Benefits of Telemedicine for Lyme Disease

Telemedicine may help patients receive earlier evaluation and treatment.
Virtual visits improved access to Lyme disease care.
Researchers also found fewer neurologic complications.

Telemedicine for Lyme disease expanded rapidly during the COVID-19 pandemic and may help improve diagnosis, treatment access, and care for patients with tick-borne illness.

Telemedicine may be especially helpful for patients with possible tick-borne illness, suspicious rashes, or limited access to specialty care.

Telemedicine may help patients receive earlier Lyme disease evaluation and treatment.

A study entitled “The Impact of Telemedicine in the Diagnosis of Erythema Migrans during the COVID Pandemic: A Comparison with In-Person Diagnosis in the Pre-COVID Era,” compared clinical data from 439 patients with an erythema migrans (EM) rash before and after the onset of the pandemic.¹

Participants were treated at an Italian dermatology clinic.

Before the pandemic, most individuals with an EM rash were diagnosed during in-person visits. After the pandemic began, many patients were evaluated using telemedicine.

1. Earlier Lyme Disease Treatment

One important benefit of telemedicine for Lyme disease was earlier treatment.

The number of individuals with an EM rash who were treated within two months improved from 35% before the pandemic to 85% after the pandemic.

Earlier diagnosis allowed physicians to begin antibiotic therapy sooner, potentially reducing the risk of neurologic and joint complications associated with delayed Lyme disease treatment.

Telemedicine may be especially helpful when patients develop suspicious symptoms but cannot quickly access in-person care.

2. Improved Access to Lyme Disease Care

Telemedicine also improved access to Lyme disease care.

The clinic was able to provide consultations for patients living far from the medical center, including individuals residing in areas considered non-endemic for Lyme disease.

“While during the COVID pandemic a significantly higher rate of patients who resided far from the consultation center were able to receive a virtual consultation and be included in the study thanks to telemedicine,” the authors wrote.

Telemedicine also allowed physicians to provide long-distance advice to children with suspicious skin lesions.

“Our results are in line with other authors highlighting that during COVID lockdown telemedicine proved to be an effective way to provide long-distance advice regarding skin lesions in children.”

Three pregnant women also received prompt treatment during the pandemic. They were treated with amoxicillin within 1–2 months after the EM rash appeared, preventing complications and resulting in healthy newborns.

3. Lower Rate of Neurologic Symptoms

The rate of neurologic symptoms, except for headaches, was lower among patients treated after the introduction of telemedicine.

The authors suggested that earlier Lyme disease treatment and improved access to care may have reduced neurologic complications.

“The number of these patients was significantly higher in the in-person consultation group,” the authors wrote, possibly reflecting delays in diagnosis and treatment.

Can Telemedicine Help Evaluate a Tick Bite?

Telemedicine may help physicians evaluate suspicious rashes, tick bites, early Lyme disease symptoms, and erythema migrans lesions—particularly when patients live far from specialty centers.

Photographs of rashes and virtual consultations may help clinicians decide whether in-person evaluation or early treatment is appropriate.

Telemedicine cannot replace in-person evaluation when neurologic symptoms, cardiac symptoms, or severe systemic illness are present.

For more on delayed diagnosis, see COVID-19 leads to delayed diagnosis of Lyme disease.

Frequently Asked Questions

Can telemedicine diagnose Lyme disease?

Telemedicine may help clinicians recognize erythema migrans rashes and early Lyme disease symptoms, especially when in-person care is not immediately available.

Can telehealth help evaluate a tick bite?

Yes. Virtual visits may help determine whether a tick bite or rash requires further evaluation or treatment.

Does telemedicine improve Lyme disease treatment?

This study found that patients evaluated with telemedicine received earlier treatment and experienced fewer neurologic complications.

Can Lyme disease rashes be evaluated virtually?

In some cases, photographs and video visits may help clinicians evaluate suspicious erythema migrans rashes remotely.

Conclusion

“Our data clearly show that the use of telemedicine for EM diagnosis is helpful as it allows shorter delays in antibiotic therapy and consequently fewer neurological and articular complications.”

The authors concluded that telemedicine could be used both by Lyme disease specialty centers and by general practitioners evaluating patients with possible Lyme disease.

Editor’s note: The higher risk of neurologic symptoms in individuals diagnosed before the pandemic using in-person consultation may also reflect differences in patient evaluation and documentation.

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Dr. Daniel Cameron, MD, MPH
Lyme disease clinician with over 30 years of experience and past president of ILADS.

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