Inpatient Care during the COVID-19 Pandemic: A Survey of Italian Physicians
Open Access
- 1 September 2020
- journal article
- research article
- Published by S. Karger AG in Respiration
- Vol. 99 (8), 667-677
- https://doi.org/10.1159/000509007
Abstract
Background:Coronavirus disease 2019 (COVID-19) is a potentially fatal disease that is of great global public health concern.Objective:We explored the clinical management of inpatients with COVID-19 in Italy.Methods:A self-administered survey was sent by email to Italian physicians caring for adult patients with COVID-19. A panel of experts was selected according to their clinical curricula and their responses were analyzed.Results:A total of 1,215 physicians completed the survey questionnaire (17.4% response rate). Of these, 188 (15.5%) were COVID-19 experts. Chest computed tomography was the most used method to detect and monitor COVID-19 pneumonia. Most of the experts managed acute respiratory failure with CPAP (56.4%), high flow nasal cannula (18.6%), and non-invasive mechanical ventilation (8%), while an intensivist referral for early intubation was requested in 17% of the cases. Hydroxychloroquine was prescribed as an antiviral in 90% of cases, both as monotherapy (11.7%), and combined with protease inhibitors (43.6%) or azithromycin (36.2%). The experts unanimously prescribed low-molecular-weight heparin to patients with severe COVID-19 pneumonia, and half of them (51.6%) used a dose higher than standard. The respiratory burden in patients who survived the acute phase was estimated as relevant in 28.2% of the cases, modest in 39.4%, and negligible in 9%.Conclusions:In our survey some major topics, such as the role of non-invasive respiratory support and drug treatments, show disagreement between experts, likely reflecting the absence of high-quality evidence studies. Considering the significant respiratory sequelae reported following COVID-19, proper respiratory and physical therapy programs should be promptly made available.This publication has 31 references indexed in Scilit:
- Clinical Use and Barriers of Thoracic Ultrasound: A Survey of Italian PulmonologistsRespiration, 2020
- Early management of COPD: where are we now and where do we go from here? A Delphi consensus projectInternational Journal of Chronic Obstructive Pulmonary Disease, 2019
- Ultrasound Fissure ObservationSocial psychiatry. Sozialpsychiatrie. Psychiatrie sociale, 2018
- Could BAL Xpert(®) MTB/RIF replace transbronchial lung biopsy everywhere for suspected pulmonary TB patients?2016
- Could BAL Xpert® MTB/RIF replace transbronchial lung biopsy everywhere for suspected pulmonary TB patients?The International Journal of Tuberculosis and Lung Disease, 2016
- Aerosol therapy during mechanical ventilation: an international surveyIntensive Care Medicine, 2013
- A guide for the design and conduct of self-administered surveys of cliniciansCMAJ : Canadian Medical Association Journal, 2008
- Electronic Health Records in Ambulatory Care — A National Survey of PhysiciansThe New England Journal of Medicine, 2008
- Adjusting for multiple testing—when and how?Journal of Clinical Epidemiology, 2001
- Multiple Regression Approach to Analyzing Contingency Tables: Post Hoc and Planned Comparison ProceduresThe Journal of Experimental Education, 1995