Clinical and Psychological Impact of COVID-19 Infection in Adult Patients with Eosinophilic Gastrointestinal Disorders during the SARS-CoV-2 Outbreak

Abstract

Eosinophilic gastrointestinal diseases (EGIDs) are chronic gastrointestinal conditions requiring corticosteroid and immunosuppressive therapy for disease control. Patients with EGIDs usually report impaired quality of life. We aimed to report the clinical and psychological impact of COVID-19 infection in EGID patients. In this prospective web-based study we invited all consecutive EGID patients attending the University Hospital of Salerno (Campania) and Padua (Veneto) to fill an ad hoc COVID-19 survey. Moreover, a telemedicine service for direct consultation was organized. Data regarding the occurrence and perception of COVID-19 infection as well as clinical information were recorded. The study population included 102 EGID patients (mean age 36.6 years, 34 females), of whom 89 had eosinophilic esophagitis, nine had gastroenteritis, and four had colitis. No patient was diagnosed with COVID-19 or had recurrence of his/her primary disease. All of them were adherent to therapy and preventive measures adoption. Most patients were worried because of COVID-19 and social preventing measures but did not consider themselves at major risk or susceptible to COVID-19 or other infections due to their chronic condition or therapy. Female gender and low education level were associated to a higher psychological perception of COVID-19 compared to lockdown status or other demographic and clinical factors (p < 0.05). Overall, COVID-19 had a limited clinical impact on patients with EGIDs. The degree of education and sex, but not the fact of living in a lockdown area, influenced the perception of SARS-CoV-2 infection.

Glycemic Control Improvement in Italian Children and Adolescents With Type 1 Diabetes Followed Through Telemedicine During Lockdown Due to the COVID-19 Pandemic

“…In patients with type 2 diabetes in a rural community, telemedicine was found to be a useful tool to share educational and treatment approaches with the diabetes team, also improving HbA1c values (55). Telemedicine tools were also demonstrated to be adaptable for direct consultation in other healthcare environments (56,57) and in access-poor populations (58). Through telemedicine, we maintained social distancing, minimized the risk of SARS-CoV-2 transmission, and suggested to patients the strategies to pursue the better glycemic control.…”

Eosinophils and COVID-19: diagnosis, prognosis, and vaccination strategies

“…Chiang et al [ 102 ] reported a diminished expression of ACE2 in esophageal tissue from adults with eosinophilic esophagitis (EoE) compared to healthy controls. While the number of patients that have been evaluated remains limited, Savarino et al [ 103 , 104 ] reported that a diagnosis of EGID presents no specific increased (or decreased) risk with respect to prognosis and outcomes of SARS-CoV-2 infection.…”

Eosinophilic Esophagitis Patients Are Not at Increased Risk of Severe COVID-19: A Report From a Global Registry

“…5,6 Early attempts to assess the COVID-19 burden in patients with eosinophilic esophagitis (EoE) and eosinophilic gastrointestinal diseases (EGIDs), whose main disease pathology is concentrated in tissues expressing the proteins necessary for viral invasion, failed to identify SARS-CoV-2 infected EoE/EGID patients. [7][8][9] Not only do EoE/EGIDs involve organs involved in SARS-CoV-2 infection, but they are also a form of immune dysregulation, and their mainstay treatments involve medications (proton pump inhibitors [PPIs] and steroids) that have been implicated in the risk for more severe COVID-19. [10][11][12][13] Furthermore, although normal and elevated peripheral eosinophil counts have been found to be associated with better outcomes in COVID-19, 14,15 it is theoretically possible that eosinophil depleting drugs, which are sometimes used for treatment of EoE/EGIDs, may induce more severe disease.…”