Patient and Clinician Attitudes Toward Telemedicine for Allergy and Immunology.

The use of telemedicine has increased in allergy/immunology, with rapid uptake of its use during the coronavirus disease 2019 pandemic. Existing data indicate an overall positive view of telemedicine by patients, particularly during the coronavirus disease 2019 pandemic. However, patients and clinicians prefer in-person visits for specific types of allergy/immunology encounters, such as those requiring a physical examination or diagnostic testing. The most data for telemedicine exist with asthma, and provide a model for treatment technique, therapeutic monitoring, and education in other allergic and immunologic conditions. Clinician satisfaction is also necessary for telemedicine to be an enduring option for patient/clinician interactions, and this is influenced by a multitude of factors, including technology quality, reimbursement, and maintenance of patient/clinician relationships. Areas of future research should include the need for more outcome data in additional disease states, which will likely help facilitate improved logistical policies around telemedicine that would facilitate its adoption.

Hypogammaglobulinemia following COVID-19 infection in a patient on maintenance rituximab.

Hypogammaglobulinemia is a known side-effect of rituximab use. It is typically asymptomatic and transient, although certain factors, such as maintenance dosing and concomitant glucocorticoid use can lead to symptomatic or prolonged hypogammaglobulinemia. Patients with symptomatic hypogammaglobulinemia leading to recurrent infections may be treated with intravenous immunoglobulin therapy. Herein, we report a case of a 49-year-old male on maintenance rituximab without prior respiratory symptoms with new onset recurrent pneumonia after COVID-19 pneumonia and treatment with glucocorticoids.

Patient Satisfaction with In-Person, Video, and Telephone Allergy/Immunology Evaluations During the COVID-19 Pandemic.

BACKGROUND: The SarsCoV2, novel coronavirus (COVID-19) pandemic necessitated a rapid transition from in-person evaluations to remote delivery of care, including both video and telephone visits, in allergy/immunology practices. OBJECTIVE: To evaluate patient satisfaction, patient and physician impression of encounter completeness, and reimbursement between in-person, video, and telephone encounters. This study also assessed factors influencing patient satisfaction, perception of completeness, and choice of future evaluation type. METHODS: This was a prospective study of all encounters at a health care-system owned practice. Encounter type, encounter modality, patient demographics, primary diagnoses, reimbursement data, and physician assessment of encounter completeness were tracked. Patient satisfaction was assessed via standardized questions. RESULTS: There were 447 encounters, with 303 in-person (67.8%), 98 video (21.9%), and 46 telephone (10.3%). Patient satisfaction data was obtained from 251 patients. There was similar patient satisfaction among all encounter modalities. Both patients and physicians were more likely to deem an in-person encounter as complete. Physicians were more likely to report an in-person encounter to be complete for food allergy (P < .001) and chronic rhinitis (P = .001) compared with video or telephone, whereas patients reported in-person encounters for food allergy to be complete compared with other modalities (P = .002). Patients reported that future encounter types should depend on the clinical situation. CONCLUSIONS: There was similar patient satisfaction with in-person, video, and telephone encounters in an allergy/immunology practice during the COVID-19 pandemic. Chronic rhinitis and food allergy are more likely to call for an in-person evaluation. New patient visits are likely to be the highest yield to focus on for in-person evaluations.