TABLE 4.
Consensus statements derived from the Delphi process and the level of agreement achieved
| Consensus statement | 1 (lowest relevance) | 2 | 3 | 4 | 5 (highest relevance) | Mean±sd |
| 1. Large droplets increase the risk of respiratory viral infection through direct transmission. | 0 (0.0) | 6 (16.2) | 6 (16.2) | 10 (27.0) | 15 (40.5) | 3.9±1.1 |
| 2. Respiratory viral infections are more likely to occur in older patients (with or without comorbidities) and infants. | 1 (2.7) | 5 (13.5) | 10 (27.0) | 12 (32.4) | 9 (24.3) | 3.6±1.1 |
| 3. Elderly patients are more likely to develop acute respiratory distress syndrome and there is an age-related death risk. | 0 (0.0) | 0 (0.0) | 4 (10.8) | 10 (27.0) | 23 (62.2) | 4.5±0.7 |
| 4. Antibodies might neutralise respiratory viruses and, then, decrease the risk of recurrent infections. | 0 (0.0) | 4 (10.8) | 7 (18.9) | 17 (46.0) | 9 (24.3) | 3.8±0.9 |
| 5. BCG vaccination might offer protection against COVID-19. RCTs are needed. | 4 (10.8) | 7 (18.9) | 10 (27.0) | 10 (27.0) | 6 (16.2) | 3.2±1.2 |
| 6. Severe COVID-19 is associated with rapid virus replication, massive inflammatory cell infiltration in the lung and elevated pro-inflammatory cytokine/chemokine response. | 0 (0.0) | 0 (0.0) | 1 (2.7) | 7 (18.9) | 29 (78.4) | 4.8±0.5 |
| 7. High initial SARS-CoV-2 load in the airways, older age (≥65 years) and comorbidities of the infected individual are associated with worse COVID-19 outcome and thus patients with these risk factors need close attention. | 0 (0.0) | 0 (0.0) | 3 (8.1) | 7 (18.9) | 27 (73.0) | 4.7±0.6 |
| 8. The combination of CT scan findings (ground-glass opacity and consolidation), clinical presentation respiratory parameters (SpO2 and PaO2/FIO2) and blood tests (C-reactive proteins, lymphocyte number, fibrinogen, D-dimers, IL-6) helps identifying COVID-19 patients at highest risk for ICU transfer. | 0 (0.0) | 1 (2.7) | 0 (0.0) | 10 (27.0) | 26 (70.3) | 4.6±0.6 |
| 9. CD4 T-cell count is key to guide the aetiological evaluation of lung infections in HIV-infected individuals. | 0 (0.0) | 3 (8.1) | 7 (18.9) | 18 (48.7) | 9 (24.3) | 3.9±0.9 |
| 10. Temporary immunosuppression induced by TB might increase the susceptibility to influenza viruses. | 2 (5.4) | 6 (16.2) | 8 (21.6) | 18 (32.5) | 9 (24.3) | 3.5±1.2 |
| 11. An excess mortality associated with influenza is found among TB patients. | 1 (2.7) | 5 (13.5) | 8 (21.6) | 15 (40.5) | 8 (21.6) | 3.7±1.1 |
| 12. Chloroquine and hydroxychloroquine have potential to improve the treatment success rate of COVID-19 patients. RCTs are needed. | 4 (10.8) | 8 (21.6) | 10 (27.0) | 9 (24.3) | 6 (16.2) | 3.1±1.3 |
| 13. Public and social distancing reduce the risk of SARS-CoV-2 transmission. | 0 (0.0) | 0 (0.0) | 3 (8.1) | 6 (16.2) | 28 (75.7) | 4.7±0.6 |
| 14. Appropriate use of facial masks (surgical masks in the general population; N95 for HCWs performing aerosol-producing activities) on symptomatic patients and their contacts can reduce the risk of SARS-CoV-2 infection by limiting the spread of droplet nuclei from isolated symptomatic patients. | 0 (0.0) | 0 (0.0) | 1 (2.7) | 9 (24.3) | 27 (73.0) | 4.7±0.5 |
| 15. SARS-CoV-2 virus remains infectious in the environment on different surfaces for days. | 0 (0.0) | 5 (13.5) | 7 (18.9) | 5 (13.5) | 20 (54.1) | 4.1±1.1 |
| 16. Social protection measures and specific national centralised emergency plans can reduce the healthcare and socioeconomic burden of respiratory viral infections resulting in epidemics/pandemics. | 0 (0.0) | 0 (0.0) | 4 (10.8) | 14 (37.8) | 19 (51.4) | 4.4±0.7 |
| 17. Stigma and social discrimination affect all virus-infected population groups but disproportionately the minorities. | 0 (0.0) | 5 (13.5) | 7 (18.9) | 12 (32.4) | 13 (35.1) | 3.9±1.1 |
| 18. Late implementation of national lockdown can itself alone be effective in reducing the burden of COVID-19 but it has serious impact on the society and the economy. | 3 (8.1) | 3 (8.1) | 6 (16.2) | 8 (21.6) | 17 (46.0) | 3.9±1.3 |
Data are presented as n (%), unless otherwise stated. BCG: bacille Calmette–Guérin; RCT: randomised controlled trial; SARS-CoV-2: severe acute respiratory syndrome coronavirus 2; CT: computed tomography; SpO2: arterial oxygen saturation measured by pulse oximetry; PaO2: arterial oxygen tension; FIO2: inspiratory oxygen fraction; IL: interleukin; ICU: intensive care unit; TB: tuberculosis; HCW: healthcare worker.