No abstract

Background Much attention has been paid to the study and reporting of gastrointestinal (GI) symptoms in COVID-19 patients. Moreover, an increasing number of COVID-19 patients have been noted to experience hepatic and pancreatic injury. In this study, we retrospectively investigated symptoms and laboratory findings related to the GI system in a single center in Athens, Greece, and assessed the role of these parameters in relation to survival and disease severity. Method We retrospectively studied 61 adult COVID-19 patients admitted to the Army Share Fund Hospital (NIMTS) in Athens, Greece, from April 6th to May 6 th , 2020. Results Sixty-one COVID-19 cases were assessed in the study period. Regarding both survival and disease severity, diarrhea was the most common finding. The multivariate analysis revealed that elevated serum aspartate aminotransferase levels and low serum albumin levels were associated with worse patient survival (odds ratio [OR] 1.029, 95% confidence interval [CI] 1.007-1.05, P=0.0088; and OR 0.219, 95%CI 0.066-0.723, P=0.0127, respectively). As far as disease severity is concerned, only a low serum albumin level (measured at hospital admission) was correlated with more severe disease (OR 0.025, 95%CI 0.004-0.161, P=0.0001). Conclusions Outpatients with new-onset GI symptoms should be considered for COVID-19 testing in a high COVID-19 prevalence setting, as these symptoms are observed more and more in clinical settings. As prospective studies begin to emerge, clinicians will have more robust research data to diagnose COVID-19 patients earlier and identify patients in need of more intensive treatment.

No abstract

No abstract

No abstract

No abstract

Background MyChart is a novel electronic portal within the electronic patient record provider EPIC. IBD patients were asked to complete an electronic questionnaire via MyChart prior to their infliximab infusions. A threshold was set that any patient who recorded a severe disease activity score (Mayo >/3, Harvey-Bradshaw Index (HBI) >/8) or signalled a concern created an automatic message that was routed to our clinical nurse specialists. Methods Electronic notes of all IBD patients who received infliximab in the month of September 2020 were reviewed. Demographics, activity status of My Chart, type of concerns raised and outcomes, number of inpatient admissions and outpatient appointments pre- and post- the introduction of the online questionnaire were recorded. Clinical remission was defined as Mayo score of <3 or HBI score of <5. Statistical comparisons were performed in GraphPad Prism software using the exact Fisher’s test and student t-test accordingly. Values were deemed significant if p<0.05. Results 140 IBD patients on infliximab were identified; 2 were excluded due to incomplete data. The cohort comprised of 77 males (55.8%) with mean age of 27 years (SD of 15.1).110 (78.70%) patients had a diagnosis of Crohn’s disease whereas 24 (17.0%) had ulcerative colitis and 4 (2.8%) unspecified type IBD. 104 (75.1%) patients were active on MyChart and 83 (58.9% of total; n=138) completed the infliximab questionnaire. Significantly fewer of the patients active on MyChart required scheduled outpatient reviews when compared to those that were inactive (59.6% vs 94.1%; p=0.0001; Table 1). There were no significant differences in terms of demographics, IBD type or clinical remission between the two groups. Strikingly, patients who did not fill in the questionnaire were significantly more likely to have scheduled outpatient review in comparison to those that filled it (83.6% vs 67.4%; p=0.047) despite a higher proportion of the first being in clinical remission at baseline (86.6% vs 67.4%; p=0.047). Furthermore, we evaluated the impact of introducing the online questionnaire by looking at the outpatient reviews and inpatient admissions before and after patients filled it in. The group was significantly less likely to require outpatient reviews (67.5% vs 87.3%; p=0.0061) or inpatient admissions (6.0% vs 17.5%; p=0.03) following introduction of the online questionnaire (Figure 1). Conclusion Overall, patients active on MyChart seemed to be significantly less likely to require outpatient review. This impact seemed particularly evident after filling in an online questionnaire which effectively addressed patient concerns and prevented unwarranted outpatient reviews and inpatient admissions.

No abstract