Telemedicine for chronic liver disease during Covid-19 pandemic: an Italian single center experience.

BACKGROUND: The Coronavirus disease 2019 (COVID-19) outbreak modified healthcare systems worldwide with greater impact on patients with chronic diseases. The response strategy was to implement social distancing, and telemedicine has been promoted to reduce the risk of transmission.

OBJECTIVE: The aim of this study was to analyze the benefits of using telemedicine services for chronic liver disease (CLD) patient' in an Italian tertiary-care center during the "lockdown".

METHODS: From March 9th to May 3rd,2020 a prospective observational study was conducted at the Liver Unit of the University Hospital of Naples "Federico II" to evaluate the impact of a fully implemented telemedicine service partially restructured for COVID-19 pandemic with virtual-video-visits, increased helpline and smart-working to allow CLD patients' follow-up during social distancing.

RESULTS: During the "Italian lockdown" almost 400 visits were performed using telemedicine approach and only patients requiring urgent evaluations were admitted in a clean COVID-19 ward of the hospital. Telemedicine services were implemented not only to perform follow-up visits, but also to screen patients prior the admission to hospital and to provide urgent evaluations during decompensation events. None of almost 1700 CLD patients followed-up at our Liver Unit contracted COVID-19 and there was no need to change treatment schedules.

CONCLUSIONS: Telemedicine demonstrated to be a useful tool to follow-up patients with CLD and to reduce the impact of COVID-19 pandemic in this setting. This modality of healthcare delivery was appreciated also by patients because gave them the opportunity to be in contact with physicians while respecting social distancing.