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Macaluso M, Rothenberg ME, Ferkol T, Kuhnell P, Kaminski HJ, Kimberlin DW, Benatar M, Chehade M. Impact of the COVID-19 Pandemic on People Living With Rare Diseases and Their Families: Results of a National Survey. JMIR Public Health Surveill 2024; 10:e48430. [PMID: 38354030 PMCID: PMC10868638 DOI: 10.2196/48430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 09/20/2023] [Accepted: 12/15/2023] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND With more than 103 million cases and 1.1 million deaths, the COVID-19 pandemic has had devastating consequences for the health system and the well-being of the entire US population. The Rare Diseases Clinical Research Network funded by the National Institutes of Health was strategically positioned to study the impact of the pandemic on the large, vulnerable population of people living with rare diseases (RDs). OBJECTIVE This study was designed to describe the characteristics of COVID-19 in the RD population, determine whether patient subgroups experienced increased occurrence or severity of infection and whether the pandemic changed RD symptoms and treatment, and understand the broader impact on respondents and their families. METHODS US residents who had an RD and were <90 years old completed a web-based survey investigating self-reported COVID-19 infection, pandemic-related changes in RD symptoms and medications, access to care, and psychological impact on self and family. We estimated the incidence of self-reported COVID-19 and compared it with that in the US population; evaluated the frequency of COVID-19 symptoms according to self-reported infection; assessed infection duration, complications and need for hospitalization; assessed the influence of the COVID-19 pandemic on RD symptoms and treatment, and whether the pandemic influenced access to care, special food and nutrition, or demand for professional psychological assistance. RESULTS Between May 2, 2020, and December 15, 2020, in total, 3413 individuals completed the survey. Most were female (2212/3413, 64.81%), White (3038/3413, 89.01%), and aged ≥25 years (2646/3413, 77.53%). Overall, 80.6% (2751/3413) did not acquire COVID-19, 2.08% (71/3413) acquired it, and 16.58% (566/3413) did not know. Self-reported cases represented an annual incidence rate of 2.2% (95% CI 1.7%-2.8%). COVID-19 cases were more than twice the expected (71 vs 30.3; P<.001). COVID-19 was associated with specific symptoms (loss of taste: odds ratio [OR] 38.9, 95% CI 22.4-67.6, loss of smell: OR 30.6, 95% CI 17.7-53.1) and multiple symptoms (>9 symptoms vs none: OR 82.5, 95% CI 29-234 and 5-9: OR 44.8, 95% CI 18.7-107). Median symptom duration was 16 (IQR 9-30) days. Hospitalization (7/71, 10%) and ventilator support (4/71, 6%) were uncommon. Respondents who acquired COVID-19 reported increased occurrence and severity of RD symptoms and use or dosage of select medications; those who did not acquire COVID-19 reported decreased occurrence and severity of RD symptoms and use of medications; those who did not know had an intermediate pattern. The pandemic made it difficult to access care, receive treatment, get hospitalized, and caused mood changes for respondents and their families. CONCLUSIONS Self-reported COVID-19 was more frequent than expected and was associated with increased prevalence and severity of RD symptoms and greater use of medications. The pandemic negatively affected access to care and caused mood changes in the respondents and family members. Continued surveillance is necessary.
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Affiliation(s)
- Maurizio Macaluso
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Marc E Rothenberg
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
- Division of Allergy and Immunology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Thomas Ferkol
- Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Pierce Kuhnell
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Henry J Kaminski
- Department of Neurology and Rehabilitation Medicine, George Washington University, Washington, DC, United States
| | - David W Kimberlin
- Division of Pediatric Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Michael Benatar
- Department of Neurology, University of Miami, Miami, FL, United States
| | - Mirna Chehade
- Mount Sinai Center for Eosinophilic Disorders, Departments of Pediatrics and Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States
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Zybarth D, Brandt M, Mundlos C, Inhestern L. [Consequences of a pandemic for people living with rare diseases and recommendations for maintaining healthcare and participation]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2024; 67:57-65. [PMID: 38019314 PMCID: PMC10776713 DOI: 10.1007/s00103-023-03810-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 11/17/2023] [Indexed: 11/30/2023]
Abstract
BACKGROUND Rare diseases are often characterized by complex symptoms and usually require coordination of multiprofessional treatment during the diagnostic and healthcare processes. In the wake of the COVID-19 pandemic, the healthcare situation and daily life of people with rare diseases and the caregivers of children with rare diseases changed drastically. The aim of the research project RESILIENT-SE-PAN was to assess the situation of people with rare diseases and caregivers during COVID-19 and to develop recommendations based on the findings. METHODS We conducted a mixed methods study including the perspective of people with rare diseases, caregivers and representatives from patient organizations and conducted a concluding workshop. RESULTS The findings indicate an impact on healthcare and daily life of participants. Moreover, mental burden, supportive needs, COVID-19-specific aspects but also positive aspects were mentioned. Based on the findings from our mixed methods study, we developed 21 recommendations referring to the following topics: medical diagnostics and healthcare of the rare diseases, additional therapies and aids, access to COVID-19 information and vaccination, psychosocial support, participation and activities, patient organisations and others. DISCUSSION The recommendations can provide an orientation for the organisation of healthcare in future crises or pandemics in order to adequately take the situations of people with rare diseases into account and consider the needs of this patient group.
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Affiliation(s)
- David Zybarth
- Institut und Poliklinik für Medizinische Psychologie, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland
| | - Maja Brandt
- Institut und Poliklinik für Medizinische Psychologie, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland
| | - Christine Mundlos
- Allianz Chronischer Seltener Erkrankungen (ACHSE) e. V., Berlin, Deutschland
| | - Laura Inhestern
- Institut und Poliklinik für Medizinische Psychologie, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland.
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De Novellis D, Folliero V, Giudice V, Pezzullo L, Sanna G, Fontana R, Guariglia R, Zannella C, Mettivier L, Ferrara I, Boccia G, Buonanno MT, Martorelli MC, Luponio S, Crudele A, Pagliano P, Sessa AM, Velino F, Langella M, Manzin A, Galdiero M, Selleri C, Franci G, Serio B. Effective Neutralizing Antibody Response Against SARS-CoV-2 Virus and Its Omicron BA.1 Variant in Fully Vaccinated Hematological Patients. Clin Exp Med 2023; 23:4943-4953. [PMID: 37898572 PMCID: PMC10725343 DOI: 10.1007/s10238-023-01223-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 10/16/2023] [Indexed: 10/30/2023]
Abstract
SARS-CoV-2 and its variants cause CoronaVIrus Disease 19 (COVID-19), a pandemic disease. Hematological malignancies increase susceptibility to severe COVID-19 due to immunosuppression. Anti-SARS-CoV-2 neutralizing antibodies protect against severe COVID-19. This retrospective real-life study aimed to evaluate seropositivity and neutralizing antibody rates against SARS-CoV-2 and its Omicron BA.1 variant in hematological patients. A total of 106 patients with different hematologic malignancies, who have mostly received three or more vaccine doses (73%), were included in this study. Serum was collected between May and June 2022. The primary endpoint was anti-SARS-CoV-2 antibody response against ancestral (wild type; wt) and Omicron BA.1 virus, defined as a neutralizing antibody titer ≥ 1:10. Adequate neutralizing antibody response was observed in 75 (71%) and 87 (82%) of patients for wt and Omicron BA.1 variants, respectively.However, patients with B-cell lymphoproliferative disorders and/or those treated with anti-CD20 monoclonal antibodies in the prior 12 months showed a lower seropositivity rate compared to other patients against both Omicron BA.1 variant (73% vs 91%; P = 0.02) and wt virus (64% vs 78%; P = 0.16). Our real-life experience confirmed that full vaccination against SARS-CoV-2 induces adequate neutralizing antibody protection for both the wt virus and Omicron BA.1 variants, even in hematological frail patients. However, protective measures should be maintained in hematological patients, especially those with B-cell lymphoproliferative diseases treated with anti-CD20 monoclonal antibodies, because these subjects could have a reduced neutralizing antibody production.
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Affiliation(s)
- Danilo De Novellis
- Department of Medicine, Surgery, and Dentistry, University of Salerno, Baronissi, Italy
- Hematology and Transplant Center, University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy
| | - Veronica Folliero
- Department of Medicine, Surgery, and Dentistry, University of Salerno, Baronissi, Italy
- Microbiology and Virology, University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy
| | - Valentina Giudice
- Department of Medicine, Surgery, and Dentistry, University of Salerno, Baronissi, Italy
- Hematology and Transplant Center, University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy
| | - Luca Pezzullo
- Hematology and Transplant Center, University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy
| | - Giuseppina Sanna
- Department of Biomedical Sciences, Microbiology and Virology Unit, University of Cagliari, Cittadella Universitaria, 09042, Monserrato, Italy
| | - Raffaele Fontana
- Hematology and Transplant Center, University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy
| | - Roberto Guariglia
- Hematology and Transplant Center, University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy
| | - Carla Zannella
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", 80138, Naples, Italy
| | - Laura Mettivier
- Hematology and Transplant Center, University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy
| | - Idalucia Ferrara
- Hematology and Transplant Center, University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy
| | - Giovanni Boccia
- Department of Medicine, Surgery, and Dentistry, University of Salerno, Baronissi, Italy
| | - Maria Teresa Buonanno
- Hematology and Transplant Center, University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy
| | - Maria Carmen Martorelli
- Hematology and Transplant Center, University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy
| | - Serena Luponio
- Hematology and Transplant Center, University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy
| | - Andrea Crudele
- Department of Medicine, Surgery, and Dentistry, University of Salerno, Baronissi, Italy
| | - Pasquale Pagliano
- Department of Medicine, Surgery, and Dentistry, University of Salerno, Baronissi, Italy
| | - Anna Maria Sessa
- Hematology and Transplant Center, University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy
| | - Francesca Velino
- Hematology and Transplant Center, University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy
| | - Maddalena Langella
- Hematology and Transplant Center, University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy
| | - Aldo Manzin
- Department of Biomedical Sciences, Microbiology and Virology Unit, University of Cagliari, Cittadella Universitaria, 09042, Monserrato, Italy
| | - Massimiliano Galdiero
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", 80138, Naples, Italy
| | - Carmine Selleri
- Department of Medicine, Surgery, and Dentistry, University of Salerno, Baronissi, Italy.
- Hematology and Transplant Center, University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy.
| | - Gianluigi Franci
- Department of Medicine, Surgery, and Dentistry, University of Salerno, Baronissi, Italy.
- Microbiology and Virology, University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy.
| | - Bianca Serio
- Department of Medicine, Surgery, and Dentistry, University of Salerno, Baronissi, Italy.
- Hematology and Transplant Center, University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy.
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Brodosi L, Stecchi M, Mita D, Marchignoli F, Guarneri V, Agnelli G, Osti V, Perazza F, Sacilotto F, Pession A, Pironi L. Symptoms of SARS-CoV-2 infection and vaccine status of sixty-seven adult patients affected by inherited metabolic diseases: a phone survey. Orphanet J Rare Dis 2023; 18:286. [PMID: 37700355 PMCID: PMC10496155 DOI: 10.1186/s13023-023-02905-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 08/31/2023] [Indexed: 09/14/2023] Open
Abstract
BACKGROUND The Covid pandemic seems to have had several detrimental effects on managing patients affected by inherited metabolic diseases (IMD), although published data about the impact of COVID-19 on patients suffering from IMD are very scarce. The scope of our work was to evaluate adherence to the vaccination plan, the side effects experienced by our adult IMD patients, and the symptoms of the SARS-CoV-2 infection. RESULTS Sixty-seven patients agreed to respond to a phone interview. The mean age was 36.5 (± 11.6 SD). Regarding the vaccination campaign, fifty-five patients (82%) joined it, of whom ten had received two doses and the remaining forty-five, three. Forty-two patients (76%) reported adverse events following vaccination, the most frequent being local reaction, fever, and asthenia, which lasted an average of two days and resolved without sequelae. Regarding SARS-CoV-2 infection, twenty-seven out of sixty-seven patients (40%) tested positive for the virus; seven of them were not vaccinated at the time of infection; on the other hand, twenty had already had at least two doses. Regarding the prevalence of long-Covid, as many as 12 patients (44%) reported symptoms that persisted after the nasopharyngeal swab tested negative and lasted an average of 81 (± 74 SD) days. There were no statistically significant differences in BMI of patients who contracted the infection and patients who did not (25.15 vs. 25.20, p = .861), between those who had adverse reactions to the vaccine and those who did not (24.40 vs. 25.75, p = .223), between those who had long-Covid and those who did not (25.9 vs. 27.7, p = .183). No relation was observed between metabolic inherited disease, SARS-CoV-2 infection symptoms and adverse vaccine reactions. CONCLUSIONS The data indicate that IMD patients adhered to the vaccination campaign comparably to the general Italian population. Adverse events to the vaccine were negligible. SARS-CoV-2 infection, which occurred in most cases after receiving at least two doses of the vaccine, did not cause serious symptoms and never required hospitalisation. A non-negligible share of patients suffered from long-Covid symptoms.
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Affiliation(s)
- Lucia Brodosi
- Department of Medical and Surgical Sciences, University of Bologna, Via Zamboni, 33, Bologna, 40126, Italy.
- Clinical Nutriti on and Metabolism Unit, IRCCS AOUBO, Via Albertoni, 15, Bologna, 40138, Italy.
| | - Michele Stecchi
- Department of Medical and Surgical Sciences, University of Bologna, Via Zamboni, 33, Bologna, 40126, Italy
| | - Dorina Mita
- Department of Medical and Surgical Sciences, University of Bologna, Via Zamboni, 33, Bologna, 40126, Italy
| | - Francesca Marchignoli
- Clinical Nutriti on and Metabolism Unit, IRCCS AOUBO, Via Albertoni, 15, Bologna, 40138, Italy
| | - Valeria Guarneri
- Department of Medical and Surgical Sciences, University of Bologna, Via Zamboni, 33, Bologna, 40126, Italy
| | - Giulio Agnelli
- Department of Medical and Surgical Sciences, University of Bologna, Via Zamboni, 33, Bologna, 40126, Italy
| | - Valentino Osti
- Department of Public Health, Azienda USL di Bologna, Via Gramsci, 12, Bologna, 40121, Italy
| | - Federica Perazza
- Department of Medical and Surgical Sciences, University of Bologna, Via Zamboni, 33, Bologna, 40126, Italy
| | - Federica Sacilotto
- Department of Medical and Surgical Sciences, University of Bologna, Via Zamboni, 33, Bologna, 40126, Italy
| | - Andrea Pession
- Department of Medical and Surgical Sciences, University of Bologna, Via Zamboni, 33, Bologna, 40126, Italy
- Pediatric Unit, IRCCS AOUBO, Via Albertoni, 15, Bologna, 40138, Italy
| | - Loris Pironi
- Department of Medical and Surgical Sciences, University of Bologna, Via Zamboni, 33, Bologna, 40126, Italy
- Clinical Nutriti on and Metabolism Unit, IRCCS AOUBO, Via Albertoni, 15, Bologna, 40138, Italy
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Motoc NȘ, Făgărășan I, Urda-Cîmpean AE, Todea DA. Prognosis Predictive Markers in Patients with Chronic Obstructive Pulmonary Disease and COVID-19. Diagnostics (Basel) 2023; 13:2597. [PMID: 37568963 PMCID: PMC10416888 DOI: 10.3390/diagnostics13152597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 07/28/2023] [Accepted: 07/30/2023] [Indexed: 08/13/2023] Open
Abstract
Some studies have reported that chronic respiratory illnesses in patients with COVID-19 result in an increase in hospitalization and death rates, while other studies reported to the contrary. The present research aims to determine if a predictive model (developed by combing different clinical, imaging, or blood markers) could be established for patients with both chronic obstructive pulmonary disease (COPD) and COVID-19, in order to be able to foresee the outcomes of these patients. A prospective observational cohort of 165 patients with both diseases was analyzed in terms of clinical characteristics, blood tests, and chest computed tomography results. The beta-coefficients from the logistic regression were used to create a score based on the significant identified markers for poor outcomes (transfers to an intensive care unit (ICU) for mechanical ventilation, or death). The severity of COVID-19, renal failure, diabetes, smoking status (current or previous), the requirement for oxygen therapy upon admission, high lactate dehydrogenase (LDH) and C-reactive protein level (CRP readings), and low eosinophil and lymphocyte counts were all identified as being indicators of a poor prognosis. Higher mortality was linked to the occurrence of renal failure, the number of affected lobes, the need for oxygen therapy upon hospital admission, high LDH, and low lymphocyte levels. Patients had an 86.4% chance of dying if their mortality scores were -2.80 or lower, based on the predictive model. The factors that were linked to a poor prognosis in patients who had both COPD and COVID-19 were the same as those that were linked to a poor prognosis in patients who had only COVID-19.
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Affiliation(s)
- Nicoleta Ștefania Motoc
- Department of Medical Sciences-Pulmonology, Faculty of Medicine, “Iuliu Haţieganu” University of Medicine and Pharmacy, 8 Victor Babeș Street, 400012 Cluj-Napoca, Romania
| | - Iulia Făgărășan
- Department of Medical Sciences-Pulmonology, Faculty of Medicine, “Iuliu Haţieganu” University of Medicine and Pharmacy, 8 Victor Babeș Street, 400012 Cluj-Napoca, Romania
| | - Andrada Elena Urda-Cîmpean
- Department of Medical Informatics and Biostatistics, Faculty of Medicine, “Iuliu Haţieganu” University of Medicine and Pharmacy, Louis Pasteur Str. No. 6, 400349 Cluj-Napoca, Romania
| | - Doina Adina Todea
- Department of Medical Sciences-Pulmonology, Faculty of Medicine, “Iuliu Haţieganu” University of Medicine and Pharmacy, 8 Victor Babeș Street, 400012 Cluj-Napoca, Romania
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Zybarth D, Brandt M, Mundlos C, Inhestern L. Impact of the COVID-19 pandemic on health care and daily life of patients with rare diseases from the perspective of patient organizations - a qualitative interview study. Orphanet J Rare Dis 2023; 18:154. [PMID: 37344904 DOI: 10.1186/s13023-023-02771-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 06/04/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND During the COVID-19 pandemic people affected by rare diseases (RD) or caregiver of affected children have faced additional challenges. The pandemic has affected physical and mental health, social life and has led to financial consequences. Our objectives were to identify the impact of COVID-19 (1) on health care and (2) on daily life and participation of patients with RDs or caregivers from the perspective of representatives of patient organizations. Moreover, we explored their perspective on experiences of pandemic stress and resources during the pandemic. RESULTS We conducted 18 semi-structured interviews with representatives of patient organizations (e.g. chairperson, members of the steering committee), who were asked about the experiences of their members. The interviews were transcribed verbatim and analyzed using the framework approach. We contextualized our findings on the basis of the International Classification of Functioning, Disability and Health (ICF) model and adapted it according to identified subthemes. Patients and caregivers were confronted with aspects of pandemic stress such as lack of information, access and information regarding vaccination and being a risk group for COVID-19 infection. Physical and mental functioning was reported to be negatively impacted. Lock downs and contact restrictions led, e.g., to increasing lack of nursing services or lack of necessary informal support. Participation e.g. in social life and work was reduced. Health care services including medical care and supportive care as well as additional therapies were disrupted and greater effort was necessary to organize care. According to participants, central resources were informal support networks, digitalization, patient organizations and individual characteristics. CONCLUSIONS Our study highlights the consequences of the COVID-19 pandemic on the situation of people affected by RDs and caregivers. Contextualization of the results into the biopsychosocial model reinforces the impact of the pandemic on health care as well as daily life and participation. Major challenges and difficulties were experienced during lockdowns and contact restrictions. Depending on the risk of an infection with COVID-19, certain patient groups were still isolated and reduced social contacts or still followed strict hygienic measures (e.g., wearing medical masks). Future pandemic control measures, e.g. on lockdowns and closing facilities, should consider the challenges of people with RDs and caregivers of affected children.
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Affiliation(s)
- David Zybarth
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Maja Brandt
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christine Mundlos
- Allianz Chronischer Seltener Erkrankungen (ACHSE) e.V, Berlin, Germany
| | - Laura Inhestern
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
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Soussand L, Kuchenbuch M, Messiaen C, Sandrin A, Jannot AS, Nabbout R. Impact of the COVID-19 pandemic on the care of rare and undiagnosed diseases patients in France: a longitudinal population-based study. Orphanet J Rare Dis 2022; 17:430. [PMID: 36494730 PMCID: PMC9733228 DOI: 10.1186/s13023-022-02580-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 11/20/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Preliminary data suggest that COVID-19 pandemic has generated a switch from face-to-face to remote care for individuals with chronic diseases. However, few data are available for rare and undiagnosed diseases (RUDs). We aimed to assess the impact of the COVID-19 pandemic on the activities of the French reference network for RUDs in 2020. RESULTS In this longitudinal retrospective study, we extracted and analyzed the data of the French national registry for RUDs collected between Jan 1, 2019 and Dec 31, 2020. We compared the annual longitudinal evolution of face-to-face and remote care activities between 2019 and 2020 focusing on adult and pediatric patients. Compared to 2019, rare diseases (RD) care activities showed a decrease in 2020 (- 12%) which occurred mostly during the first lockdown (- 45%) but did not catch up completely. This decrease was mainly in face-to-face care activities. Telehealth activities showed a 9-fold increase during the first lockdown and was able to cover for one third of the decrease in RD activities. Finally, the total number of patients receiving care was lower in 2020(- 9%) with a drastic decrease of cases with newly confirmed diagnosis (- 47%). CONCLUSION Although telehealth was quickly introduced during the COVID-19 pandemic, RUD patient care was strongly affected in France with a decline in the number of patients treated and new patients recruited. This is likely to result in delays in patient diagnosis and care over the next few years.
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Affiliation(s)
- Louis Soussand
- grid.50550.350000 0001 2175 4109Banque Nationale de Données Maladies Rares, DSI-Innovation and Données, APHP, Paris, France
| | - Mathieu Kuchenbuch
- grid.412134.10000 0004 0593 9113Department of Pediatric Neurology, Reference Centre for Rare Epilepsies, Hôpital Necker-Enfants Malades, 149 Rue de Sèvres, 75015 Paris, France ,grid.462336.6Laboratory of Translational Research for Neurological Disorders, INSERM-MR1163, Imagine Institute, Paris, France
| | - Claude Messiaen
- grid.50550.350000 0001 2175 4109Banque Nationale de Données Maladies Rares, DSI-Innovation and Données, APHP, Paris, France
| | - Arnaud Sandrin
- grid.50550.350000 0001 2175 4109Banque Nationale de Données Maladies Rares, DSI-Innovation and Données, APHP, Paris, France
| | - Anne-Sophie Jannot
- grid.50550.350000 0001 2175 4109Banque Nationale de Données Maladies Rares, DSI-Innovation and Données, APHP, Paris, France ,grid.50550.350000 0001 2175 4109AP-HP. Centre - Université de Paris Cité, Paris, France ,grid.5328.c0000 0001 2186 3954HeKA Centre de Recherche des Cordeliers Inserm, INRIA, Paris, France
| | - Rima Nabbout
- grid.412134.10000 0004 0593 9113Department of Pediatric Neurology, Reference Centre for Rare Epilepsies, Hôpital Necker-Enfants Malades, 149 Rue de Sèvres, 75015 Paris, France ,grid.462336.6Laboratory of Translational Research for Neurological Disorders, INSERM-MR1163, Imagine Institute, Paris, France ,grid.50550.350000 0001 2175 4109AP-HP. Centre - Université de Paris Cité, Paris, France
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Taruscio D, Scopinaro A, Limongelli G. COVID-19 and the rare disease organization response during pandemic: the 'Italian model'. FUTURE RARE DISEASES 2022; 2:FRD21. [PMID: 38051988 PMCID: PMC8989368 DOI: 10.2217/frd-2022-0001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Accepted: 03/08/2022] [Indexed: 11/21/2022]
Affiliation(s)
- Domenica Taruscio
- Director of The National Centre for Rare Diseases, Istituto Superiore di Sanità, Rome, Italy
| | | | - Giuseppe Limongelli
- Università della Campania ‘Luigi Vanvitelli’; Director of the Coordinator Rare Disease Centre, Campania Region, Naples, Italy
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Sebastião FM, Michelin-Tirelli K, Bender F, Lopes FF, Moraes I, Kubaski F, Giugliani R, Burin M. COVID-19 impact on the diagnosis of Inborn Errors of Metabolism: Data from a reference center in Brazil. Genet Mol Biol 2021; 45:e20210253. [PMID: 34927665 PMCID: PMC8691104 DOI: 10.1590/1678-4685-gmb-2021-0253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 11/09/2021] [Indexed: 11/21/2022] Open
Abstract
The COVID-19 pandemic led to the reorganization of health care in several countries, including Brazil. Inborn Errors of Metabolism (IEM) are a group of rare and difficult to diagnose genetic diseases caused by pathogenic variants in genes that code for enzymes, cofactors, or structural proteins affecting different metabolic pathways. The aim of this study was to evaluate how COVID-19 affected the diagnosis of patients with IEM during the first year of the pandemic in Brazil comparing two distinct periods: from March 1st, 2019 to February 29th, 2020 (TIME A) and from March 1st, 2020 to February 28th, 2021 (TIME B), by the analysis of the number of tests and diagnoses performed in a Reference Center in South of Brazil. In the comparison TIME A with TIME B, we observe a reduction in the total number of tests performed (46%) and in the number of diagnoses (34%). In both periods analyzed, mucopolysaccharidoses (all subtypes combined) was the most frequent LD suspected and/or confirmed. Our data indicates a large reduction in the number of tests requested for the investigation of IEM and consequently a large reduction in the number of diagnoses caused by the COVID-19 pandemic leading to a significant underdiagnosis of IEM.
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Affiliation(s)
| | | | - Fernanda Bender
- Hospital de Clínicas de Porto Alegre (HCPA), Serviço de Genética Médica, Porto Alegre, RS, Brazil
| | - Franciele Fátima Lopes
- Hospital de Clínicas de Porto Alegre (HCPA), Serviço de Genética Médica, Porto Alegre, RS, Brazil
| | - Inamara Moraes
- Hospital de Clínicas de Porto Alegre (HCPA), Serviço de Genética Médica, Porto Alegre, RS, Brazil
| | - Francyne Kubaski
- Hospital de Clínicas de Porto Alegre (HCPA), Serviço de Genética Médica, Porto Alegre, RS, Brazil
| | - Roberto Giugliani
- Hospital de Clínicas de Porto Alegre (HCPA), Serviço de Genética Médica, Porto Alegre, RS, Brazil.,Universidade Federal do Rio Grande do Sul, Departamento de Genética, Porto Alegre, RS, Brazil
| | - Maira Burin
- Hospital de Clínicas de Porto Alegre (HCPA), Serviço de Genética Médica, Porto Alegre, RS, Brazil
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10
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Tobór-Świętek E, Sykut-Cegielska J, Bik-Multanowski M, Walczak M, Rokicki D, Kałużny Ł, Wierzba J, Pac M, Jahnz-Różyk K, Więsik-Szewczyk E, Kieć-Wilk B. COVID-19 Pandemic and Patients with Rare Inherited Metabolic Disorders and Rare Autoinflammatory Diseases-Organizational Challenges from the Point of View of Healthcare Providers. J Clin Med 2021; 10:jcm10214862. [PMID: 34768381 PMCID: PMC8584872 DOI: 10.3390/jcm10214862] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 10/16/2021] [Accepted: 10/19/2021] [Indexed: 01/12/2023] Open
Abstract
COVID-19 pandemic is an organisational challenge for both healthcare providers and patients. People with rare inherited metabolic disorders (IMD) and rare autoinflammatory diseases (AD) are vulnerable patients whose well-being is deeply connected with regular follow-ups. This study aimed to assess how e one year of coronavirus pandemic has impacted the treatment of patients with IMD and AD in Poland. Surveys were distributed to all healthcare providers that coordinate the treatment of IMD and AD patients. Thirty-two responders (55%) answered the survey. They provide care to 1726 patients with IMD/AD, including 246 patients on dedicated treatment. In 35% of units, the regular appointments were disrupted, primarily because of patient infection. In 18 hospitals, remote visits were implemented, but only 66.6% of patients used this form of consultation. In 14/32 hospitals, administration of the therapy was delayed (median: 17.4 days). Forty-four patients suffered from SARS-COV-2 infection, in majority with mild symptoms. However, four adult patients developed complications, and one died following a SARS-COV-2 infection. Although most hospitals managed to maintain regular visits during the pandemic, more comprehensive implementation of telemedicine and switch to oral therapy or home infusions would be a reasonable solution for the current epidemic situation.
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Affiliation(s)
- Ewa Tobór-Świętek
- Department of Metabolic Diseases, Jagiellonian University Medical College, 31-008 Cracow, Poland;
- Department of Metabolic Diseases, University Hospital, Jakubowskiego 2 Street, 30-688 Cracow, Poland
| | - Jolanta Sykut-Cegielska
- Department of Inborn Errors of Metabolism and Paediatrics, Institute of Mother and Child, Kasprzaka 17a Street, 01-211 Warsaw, Poland;
| | - Mirosław Bik-Multanowski
- Department of Medical Genetics, Medical College, Jagiellonian University, Wielicka 265 Street, 30-633 Cracow, Poland;
| | - Mieczysław Walczak
- Department of Pediatrics, Endocrinology, Diabetology, Metabolic Diseases and Cardiology of the Developmental Age, Pomeranian Medical University, Unii Lubelskiej 1 Street, 71-242 Szczecin, Poland;
| | - Dariusz Rokicki
- Department of Paediatrics, Nutrition and Metabolic Diseases, Institute “Children’s Memorial Health Institute”, al. Dzieci Polskich 20, 04-730 Warsaw, Poland;
| | - Łukasz Kałużny
- Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, Szpitalna 27/33 Street, 60-572 Poznan, Poland;
| | - Joanna Wierzba
- Department of Paediatrics, Hematology and Oncology Medical University of Gdansk, Debniki 7, 80-752 Gdansk, Poland;
| | - Małgorzata Pac
- Department of Immunology, Institute “Children’s Memorial Health Institute”, al. Dzieci Polskich 20, 04-730 Warsaw, Poland;
| | - Karina Jahnz-Różyk
- Department of Internal Diseases, Pneumology, Allergology and Clinical Immunology, Military Medical Institute, Szaserów 128 Street, 04-141 Warsaw, Poland; (K.J.-R.); (E.W.-S.)
| | - Ewa Więsik-Szewczyk
- Department of Internal Diseases, Pneumology, Allergology and Clinical Immunology, Military Medical Institute, Szaserów 128 Street, 04-141 Warsaw, Poland; (K.J.-R.); (E.W.-S.)
| | - Beata Kieć-Wilk
- Unit of Rare Metabolic Diseases, Department of Metabolic Diseases Jagiellonian University, Medical College, University Hospital, Jakubowskiego 2 Street, 30-688 Cracow, Poland
- Correspondence: ; Tel.: +48-12-400-29-50
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11
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Kaiafa G, Pilalas D, Koletsa T, Daios S, Arsos G, Hatzidakis A, Protopapas A, Stamatopoulos K, Savopoulos C. Diagnosing a Patient with Erdheim-Chester Disease during the COVID-19 Pandemic. ACTA ACUST UNITED AC 2021; 57:medicina57101001. [PMID: 34684037 PMCID: PMC8540257 DOI: 10.3390/medicina57101001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 09/14/2021] [Accepted: 09/19/2021] [Indexed: 11/16/2022]
Abstract
Background: Erdheim-Chester disease (ECD) is a rare hematopoietic neoplasm of histiocytic origin characterized by an insidious course. The coronavirus disease 2019 (COVID-19) pandemic has put an enormous strain on healthcare systems worldwide both directly and indirectly, resulting in the disruption of healthcare services to prevent, diagnose and manage non-COVID-19 disease. Case Presentation: We describe the case of a 58-year-old male patient with sporadic episodes of self-resolving mild fever and anemia of chronic disease with onset two years before the current presentation. Positron emission/computed tomography scan revealed the presence of moderately hypermetabolic perirenal tissue masses. In order to achieve diagnosis, repeated perirenal tissue biopsies were performed, and the diagnostic evaluation was complicated by the strain put on the healthcare system by the COVID-19 pandemic. The patient contracted SARS-CoV-2 and required hospitalization, but recovered fully. No further ECD target organ involvement was documented. Treatment options were presented, but the patient chose to defer treatment for ECD. Conclusion: A high index of suspicion and multidisciplinary team collaboration is paramount to achieve diagnosis in rare conditions such as ECD. Disruptions in healthcare services in the pandemic milieu may disproportionately affect people with rare diseases and further study and effort is required to better meet their needs in the pandemic setting.
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Affiliation(s)
- Georgia Kaiafa
- First Propedeutic Department of Internal Medicine, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (D.P.); (S.D.); (A.P.); (C.S.)
- Correspondence: ; Tel.: +30-231-099-4779
| | - Dimitrios Pilalas
- First Propedeutic Department of Internal Medicine, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (D.P.); (S.D.); (A.P.); (C.S.)
| | - Triantafyllia Koletsa
- Department of Pathology, Medical School, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | - Stylianos Daios
- First Propedeutic Department of Internal Medicine, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (D.P.); (S.D.); (A.P.); (C.S.)
| | - Georgios Arsos
- 3rd Department of Nuclear Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, 56403 Thessaloniki, Greece;
| | - Adam Hatzidakis
- Radiology Department, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece;
| | - Adonis Protopapas
- First Propedeutic Department of Internal Medicine, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (D.P.); (S.D.); (A.P.); (C.S.)
| | - Kostas Stamatopoulos
- Institute of Applied Biosciences, Center for Research and Technology Hellas, 57001 Thessaloniki, Greece;
| | - Christos Savopoulos
- First Propedeutic Department of Internal Medicine, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (D.P.); (S.D.); (A.P.); (C.S.)
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