Telemedicine for routinary multiple sclerosis follow-up during SARS-CoV2 pandemic: A single center experience

Sartori, Arianna; Dinoto, Alessandro; Pasquin, Fulvio; Baldini, Sara; Bratina, Alessio; Bosco, Antonio; Manganotti, Paolo

Background and aims: Telemedicine in multiple sclerosis (MS) is promising, particularly for patients with high disability and difficulties to reach the treating centre. During SARS-CoV2 pandemic, teleconsults are gaining a central role. The aim of the present study was to report our single-center experience and to verify the effectiveness of teleconsults in diagnosing relapses and rating progression. Methods: During the first lockdown phase (March–May 2020) all the pre-planned consults were converted in teleconsults. The evaluation focused on new symptoms or worsening of known symptoms, disability (PDDS), patients’ satisfaction of such assessment modality (rated form 0 to 10). Patients were then re-evaluated in person within 6 months. We verified the changes in disability and the accuracy of teleconsults in diagnosing MS relapses. Results: Eighty-four patients underwent teleconsult and were re-evaluated in person within 6 months after the lockdown (69% female, mean age 50.5 ± 11.0 y, mean disease duration 13.0 ± 9.7 y 78.6% relapsing-remitting disease form, 76.2% on disease modifying treatment). Median pre-lockdown EDSS was 1.5 (range 0–8) median EDSS post lockdown was 2 (1–8) (p = 0.836);median PDDS during lockdown was 1.5 (0–8). A single disease relapse was detected with teleconsults. In the post lock-down in person evaluation no additional undiagnosed relapses were detected. Patients’ reported satisfaction was very high (median 10, range 8–10). Conclusions: Teleconsult in MS patients allowed us to guarantee a regular neurological follow-up during pandemic lockdown. No unreported relapses were missed, no significant disability changes were reported nor detected compared to pre-lockdown evaluation. Finally, patients' satisfaction of this modality was very high.