Caratteristiche dei centri per l’assistenza e la diagnosi del Long-CoViD in Italia

Sebbene la rilevanza clinica del Long-CoViD sia in crescente aumento, sono disponibili poche informazioni riguardo la risposta organizzativa del servizio sanitario rivolto alla diagnosi e assistenza di pazienti con Long-CoViD.

124 centri clinici hanno completato un questionario sviluppato per la definizione delle tipologie di assistenza clinica a pazienti con Long-CoViD.

Dall’analisi dei risultati è emerso che la maggior parte dei centri ha fornito assistenza attraverso visite ambulatoriali o servizi di day hospital con visite programmate o il rinvio a cure primarie. Più dell’80% dei centri ha competenze specialistiche in malattie respiratorie, malattie infettive o medicina interna e ha contemplato un approccio multidisciplinare al soggetto con sospetta condizione di Long-CoViD. La valutazione clinica è solitamente supportata da diagnostica di laboratorio e strumentale e da valutazioni multidimensionali.

Questi risultati vogliono essere di aiuto nella definizione di standard, interventi e linee guida in grado di ridurre i gap e l'eterogeneità nell'assistenza ai pazienti con Long-CoViD.

Questi dati sono pubblicati in:

Floridia M., Grassi T., Giuliano M., Tiple D., Pricci F., Villa M., Silenzi A. and Onder G. Characteristics of Long-CoViD care centers in Italy. A national survey of 124 clinical sites. Front. Public Health 10:975527. doi: 10.3389/fpubh.2022.975527

Abstract

Background: Despite the growing clinical relevance of Long-CoViD, there is minimal information available on the organizational response of health services to this condition. Methods: A national online survey of centers providing assistance for Long-CoViD was implemented. Information collected included date of start of activity, target population, mode of assistance and of referral, type and number of specialists available, diagnostic and instrumental tests, use of telemedicine and of specific questionnaires. Results: Between February and May 2022, 124 centers completed the survey. Half of them were situated in northern Italy. Most (88.9%) provided assistance through either outpatient visits or day hospital services. Eleven (8.9%) assisted pediatric patients. Access to centers included scheduled visits for previously hospitalized patients (67.7%), referral from primary care (62.1%), from other specialists (46.8%), and, less commonly, from other services. Almost half of the centers (46.3%) started their activity early in the pandemics (March-September 2020). Almost all (93.5%) communicated with primary care physicians, and 21.8% used telemedicine tools. The mean number of patients followed was 40 per month (median 20, IQR 10-40). In most cases, the center coordinator was a specialist in respiratory diseases (30.6%), infectious diseases (28.2%), or internal medicine (25.0%). At least half of the centers had specialistic support in cardiology, respiratory diseases, radiology, infectious diseases, neurology and psychology, but roughly one quarter of centers had just only one (14.5%) or two (9.7%) specialists available. The clinical assessment was usually supported by a wide range of laboratory and instrumental diagnostics and by multidimensional evaluations. Conclusions: Most of the centers had an articulate and multidisciplinary approach to diagnosis and care of Long-CoViD. However, aminority of centers provided only single or dual specialistic support. These findings may be of help in defining common standards, interventions and guidelines that can reduce gaps and heterogeneity in assistance to patients with Long-CoViD. Full text