COVID-19 pandemic: a large boulder on the head of stoma patients.

Editor

During the COVID-19 pandemic, numbers of patients with colorectal cancer needing a stoma are likely to increase. The recommendations of scientific societies encourage interventions with a lower risk of complications, short recovery time and less likelihood of ICU admission (particularly Hartmann's procedure) in these patients, especially those who test positive for COVID-19.

At present, patients may have great difficulty handling the paperwork required to obtain stoma bags and aids that prevent peristomal skin complications from the National Health System. Furthermore, an additional problem both for patients and caregivers is the possible withdrawal of medical devices from pharmacies due to restrictive measures on mobility.

The Italian government has requested that regional administrations protect patients with disabilities, and many regions have introduced self-renewal of medical prescriptions, strengthened regional services to avoid hospital attendance and provided for direct home delivery of prosthetic devices. These solutions are proving useful and we recommend they be established by all countries.

Viral RNA has been detected in gastrointestinal secretions and faeces, so faecal excretion could represent a further potential route of viral transmission. For this reason, adherence to proper handwashing, use of antiseptic foam, as well as use of appropriate personal protective equipment should be strictly enforced for patients, stoma nurses and caregivers[4,5]. Moreover, the use of stool-containment bags with a safe locking system is recommended to prevent accidental spillage of intestinal material. In COVID-19-positive stoma patients, negative pressure rooms should be considered during procedures, if available.

In conclusion, the COVID-19 pandemic is worsening disability in stoma patients. Only good synergy between adequate government provisions and correct stoma care practices can help overcome this challenging situation.