Beneficial Effects of Remote Medical Care for Patients with Hereditary Hemorrhagic Telangiectasia during the COVID-19 Pandemic

Abstract

Background: Hereditary hemorrhagic telangiectasia (HHT) needs high-quality care and multidisciplinary management. During the COVID-19 pandemic, most non-urgent clinical activities for HHT outpatients were suspended. We conducted an analytical observational cohort study to evaluate whether medical and psychological support, provided through remote consultation during the COVID-19 pandemic, could reduce the complications of HHT. Methods: A structured regimen of remote consultations, conducted by either video-calls, telephone calls, or e-mails, was provided by a multidisciplinary group of physicians to a set of patients of our HHT center. The outcomes considered were: number of emergency room visits/hospitalizations, need of blood transfusions, need of iron supplementation, worsening of epistaxis, and psychological status. Results: The study included 45 patients who received remote assistance for a total of eight months. During this period, 9 patients required emergency room visits, 6 needed blood transfusions, and 24 needed iron supplementation. This was not different from what was registered among the same 45 patients in the same period of the previous year. Remote care also resulted in better management of epistaxis and improved quality of life, with the mean epistaxis severity score and the Euro-Quality of Life-Visual Analogue Scale that were significantly better at the end than at the beginning of the study. Discussion: Remote medical care might be a valid support for HHT subjects during periods of suspended outpatient surveillance, like the COVID-19 pandemic.

Effectiveness of telehealth versus in-person care during the COVID-19 pandemic: a systematic review

“…3A, Supplementary Table 8 -Top Tier, and Supplementary Fig. 1A) [11][12][13][14][15][16][17][18][19][20][21][22][23][24] one study (n = 1769) addressed general medical care for children reporting no difference in ED visit rates between in-person and telehealth care. For three of the clinical areas, the use of telehealth was associated with an increase in ED visits: for general medical care among adults one study and care for specific conditions, three studies on COVID-19, and one study on pregnancy/prenatal/gynecological care reported lower ED visits among those in the in-person groups versus those in the telehealth groups.…”

Hereditary Hemorrhagic Telangiectasia: Diagnosis and Management

“…It would be incredibly useful if a larger and international retrospective study were to confirm these data, which were obtained from 138 HHT patients. Moreover, the results of an Italian observational study on the remote care of HHT patients identified the benefits and rapid response of this kind of assistance [ 11 ].…”