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Telemedicine in the COVID-19 era for Liver Transplant Recipients: an Italian lockdown area experience - 07/09/20

Doi : 10.1016/j.clinre.2020.07.013 
Antonella Santonicola a , Fabiana Zingone b , Silvia Camera a , Monica Siniscalchi a , Carolina Ciacci a,
a Liver Transplant Clinic, Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, 84131 Salerno, Italy 
b Department of Surgery, Oncology, and Gastroenterology, University of Padua, 35100 Padua, Italy 

Corresponding author at: Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, Via S. Leonardo 184131, Salerno, Italy.Department of Medicine, Surgery and Dentistry"Scuola Medica Salernitana"University of SalernoVia S. LeonardoSalerno184131Italy

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Highlights

We contacted 153 LT during the lockdown period through active follow-up by telephone, inviting them to access remote consultation to assess the status of well-being.
74/153 (48.3%) LT recipients were unable to access remote consultation. They were older and had lower school degree compared to those who accessed it.
Among the remaining LT recipients, 50/79 (63.3%) responded to complete a self-administered, internet-based questionnaire. Forty-four percent of LT recipients declared to be worried because of COVID-19 infection, and 64% considered themselves more vulnerable than the general population.
Forty percent of responders refused the routine follow-up visit, 62% were very interested in using Telemedicine.
For continuing services during the COVID-19 era, new strategies are needed and Telemedicine shows promise.

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Abstract

Background

Data on COVID-19 in Liver Transplant (LT) recipients are scanty, but one can hypothesize that they are more susceptible to infection due to chronic immunosuppression. Telemedicine could be an alternative to the routine clinical care in this difficult period. We aimed to investigate in a cohort of LT recipients the access to remote consultation and the attitude towards Telemedicine using an internet-based survey.

Material and methods

We invited LT recipients from the Liver Transplant Follow-up Center of the University Hospital of Salerno to access remote consultation. A subgroup of them also participated in a self-administered, internet-based survey evaluating demographics; LT data and immunosuppressive therapy; comorbidities; attitudes towards COVID-19 infection; their perceptions of the need for health care, and their approach to telemedicine.

Results

Seventy-four/one hundred and fifty-three (48.3%) LT recipients were unable to access remote consultation. They showed a significantly higher mean age and a higher percentage of low school degree compared to those who accessed it (p=0.03 and p=0.001, respectively). Among the remaining LT recipients, 50/79 (63.3%) responded to the survey; mean time from liver transplantation was 12±7 years; 94% of the sample reported at least one comorbidity; 44% of LT recipients declared to be “very much/much” worried because of COVID-19 infection, and 64% considered themselves more vulnerable than the general population. Forty percent of responders refused the routine follow-up visit, and 62% were very interested in using Telemedicine.

Conclusion

LT recipients were anxious because of COVID-19 infection and considered themselves more vulnerable than the general population, refusing the routine clinical visit. For continuing services during the COVID-19 era, new strategies are needed and telemedicine shows promise.

Le texte complet de cet article est disponible en PDF.

Keywords : Liver transplant, COVID-19, Internet-based survey, telemedicine


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