ABSTRACT
AIGkit is an easy-to-use mobile application, created with the aim of allowing a telematic interaction between adult patient with Pompe disease and clinicians that can be downloaded for free on smartphone. After a first phase, whose results were presented as oral communication at AIM congress in 2018 and 2019, and published as original article in Neuromuscolar Disorders, the second operational phase of the project has been activated for its use in real life and clinical practice. The pre-established goal has been therefore to create an informatic platform for the collection of clinical data where each patient can access through the personal app on their smartphone, in order to allow the registration of their data and facilitate interaction with their clinicians. The design activity and procedures, despite the difficulties encountered in the various phases also caused by the Sars-COVID-19 emergency, were carried out to meet the requirements of the privacy guarantor, in order to activate the use of the platform and the real-time sharing of the data collected remotely on the app of each patients. We are now planning the dissemination of the initiative at national level and the implementation of this project in collaboration with other clinical centers that will be able to use the servers of the Azienda Ospedaliera Universitaria Pisana (AOUP) as coordinating center, thus improving value and utility for users, both patients and clinicians.
ABSTRACT
Background and aims: Several neurological complications related to SARS-CoV-2 infection have been reported. The involvement of peripheral nervous system (PNS) consists in the development of immune-mediated neuropathies such as Guillain-Barrè Syndrome. In this study we aim at assessing the presence of asymptomatic abnormalities in peripheral nerves conduction during the acute phase of COVID-19 and, their correlation with blood circulating inflammatory markers. Methods: Thirty-nine patients with COVID-19 were assessed by electroneurographic study of lower limbs and blood tests within one week of hospital admission (T0) and after 30 ± 10 days (T1). Results: Electroneurographic changes were found at least on one nerve at T0 in 12 patients, consisting of axonal or demyelinating changes. Two biological markers were found to be significantly correlated with the presence of neuropathic changes: Reactive Protein C and lymphocyte count. Patients with pathological electrophysiology at T0 showed significant improvement of electrophysiological parameters at T1. The improvements in electroneurographic data were significantly correlated with the trend of laboratory parameters, in particular with fibrinogen, D-Dimer, ferritin, C Reactive protein and lymphocytes. None of the patients with neuropathic changes developed clinical evidence of a full-blown peripheral neuropathy over time. Conclusions: Our study shows that asymptomatic alterations of the PNS can be found during the acute phase of COVID-19. These alterations significantly improve after 20–40 days from the acute phase of infection and that the improvement correlates significantly with the trend of laboratory parameters. Further studies are needed to evaluate possible long-term neurological complications and the predictive value of subclinical damage of PNS in the acute phase of infection.