New coronavirus infection (COVID-19) and hemorrhoids disease

ABSTRACT

Introduction. In COVID-19, in addition to the symptoms of respiratory system damage, gastrointestinal symptoms, hemostasis disorders are observed, leading to the development of thrombosis and venous thromboembolism, which can worsen the course of hemorrhoidal disease and lead to exacerbation and serious complications. Given the complexity of the availability of specialized care in quarantine conditions, the role of outpatient consultation with elements of telemedicine is increasing. The aim of this study is to highlight current data on the course of hemorrhoidal disease in (COVID-19), to assess the impact of quarantine on patients suffering from hemorrhoidal disease, and the role of timely outpatient consultation with telemedicine elements in patient management. Methods. We conducted an observational study in the conditions of the regional diagnostic center in Almaty. The study included all patients with exacerbations of hemorrhoidal disease who applied during quarantine in the period July-October 2020. At the first admission, the patients were divided into 3 categories. The patients who were included in the study were surveyed, the symptoms of hemorrhoidal disease (HDSS) were evaluated. After 10-14 days, all patients were contacted again to assess the symptoms of GB and general health using HDSS questionnaires, respectively, and the responses were compared with the responses received at the first visit. From July 2020 to October 2020, 148 patients answered questionnaires and were identified by category. Results. The analysis showed that a long waiting time for an outpatient appointment with a proctologist prolonged the period of exacerbation and worsened the course of the disease. The use of self-prescribed medications for treatment also led to a negative prognosis, which, in particular, led to deterioration. About 80% of patients noted positive dynamics after outpatient admission. According to our established outpatient appointment, 22 patients from the entire sample were operated on in the first month 10 of them were transferred from the usual waiting list to the priority one and two were operated on urgently. Conclusion. Questions about the relationship of complications of hemorrhoid disease with COVID-19 remain insufficiently studied and require further research. In the conditions of quarantine, it is necessary to review the organization of specialized proctological care for patients, and the introduction of accessible outpatient consultations with elements of telemedicine.