Observational Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Jan 27, 2022; 14(1): 274-286
Published online Jan 27, 2022. doi: 10.4254/wjh.v14.i1.274
COVID-19 emergency: Changes in quality of life perception in patients with chronic liver disease-An Italian single-centre study
Alessandra Zannella, Silvia Fanella, Massimo Marignani, Paola Begini
Alessandra Zannella, Silvia Fanella, Massimo Marignani, Paola Begini, Department of Gastroenterology, Sant’Andrea Hospital, Rome 00189, Italy
Author contributions: Zannella A and Fanella S developed study concept, developed and administered the questionnaire, performed data collection and statistical analysis, and wrote final manuscript; Marignani M developed the questionnaire, contributed to data analysis and statistical analysis, performed initial and final draft review, and supervised the project; Begini P developed study concept and the questionnaire and supervised the project; all authors have read and approved the final manuscript.
Institutional review board statement: The study was conducted according to Sant’Andrea Hospital directives following Latium Region order (No. 3405/2020 and 4888/2020, Regione.Lazio.Ufficiale UO54467/U0218196, 11/03/2020).
Informed consent statement: Written informed consent for publication was obtained from the patients.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE statement, and the manuscript was prepared and revised according to the STROBE statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Silvia Fanella, MD, Doctor, Department of Gastroenterology, Sant’Andrea Hospital, Via di Grottarossa 1089, Rome 00189, Italy. silviafanella91@gmail.com
Received: March 17, 2021
Peer-review started: March 17, 2021
First decision: May 2, 2021
Revised: June 8, 2021
Accepted: December 28, 2021
Article in press: December 28, 2021
Published online: January 27, 2022
Processing time: 309 Days and 17.2 Hours
Abstract
BACKGROUND

In December 2019, the coronavirus disease-2019 (COVID-19) emerged and rapidly spread worldwide, becoming a global health threat and having a tremendous impact on the quality of life (QOL) of individuals.

AIM

To evaluate the awareness of patients with chronic liver disease (CLD) regarding the COVID-19 emergency and how it impacted on their QOL.

METHODS

Patients with an established diagnosis of CLD (cirrhosis, autoimmune hepatitis, primary biliary cholangitis, and primary sclerosing cholangitis) who had been evaluated at our Outpatient Liver Disease Clinic during the 6-mo period preceding the start of Italian lockdown (March 8, 2020) were enrolled. Participants were asked to complete a two-part questionnaire, administered by telephone according to governmental restrictions: The first section assessed patients’ basic knowledge regarding COVID-19, and the second evaluated the impact of the COVID-19 emergency on their QOL. We used the Italian version of the CLD questionnaire (CLDQ-I). With the aim of evaluating possible changes in the QOL items addressed, the questionnaire was administered to patients at the time of telephone contact with the specific request to recall their QOL perceptions during two different time points. In detail, patients were asked to recall these perceptions first during time 0 (t0), a period comprising the 2 wk preceding the date of ministerial lockdown decree (from February 23 to March 7, 2020); then, in the course of the same phone call, they were asked to recall the same items as experienced throughout time 1 (t1), the second predetermined time frame encompassing the 2 wk (from April 6 to April 19) preceding our telephone contact and questionnaire administration. All data are expressed as number (%), and continuous variables are reported as the median (interquartile range). The data were compared using the Wilcoxon paired non-parametric test.

RESULTS

A total of 111 patients were enrolled, of whom 81 completed the questionnaire. Forty-nine had liver cirrhosis, and all of them had compensated disease; 32 patients had autoimmune liver disease. The majority (93.8%) of patients were aware of COVID-19 transmission modalities and on how to recognize the most common alarm symptoms (93.8%). Five of 32 (15.6%) patients with autoimmune liver disease reported having had the need to receive more information about the way to manage their liver disease therapy during lockdown and nine (28.2%) thought about modifying their therapy without consulting their liver disease specialist. About the impact on QOL, all CLDQ-I total scores were significantly worsened during time t1 as compared to time t0.

CONCLUSION

The COVID-19 epidemic has had a significant impact on the QOL of our population of patients, despite a good knowledge of preventive measure and means of virus transmission.

Keywords: COVID-19; Liver disease; Quality of life; Liver cirrhosis; Chronic liver disease questionnaire

Core Tip: Although negative mental health outcomes in the Italian general population during coronavirus disease-2019 (COVID-19) lockdown have already been reported, our study was among one of the first investigating the impact of the COVID-19 pandemic on patients with chronic liver disease and addressing the subpopulation of patients with autoimmune chronic hepatitis.