'No ticket' treatment centers for former Covid patients at the start

'Ad hoc' centers in hospitals and day hospitals for periodic monitoring and targeted treatments for former Covid patients, in various cases with complications, even stable after overcoming the Covid-19 infection.

Centers that take charge of former patients, with periodic examinations, and which can be accessed without having to pay the ticket.

This is the network that the Federation of hospital internists (Fadoi) is working on, with pilot experiences already started in some Regions.

    The day hospital model for Covid veterans, presented on the occasion of the Fadoi national congress, has already started with regional resolutions in Liguria and Tuscany and in the patchy areas in Lombardy, Lazio, Campania, Calabria, Sicily and Sardinia.

With the other regions ready to follow suit: a table at the Ministry of Health is in fact studying how to extend it to the rest of Italy.

The goal is therefore to take care of patients who, after the infection, are at risk of suffering chronic damage not only to the lungs, but also to the heart, kidneys and brain.

    All with exemption from the ticket.

    And it is the experience gained in the field, together with international studies, that has shown how coronavirus survivors continue to have lung problems that become chronic in 30% of cases and permanent damage extended to other organs.

Hence the multidisciplinary control system developed by the internists, as explained by Paola Gnerre, first level manager of internal medicine at the San Paolo hospital in Savona where one of the first day hospitals for former Covid patients was born, totally free.

In an outpatient setting, he says, "the vital parameters are measured every 3-6-12 and 24 months in former patients, such as heart and respiratory rate, arterial pressure and blood saturation level. The patient is subjected to the same frequency. ECG and respiratory tests to check the state of the heart and lungs and blood tests to check blood counts, kidney function and any inflammatory states. The same time intervals occur to check the body fat mass and take stock of the patient's quality of life through a questionnaire ".

And through this, Gnerre points out, "we have already identified 30% of patients who need further psychological evaluation".

At 1 and 2 years later, an echocardiogram, arterial blood gas analysis and, according to medical opinion, CT scan of the chest or angio-CT are planned.

Even at the Magenta hospital, in the Milanese metropolitan area, explains the head of internal medicine Nicola Mumoli, "we started to follow the most serious ex-patients and we realized that 5% of them have lung scars, while those who had thrombotic episodes heals without any particular aftermath, which instead for many are psychological in nature ".

Also in Tuscany, differentiated paths have been launched for taking charge of former Covid patients, with different protocols for those who had other previous pathologies and those who did not.

    "The experience gained in these months of emergency - explains Dario Manfellotto, president of Fado - has called into question the old hospital organization based on the division into departments, favoring the multispecialist approach which has proved effective today for a systemic disease such as Covid-19 but which it can be the same to face the permanent emergency of chronic diseases ".

    A commitment came from the Deputy Minister of Health Pierpaolo Sileri: "As a ministry - he stated in connection with the Fadoi congress - we will favor these paths, financing them so that they are free tickets for those who have to undergo a long series of periodic checks".

(HANDLE).