Remote support by multidisciplinary teams: A crucial means to cope with the psychological impact of SARS-COV-2 pandemic on patients with cystic fibrosis and inflammatory bowel disease in Lombardia

BACKGROUND: During Coronavirus Disease 2019 (COVID-19) outbreak in Lombardia, people were recommended to avoid visiting emergency departments and attending routine clinic visits. In this context it was necessary to understand the psychological reactions of patients with chronic diseases. We evaluated the psychological effects on patients with chronic respiratory conditions and inflammatory bowel disease (IBD) through the analysis of their spontaneous contacts with their referral centers.METHODS: Cross-sectional study conducted from February 23 to April 27, 2020 in patients, or their parents, who contacted their multidisciplinary teams (MDT). E-mails and phone calls directed to the MDT of the center for cystic fibrosis in Milano and for pediatric IBD in Bergamo, were categorized according to their contents as information on routine disease-management, updates on the patient's health status, COVID-19 news monitoring, empathy towards health professionals, positive feedback and concern of contagion during the emergency.RESULTS: 1816 contacts were collected during the study period. In Milano, where the majority of patients were affected by CF, 88.7% contacted health professionals by e-mail, with pediatricians receiving the largest volume of emails and phone calls compared to other professionals (P<.001). Compared to Milano, the center for IBD in Bergamo recorded more expression of empathy towards health professionals and thanks for their activity in the COVID-19 emergency (52.4% versus 12.7%, P<.001), as well as positive feedback (64.3% versus 2.7%, P=.003).CONCLUSION: One of the most important lessons we can learn from COVID-19 is that it is not the trauma itself that can cause psychological consequences but rather the level of balance, or imbalance, between fragility and resources. To feel safe, people need to be able to count on the help of those who represent a bulwark against the threat. This is the role played, even remotely, by health professionals.