. 1.82–88.58).(figure presented) Conclusions: Most CeD patients would accept COVID-19 vaccines. Data on the reasons and the determinants of vaccine hesitancy plays a pivotal role in the development of an efficient vaccine campaign

DETERMINANTS OF COVID-19 VACCINE HESITANCY IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE (IBD): RESULTS OF A NATIONAL SURVEY OF THE ITALIAN IBD PATIENTS’ ASSOCIATION (AMICI ONLUS)

Background and aim: Vaccine hesitancy, the delay in acceptance or refusal of vaccination despite its availability, threatens the control of infectious diseases. COVID-19 vaccination has been recommended by national and international organizations in patients with Inflammatory Bowel Diseases (IBD). The aim of the study was to evaluate COVID-19 vaccine hesitancy in a population of Italian patients with IBD. Materials and methods: In February 2021 an online questionnaire focused on COVID-19 vaccine was proposed to a representative sample of Italian IBD patients. Socio-demographic characteristics, IBD features, lifestyle, perception of COVID-19, general attitude towards vaccinations and to COVID-19 vaccines were investigated. Patients were divided into willing, hesitant and refusive towards COVID-19 vaccine. The hesitation reasons were investigated. The associations between baseline characteristics and willingness (determinants) were evaluated by calculating crude and adjusted Odds Ratio (AdjOR) with 95% confidence intervals (CI). Results: A total of 1252 surveys were collected. 1005 (80.3%), 222 (18.1%) and 33 (2.63%) patients were defined as willing, hesitant and refusive, respectively. The baseline characteristics are shown below. Concerns for vaccine adverse effects constituted the main reason for refusal (73.4%) (Figure). 49.1% of hesitant patients reported that presence of IBD exerted an influence on their answer. Among the patients willing to be vaccinated whenever possible, 78.2% (786) thought that their IBD represented a valid motivation to access vaccination with priority. Willingness to COVID-19 vaccine was significantly associated with adherence to previous vaccinations (AdjOR 17.6;95% CI: 11.4-27.2), male gender (1.68 95%;CI: 1.16-2.43), graduation degree (1.48;95%;CI: 1.03-2.13), perceived higher risk of COVID-19 becaues of IBD (1.47;95% CI: 1.05-2.08), alcohol intake (1.69;95% CI: 1.16-2.45). Conversely, the hesitancy was significantly associated with complementary and alternative medicine use (0.58;95% CI: 0.36-0.92). 54.5% of patients were under the impression to have a higher risk of COVID-19 and 31.8% to have a more severe course due to their IBD. (figure presented) Conclusions: Most IBD patients would accept COVID-19 vaccines, although one in five was hesitant, primarily due to fear of adverse events. Knowledge of determinants and reasons for COVID-19 vaccination acceptance or refusal could be key in developing targeted communication strategies to fight vaccine hesitancy, also in the future for general vaccinations.

THE EMERGING ROLE OF TELEMEDICINE IN GASTROENTEROLOGY DURING THE COVID-19 PANDEMIC: A STUDY ON ITS FEASIBILITY AND PATIENTS’ TRUST

Background and aim: During the on-going COVID-19 pandemic telemedicine has enabled many patients with chronic diseases worldwide to get access to remote assistance. Telemedicine has emerged as the ideal solution to overcome the restrictions in place on performing regular non-urgent follow-up visits for chronic patients and continuing patients’ assistance. Some positive reports on the use of telemedicine in gastroenterology among healthcare providers and patients have been published, but a patient’s trust perspective about televisits has so far been unavailable. Our study aimed at ascertaining telemedicine feasibility and gastroenterological patients’ trust in televisits during the COVID-19 pandemic. Materials and methods: At our Gastroenterology Unit in Milan (Italy), which is a tertiary referral center for Inflammatory Bowel Diseases (IBD) and Celiac Disease (CeD), telemedicine was used in place of on-site follow-up visits scheduled but not provided during the COVID-19 pandemic. All IBD and CeD outpatients were contacted by phone and televisits were arranged for patients with mild-to-moderate symptoms, with bio-umoral alterations or as needed for those who requested it. The patients’ trust in telemedicine was assessed through an adapted version of the PAtient Trust Assessment Tool (PATAT) questionnaire. The primary endpoint was expressed patient’s trust as assessed through the questionnaire. The secondary endpoint was feasibility and acceptance of televisits. Results: A total 188 out of 218 scheduled (86.2%) televisits were performed and among these a total of 163 (86.7%) questionnaires compiled was accomplished. The primary endpoint of trust in the telemedicine service was achieved in 95.2%, 89.7% and 87.3% of the respondents for the three selected key statements about trust in the telemedicine service, its capability to solve clinical problems and ease to use, respectively.(figure presented) Conclusions: Our results showed that during the COVID-19 pandemic televisits were feasible for most of our patients with chronic gastroenterological diseases, and that most patients accepted and trusted televisits as an alternative to the traditional in-person examination

Have liver transplant recipients displayed COVID-19 vaccine hesitancy?

Background: Vaccines provide effective protection against COVID-19. Nevertheless, concerns about their efficacy and safety have been reported.1-2 The term vaccine hesitancy refers to delay in the acceptance of vaccines (or total refusal) despite their availability.3 COVID-19 vaccination was strongly recommended for Liver Transplant (LT) recipients by the AASLD. The aim of our study was to assess COVID-19 vaccine hesitancy among LT patients, its reasons and possible determinants. Methods: Between January and February 2021, a web-based questionnaire was sent to LT patients followed at our liver transplant out-patient clinic in Milan, Italy. The questionnaire was adapted from a previous validated questionnaire.4 Patients were classified as willing, hesitant and refusing (totally opposing) to accept COVID-19 vaccination, and the reasons and possible factors influencing vaccine hesitancy were investigated. When the COVID-19 vaccines became available for LT candidates and recipients in Italy (March 2021), the entire cohort of LT recipients was contacted by phone and called for vaccination, and the rate of refusals recorded. Results: The web-based survey was sent to 583 patients, of whom 190 responded (response rate of 32.6%). Among the respondents, 157 (82.7%) were willing to be vaccinated against COVID-19, while 27 (14.2%) were hesitant and 6 (3.1%) did not answer this specific question. Among the hesitant, 3 were refusing, for a refusal rate of 1.5%. The reasons most frequently given by hesitant patients to justify their refusal (more than one could be indicated) was the fear of adverse events in 22/27 and concerns about the rapid development of COVID-19 vaccines in 17/27 (Figure). Thirteen hesitant patients (48.1%) answered that their COVID-19 vaccine hesitancy was influenced by being a transplant recipient. None of the possible determinants were significantly associated with vaccination hesitancy/refusal in multivariate analysis. Of the 667 patients followed at our Centre 628 were called by phone to be vaccinated and asked about their COVID-19 willingness and the 6.5% (41) of the patients refused the scheduled vaccination. Conclusion: Since it is crucial to achieve adequate vaccinations of LT patients, it is very important to identify the reasons influencing hesitancy so that appropriate patient-doctor communication can be established and specific vaccinations campaigns further implemented.

Nutritional and Gastroenterological Monitoring of Patients With Celiac Disease During COVID-19 Pandemic: The Emerging Role of Telemedicine and Point-of-Care Gluten Detection Tests

Background and Aims: Since the beginning of the coronavirus disease 2019 (COVID-19) pandemic, telemedicine has been supporting many patients with chronic diseases worldwide. However, data on celiac disease (CeD) nutritional and gastroenterological remote monitoring are scanty. The aims of our study were to verify patients' trust in telemedicine and to evaluate the feasibility of telemedicine in nutritional monitoring. Material and Methods: We used telemedicine in place of the scheduled but not provided follow-up visits during the first lockdown of the COVID-19 pandemic. Patients received a phone call, and televisits were conducted for CeD patients with mild or moderate symptoms and/or with blood alterations. The patient's adherence to the gluten-free diet (GFD) was evaluated according to the Celiac Dietary Adherence Test (CDAT). When gluten contamination was suspected, a point-of-care gluten detection test was prescribed. The patient's trust in telemedicine was assessed, through an adapted version of the Patient Trust Assessment Tool (PATAT) questionnaire, as the percentage of patients giving a score of at least 4 out of 5 on a Likert scale for three selected key statements: "I can trust televisit," "I can trust that possible problems with the telemedicine service will be solved properly," and "I feel at ease when working with this website." Results: One hundred and twelve CeD patients were phone called;among symptomatic patients, 39 out of the 42 scheduled (92.9%) televisits were performed. Among the 39 visits, 34 (87.2%) questionnaires were compiled. The patients included in the study obtained a CDAT score from 7 to 13 (11 +/- 2). Gluten detection tests were prescribed to 11 patients, resulting positive in 2. Trust in the telemedicine service was achieved in 94.1, 88.2, and 97.1% for the three selected key statements of the PATAT questionnaire. Conclusion: During the COVID-19 pandemic, telemedicine showed to be feasible and the majority of patients trusted the combined gastroenterological and nutritional televisits. Gluten detection tests demonstrated to be useful tools for the patient and for the caregiver to confirm adherence to the GFD remotely.

TELEMEDICINE IN IBD: GOOD TRUST FROM OUTPATIENTS DURING THE COVID-19 PANDEMIC IN MILAN (LOMBARDY)

Background and Aim: During the recent COVID-19 pandemic, telemedicine has enabled many IBD patients worldwide to get access to remote assistance. Some positive reports on the use of telemedicine among patients and healthcare providers have been published1-4, but a patient’s trust perspective is not available yet. The aim of our study was to verify IBD patients’ trust in telemedicine. This study was approved by our local Ethics Committee. Material and Methods: At our Gastroenterology Unit in Milan (Italy), 123 video-consultations were delivered to IBD patients with mild or moderate disease, in place of follow-up visits scheduled but not provided during the general lockdown (March-April 2020). Video-calling solutions from Google (Hangouts or Meet) or Microsoft Teams were used according to the patient’s preference. The patients’ trust in telemedicine was assessed through an adapted version of the PAtient Trust Assessment Tool (PATAT) questionnaire.5 The primary endpoint was expressed as a >75% percentage of patients giving a score of at least 4 out of 5 in a Likert Scale for three selected key statements: “I can trust video-consultation”, “I can trust that possible problems with the telemedicine service will be solved properly” and “I feel at ease when working with this website”. The questionnaire was formulated through the EUSurvey platform, widely used for clinical research questionnaires in Europe. Results: One-hundred-fifteen (93.4%) video-consultations were performed out of the 123 scheduled. Among the 115 consultations, 100 questionnaires were completed (86.9%). The primary endpoint of trust in the telemedicine service was achieved in 95%, 90% and 84% of patients for the three selected key statements about the trust in the telemedicine service, its capability to solve clinical problems and its ease to use. While clinical outcomes were beyond our intentions, we reported no drugs withdrawal in this cohort nor major events. Conclusion: Our results showed that during the COVID-19 pandemic most of our IBD patients accepted to receive a video-consultation in spite of the traditional in-person visit and trusted the video-consultation. References: 1. Bezzio C. et al. Gut 2020;69:1213–1217 2. George L.A., Raymond K. Current Gastroenterology Reports (2020) 22: 12 3. Lees C. W. et al. Gastroenterology 2020;2020 May 28 4. Allocca M et al. Clin Gastroenterol Hepatol 2020;18:1882–1883 5. Velsen, L. V. et al, H. Int. J. Med. Inform 2017;97:52–58. [Formula presented]

Assisted reproduction and Coronavirus in Italy.

OBJECTIVE: A novel type of Coronavirus was identified in China in December 2019. The first cases of a form of pneumonia of unknown etiology were detected at the beginning of that month in Wuhan. The virus is believed to have emerged at the Wuhan Huanan Seafood Market, where transmission of a zoonotic pathogen to humans occurred. PATIENTS AND METHODS: Some studies conducted in China during the epidemic report small numbers of pregnant women infected with SARS-CoV-2 and some pregnancy complications in patients with COVID-19. However, they fail to document the transplacental passage of the virus from mother to fetus. RESULTS: Following the COVID-19 outbreak, guidelines for couples who are undergoing treatments of assisted reproduction have been issued by the International Federation for Fertility Societies (IFFS), the American Society for Reproductive Medicine (ASRM), the European Society of Human Reproduction and Embryology (ESHRE) and the Latin American Network of Assisted Reproduction (REDLARA). They recommend couples to discuss assisted reproduction with their doctors while those at risk or with SARS-CoV-2 should consider freezing oocytes or embryos and retransferring them later. CONCLUSIONS: Other than the US, Italy is the country with the highest number of cases (197675 positives, 26644 deaths) (updated on April 26). The Italian National Transplant Centre and the Higher Institute of Health advised on March 17 to complete the cycles already started and not to start new cycles. Phase 2 will begin on 4 May with an increase in freedom of action and fertilization treatments will start again. The Society that brings together embryologists (SIERR) has issued the guidelines to be followed when this happens.