NEW CORONAVIRUS INFECTION (COVID-19) AND HEMORRHOIDS DISEASE
Introduction. In COVID-19, in addition to the symptoms of respiratory system damage, gastrointestinal symptoms, hemostasis disorders are observed, leading to the development of thrombosis and venous thromboembolism, which can worsen the course of hemorrhoidal disease and lead to exacerbation and serious complications. Given the complexity of the availability of specialized care in quarantine conditions, the role of outpatient consultation with elements of telemedicine is increasing.
The aim of this study is to highlight current data on the course of hemorrhoidal disease in (COVID-19), to assess the impact of quarantine on patients suffering from hemorrhoidal disease, and the role of timely outpatient consultation with telemedicine elements in patient management.
Methods. We conducted an observational study in the conditions of the regional diagnostic center in Almaty. The study included all patients with exacerbations of hemorrhoidal disease who applied during quarantine in the period July-October 2020. At the first admission, the patients were divided into 3 categories. The patients who were included in the study were surveyed, the symptoms of hemorrhoidal disease (HDSS) were evaluated. After 10-14 days, all patients were contacted again to assess the symptoms of GB and general health using HDSS questionnaires, respectively, and the responses were compared with the responses received at the first visit. From July 2020 to October 2020, 148 patients answered questionnaires and were identified by category.
Results. The analysis showed that a long waiting time for an outpatient appointment with a proctologist prolonged the period of exacerbation and worsened the course of the disease. The use of self-prescribed medications for treatment also led to a negative prognosis, which, in particular, led to deterioration. About 80% of patients noted positive dynamics after outpatient admission. According to our established outpatient appointment, 22 patients from the entire sample were operated on in the first month: 10 of them were transferred from the usual waiting list to the priority one and two were operated on urgently.
Conclusion. Questions about the relationship of complications of hemorrhoid disease with COVID-19 remain insufficiently studied and require further research. In the conditions of quarantine, it is necessary to review the organization of specialized proctological care for patients, and the introduction of accessible outpatient consultations with elements of telemedicine.
Dinara Nuspekova 1, https://orcid.org/0000-0003-3577-907X
Aidos Doskaliev 2, https://orcid.org/0000-0001-8727-567X
Ardak Auezova 1, https://orcid.org/0000-0001-5620-1651
Almagul' Kauysheva 1, https://orcid.org/0000-0002-5341-3189
Natal'ya Glushkova 1, https://orcid.org/0000-0003-1400-8436
Yersin Belispaev 3,
1 Kazakhstan Medical University "Higher School of Public Health",, Almaty c., Republic of Kazakhstan;
2 National Center for Neurosurgery, Nur-Sultan c., Republic of Kazakhstan;
3 Regional Diagnostic Center, Almaty c., Republic of Kazakhstan.
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7. Di Renzo L., Gualtieri P., Pivari F., Soldati, L., Attinà, A., Cinelli G., Leggeri C., Caparello G., Barrea L., Scerbo F. et al. Eating habits and lifestyle changes during COVID-19 lockdown: An Italian survey. J. Transl. Med. 2020, 18, 229. [CrossRef] [PubMed]
8. Buscarini E. et al., GI symptoms as early signs of COVID-19 in hospitalised Italian patients. Gut, vol. 69, no. 8. BMJ Publishing Group, pp. 1547–1548, Aug. 01, 2020, doi: 10.1136/gutjnl-2020-321434.
9. Genсosmanоglu R., Sad O., Koс D., Inceoоglu R. Hemorrhoidectomy: Open or closed technique? A prospective, randomized clinical trial. Dis. Colon. Rectum. 2002, 45, 70–75. [CrossRef] [PubMed]
10. Gu J., Han B., Wang J. COVID-19: gastrointestinal manifestations and potential fecal–oral transmission. Gastroenterology. 2020;158(6):1518–19. DOI: 10.1053/j.gastro.2020.02.054.
11. Guan W.J., Ni Z.Y., Hu Y., Liang W.H., Ou C.Q., He J.X., et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020;382(18):1708–20. DOI:10.1056/NEJMoa2002032
12. Rørvik H.D. et al., Hemorrhoidal disease symptom score and short health scaleHD: New tools to evaluate symptoms and health-related quality of life in hemorrhoidal disease. Dis. Colon Rectum, vol. 62, no. 3, pp. 333–342, Mar. 2019, doi: 10.1097/DCR.0000000000001234.
13. Ivashkin V.T., Sheptulin A.A., Zolnikova O.Yu., Okhlobystin A.V., Poluektova E.A., Trukhmanov A.S., Shirokova E.N., Gonik M.I., Trofimovskaya N.I. New Coronavirus Infection (COVID-19) and Digestive System. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2020;30(3):7–13. https://doi.org/10.22416/1382-4376-2020-30-3-7
14. Lin L., Jiang X., Zhang Z., Huang S., Zhang Z., Fang Z., et al. Gastrointestinal symptoms of 95 cases with SARS-CoV-2 infection. Gut. 2020; 69(6):997–1001 DOI:10.1136/gutjnl-2020-321013
15. Lippi G., Plebani M., Henry B.M. Thrombocytopenia is associated with severe coronavirus disease 2019 (COVID-19) infections: A meta-analysis. Clinica Chimica Acta; International Journal of Clinical Chemistry. 2020. V. 506. P. 145-148.
16. Lohsiriwat V. Anatomy, Physiology, and Pathophysiology of Haemorrhoids. In Haemorrhoids, 1-st ed.; Ratto, C., Parello, A., Litta, F., Eds.; Springer: Cham, Switzerland, 2018; Volume 2, pp. 9–18.
17. Pan L., Mu M., Ren H. G., Yang P., Sun Y. Wang R., et al. Clinical characteristics of COVID-19 patients with digestive symptoms in Hubei, China: a descriptive, cross-sectional, multicenter study. Am J Gastroenterol, 2020;115(5):766–73. DOI: 10.14309/ajg.0000000000000620
18. Parasa S. et al., Prevalence of Gastrointestinal Symptoms and Fecal Viral Shedding in Patients with Coronavirus Disease 2019: A Systematic Review and Meta-analysis. JAMA Network Open, vol. 3, no. 6. American Medical Association, Jun. 11, 2020, doi: 10.1001/jamanetworkopen.2020.11335.
19. Wang D., Hu B., Hu C., Zhu F., Liu X., Zhang J., et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA. 2020; 323(11):1061–69. DOI:10.1001/jama.2020.1585
20. Yliu et al., Effectiveness and safety of light vegetarian diet on functional constipation with gastrointestinal damp-heat pattern: An exploratory study protocol for randomized controlled trial. Med. (United States), vol. 98, no. 50, 2019, doi: 10.1097/MD.0000000000018325.
21. Zachary Z., Brianna F., Brianna L., Garrett P., Jade W., Alyssa D., Mikayla K. Self-quarantine and weight gain related risk factors during the COVID-19 pandemic. Obes. Res. Clin. Pract. 2020, 14, 210–216. [CrossRef] [PubMed]
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Nuspekova D., Doskaliev A., Auezova A., Kauysheva A., Glushkova N., Belispaev Ye. New coronavirus infection (COVID-19) and hemorrhoids disease // Nauka i Zdravookhranenie [Science & Healthcare]. 2021, (Vol.23) 4, pp. 31-38. doi 10.34689/SH.2021.23.4.003Related publications:
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