Telemedicine in the COVID-19 lockdown: implementation from 0% to 100% in an Italian celiac disease-devoted clinic

Introduction: COVID-19 pandemic also had direct effects on traditional healthcare Celiac Disease (CeD) patients require a lifelong follow-up At the beginning of the lockdown in Italy, among the others also CeD patients could not reach the GPs or the outpatients' clinic for regular care Aims & Methods: The study reports the results of remote consultation offered in the CeD clinicBetween the 9-24 March 2020 we called by telephone all CeD patients in active follow up at the Celiac Disease Centers Units of the University of Salerno (Campania, South Italy) to cancel the planned control visit and to offer remote consultation We report data of the remote consultation performed from March 9 to May 9 2020 Results: With the help of all hospital staff, students, and residents we called by phone 611 patients who should have attended the clinic in the next two months 214 patients ( mean age 56±4,3 ys) were unable to access remote consultation, of them 62 did not owe a cellular phone Remote consultation was mostly led by telephone and with the help of the GPs The remaining patients scheduled their visit by WhatsApp video-call in 215 cases, skype video call in 112, other platforms in 70 In the days before the remote consultation, we asked the CeD patients to send via email or WhatsApp the laboratory tests if they had them and to provide the contacts of their GP In 60 days, we performed 115 remote consultations, free of charge for the patient The primary needs for consultation were: check of laboratory tests (n 52), gastrointestinal symptoms (31), psychological imbalance (26, with 4 panic attacks), one case of diverticulitis that was guided to the Emergency, new-onset constipation (4, 1 of severe constipation), severe hyperglycemia in a diabetic woman None of the patients attending the clinic suffered from COVID-19 Conclusion: Remote consultation was not available in our hospital before the COVID-19 pandemic In the occasion of the COVID-19 crisis we improvised a system of telemedicine adapting the consultation to the digital tools in posses of patients However, our experience indicates that at least in our region, the access to simple, essential digital tools should be implemented mostly among older people The majority of patients were happy with remote consultation, grateful and supportive with the team Our data demonstrate that in an emergency remote consultation, although nonstructured, was highly effective in two-thirds of patients