Feasibility of telehealth in the management of autoimmune hepatitis before and during the COVID-19 pandemic.

Efe, Cumali; Simşek, Cem; Batıbay, Ersin; Calışkan, Ali Rıza; Wahlin, Staffan

OBJECTIVES Autoimmune hepatitis (AIH) is a life-long liver disease for most patients. Telehealth may be an alternative way to follow these patients remotely. We aimed to evaluate the feasibility of telehealth in the management of patients with AIH. The COVID-19 outbreak during the study period provided an opportunity to evaluate any pandemic influence on how telehealth was perceived by patients and physicians. METHODS We included patients with AIH who were followed in the Harran University hospital, Turkey. Patients were managed by either remote telehealth or standard care. The clinical courses of these two groups were compared. RESULTS A total of 46 (telehealth, n=19 and standard care, n= 27) patients (40 female) with a median age of 32 (range 17-74) years at diagnosis were included in the study. Until the start of the COVID-19 pandemic (March 11, 2020), the rates of biochemical remission and relapse after remission were similar in the telehealth and standard care groups (89.5% vs. 89.1% and 15.8% vs. 25.9%, p=ns, for both). The telehealth group maintained remission significantly better than the standard care group (100% vs. 77.3%, p=0.035) during the COVID-19 period. All relapses were due to non-adherence to therapy. Psychiatric problems, pregnancy related issues and drug side-effects could all be managed remotely by telehealth. CONCLUSIONS In this study, we show for the first time that telehealth is a feasible alternative for managing AIH, both under normal circumstances and during the COVID-19 pandemic.