The coronavirus disease 2019 (COVID-19) pandemic is having a major clinical as well as organisational impact on the national health-care system in Italy, particularly in high-volume hospitals which are usually active for many essential clinical needs, including inflammatory bowel disease (IBD). Here, we report major clinical and organisational challenges at a high-volume Italian IBD centre one month after the start of the Italian government's restrictions due to the COVID-19 pandemic. All routine follow-up IBD visits of patients in remission were cancelled or rescheduled for 8-12 weeks' time. However, access to the hospital for therapy or for unstable/relapsing patients was not considered postponable. Everyone attending the centre (e.g. physicians, nurses, administrative personnel and patients) were advised to respect the general recommended rules for hand hygiene and social distancing, to disclose if they had a fever or cough or flu-like symptoms and to wear a surgical mask and gloves. At the entrance of the therapy area, a control station was set up in order to double-check all patients with a clinical interview and conduct thermal scanning. A total of 1451 IBD patients under biotechnological or experimental therapy actively followed in the CEMAD IBD centre were included in the study. About 65% of patients maintained their appointment schedules without major problems, while in 20% of cases planned infusions were delayed because of the patient's decision or practical issues. About 10% of patients receiving subcutaneous therapy were allowed to collect their medicine without a follow-up visit. Finally, 10% of patients living outside the Lazio region requested access to their therapy at a local centre closer to their home. At present, five patients have been found to be positive for SARS-CoV-2 infection but with minimal symptoms, 22 are in 'quarantine' for contact considered to be 'at risk' for the infection. Up to now, none of them has experienced significant symptoms. This study represents the first observational detailed report about short-term impact of the COVID-19 pandemic on patient organisation and management in a high-volume IBD centre.

中文翻译：

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COVID-19 大流行对炎症性肠病患者生物技术治疗日常管理的影响：意大利炎症性肠病大容量中心的重组反应。

2019 年冠状病毒病 (COVID-19) 大流行对意大利的国家医疗保健系统产生了重大的临床和组织影响，特别是在通常满足许多基本临床需求（包括炎症性肠病）的大容量医院中（IBD）。在此，我们报告意大利政府因 COVID-19 大流行而实施限制一个月后，意大利一家大容量 IBD 中心面临的重大临床和组织挑战。缓解期患者的所有 IBD 常规随访均被取消或重新安排 8-12 周的时间。然而，前往医院接受治疗或病情不稳定/复发的患者不被认为是可以推迟的。建议到该中心的每个人（例如医生、护士、行政人员和患者）遵守手部卫生和社交距离的一般建议规则，告知他们是否出现发烧、咳嗽或流感样症状，并佩戴外科口罩和手套。在治疗区入口处设立了控制站，以便对所有接受临床访谈的患者进行复核并进行热扫描。该研究共纳入了 1451 名在 CEMAD IBD 中心积极接受生物技术或实验治疗的 IBD 患者。大约 65% 的患者维持了预约时间表，没有出现重大问题，而 20% 的病例中，由于患者的决定或实际问题，计划的输液被推迟。大约 10% 接受皮下治疗的患者无需随访即可获准领取药物。最后，居住在拉齐奥地区以外的 10% 的患者要求在离家较近的当地中心接受治疗。目前，已发现 5 名患者 SARS-CoV-2 感染呈阳性，但症状轻微，其中 22 名患者因被认为有感染“风险”的接触者而处于“隔离”状态。到目前为止，他们都没有出现明显症状。这项研究是第一份关于 COVID-19 大流行对大容量 IBD 中心患者组织和管理的短期影响的观察性详细报告。