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1. Telemedicine Is an Effective Tool to Monitor Disease Activity in IBD Patients in the COVID-19 Era: A Single Centre Experience Based on Objective Data

Author

Emanuele Sinagra, Anita Busacca, Laura Guida, Lucio Carrozza, Daniele Brinch, Federica Crispino, Marcello Maida, Salvatore Battaglia, Ciro Celsa, Calogero Cammà, and Maria Cappello

Subjects
inflammatory bowel disease, COVID-19, telemedicine, ulcerative colitis, Crohn’s Disease, Diseases of the digestive system. Gastroenterology, RC799-869
Abstract

Background: The COVID-19 outbreak has led IBD clinics to adopt a remote monitoring approach in order to guarantee an adequate follow-up of patients with inflammatory bowel disease (IBD) and ensure the rules of social distancing. Aim: The aim of the study was to perform a survey on IBD patients who underwent remote monitoring in our tertiary referral center, to assess adherence, patients’ perceptions and satisfaction, and finally their opinions for future monitoring. Furthermore, we evaluated changes in disease activity and Quality of Life (QoL) using validated questionnaires. Methods: Consecutive patients with IBD scheduled for follow-up visits were switched to remote monitoring through e-mail from March 2020 to February 2021. Patients were asked to complete a questionnaire focusing on the following elements of the intervention: (1) self-assessment questions, (2) action plans, and (3) educational messages. Results: Four hundred and twenty four Caucasian patients completed the survey. 233 (55.1%) were male, 220 (52.0%) had Crohn’s Disease (CD). Median baseline Mayo Score and Harvey Bradshaw Index were 3 and 4, respectively. 9 (2.1%) patients were referred to the emergency department because of disease flares. 410 (96.9%) patients were satisfied with telemedicine, and 320 (76.5%) patients reported that they would maintain this approach also after COVID-19 pandemic. Overall, on univariate logistic regression analysis, none of the variables were related to patients’ satisfaction or to an improved QoL. The presence of ulcerative colitis was associated with the need for treatment change. Conclusions: Our results suggest that a telemedicine approach is well accepted by patients with IBD and could represent an effective tool in monitoring disease activity. Further controlled studies are warranted to properly assess if telemedicine can replace face-to-face consultations in IBD.

Published
2022
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2. Therapies for inflammatory bowel disease do not pose additional risks for adverse outcomes of SARS-CoV 2 infection: an IG-IBD study

Author

Bezzio, C., Armuzzi, A., Furfaro, F., Ardizzone, S., Milla, M., Carparelli, S., Orlando, A., Caprioli, F. A., Castiglione, F., Vigano, C., Ribaldone, D. G., Zingone, F., Monterubbianesi, R., Imperatore, N., Festa, S., Daperno, M., Scucchi, L., Ferronato, A., Pastorelli, L., Balestrieri, P., Ricci, C., Cappello, M., Felice, C., Fiorino, G., Saibeni, S., Coppini, F., Alvisi, P., Gerardi, V., Variola, A., Mazzuoli, S., Lenti, M. V., Pugliese, D., Allocca, M., Ferretti, F., Roselli, J., Bossa, F., Giuliano, A., Piazza, N., Manes, G., Sartini, A., Buda, A., Micheli, F., Ciardo, V., Casella, G., Viscido, A., Bodini, G., Casini, V., Soriano, A., Amato, A., Grossi, L., Onali, S., Rottoli, M., Spagnuolo, R., Baroni, S., Cortelezzi, C. C., Baldoni, M., Vernero, M., Scaldaferri, F., Maconi, G., Guarino, A. D., Palermo, A., D'Inca, R., Scribano, M. L., Biancone, L., Carrozza, L., Ascolani, M., Costa, F., Di Sabatino, A., Zammarchi, I., Gottin, M., Conforti, F. S., Bezzio, Cristina, Armuzzi, Alessandro, Furfaro, Federica, Ardizzone, Sandro, Milla, Monica, Carparelli, Sonia, Orlando, Ambrogio, Caprioli, Flavio Andrea, Castiglione, Fabiana, Viganò, Chiara, Ribaldone, Davide Giuseppe, Zingone, Fabiana, Monterubbianesi, Rita, Imperatore, Nicola, Festa, Stefano, Daperno, Marco, Scucchi, Ludovica, Ferronato, Antonio, Pastorelli, Luca, Balestrieri, Paola, Ricci, Chiara, Cappello, Maria, Felice, Carla, Fiorino, Gionata, Saibeni, Simone, and Francesca Coppini, Patrizia Alvisi, Viviana Gerardi, Angela Variola, Silvia Mazzuoli, Marco Vincenzo Lenti, Daniela Pugliese, Mariangela Allocca, Francesca Ferretti, Jenny Roselli, Fabrizio Bossa, Alessandra Giuliano, Nicole Piazza, Gianpiero Manes, Alessandro Sartini, Andrea Buda, Federica Micheli, Valeria Ciardo, Giovanni Casella, Angelo Viscido, Giorgia Bodini, Valentina Casini, Alessandra Soriano, Arnaldo Amato, Laurino Grossi, Sara Onali, Matteo Rottoli, Rocco Spagnuolo, Stefania Baroni, Claudio Cortelezzi, Monia Baldoni, Marta Vernero, Franco Scaldaferri, Giovanni Maconi, Alessia Dalila Guarino, Andrea Palermo, Renata D'Incà, Maria Lia Scribano, Livia Biancone, Lucio Carrozza, Marta Ascolani, Francesco Costa, Antonio Di Sabatino, Irene Zammarchi, Matteo Gottin, Francesco Simone Conforti

Subjects
medicine.medical_specialty, Settore MED/12 - GASTROENTEROLOGIA, IBD, Population, Ulcerative, Disease, Lower risk, Asymptomatic, Inflammatory bowel disease, Aged, Humans, SARS-CoV-2, Tumor Necrosis Factor Inhibitors, COVID-19, Colitis, Ulcerative, Crohn Disease, Inflammatory Bowel Diseases, IBD Treatments and Sars‐cov‐2 Infection, Internal medicine, medicine, biologics, Pharmacology (medical), education, therapy, education.field_of_study, Hepatology, business.industry, INFLAMMATORY BOWEL DISEASE, Gastroenterology, medicine.disease, Colitis, Ulcerative colitis, Pneumonia, Original Article, medicine.symptom, business, Cohort study
Abstract

Summary Background Older age and comorbidities are the main risk factors for adverse COVID‐19 outcomes in patients with inflammatory bowel disease (IBD). The impact of IBD medications is still under investigation. Aims To assess risk factors for adverse outcomes of COVID‐19 in IBD patients and use the identified risk factors to build risk indices. Methods Observational cohort study. Univariable and multivariable logistic regression was used to identify risk factors associated with pneumonia, hospitalisation, need for ventilatory support, and death. Results Of the 937 patients (446 with ulcerative colitis [UC]) evaluated, 128 (13.7%) had asymptomatic SARS‐CoV‐2 infection, 664 (70.8%) had a favourable course, and 135 (15.5%) had moderate or severe COVID‐19. In UC patients, obesity, active disease and comorbidities were significantly associated with adverse outcomes. In patients with Crohn's disease (CD), age, obesity, comorbidities and an additional immune‐mediated inflammatory disease were identified as risk factors. These risk factors were incorporated into two indices to identify patients with UC or CD with a higher risk of adverse COVID‐19 outcomes. In multivariable analyses, no single IBD medication was associated with poor COVID‐19 outcomes, but anti‐TNF agents were associated with a lower risk of pneumonia in UC, and lower risks of hospitalisation and severe COVID‐19 in CD. Conclusion The course of COVID‐19 in patients with IBD is similar to that in the general population. IBD patients with active disease and comorbidities are at greater risk of adverse COVID‐19 outcomes. IBD medications do not pose additional risks. The risk indices may help to identify patients who should be prioritised for COVID‐19 re‐vaccination or for therapies for SARS‐CoV‐2 infection., The course of COVID‐19 in patients with IBD patients is similar to that in the general population. IBD patients with active disease and comorbidities are at greater risk of adverse COVID‐19 outcomes. IBD medications do not pose additional risks.

Published
2021

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