Table 2.
Knowledge of the management of COVID-19 infection disease
| Sufficiently expert physicians (n = 294) | Expert physicians (n = 188) | p value | |
|---|---|---|---|
| What do you consider to be the likelihood of COVID-19 pneumonia in a patient with suggestive symptoms and 1 or more negative NPS?1 | ns | ||
| Very likely | 238 (80.1) | 163 (86.7) | |
| Less likely | 56 (18.9) | 21 (11.2) | |
| Unlikely | 3 (1.0) | 4 (2.1) | |
| Which imaging method do you use to diagnose COVID-19 pneumonia? | ns | ||
| Chest CT | 136 (45.8) | 92 (48.9) | |
| Thorax X-ray | 106 (35.7) | 69 (36.7) | |
| LUS | 55 (18.5) | 27 (14.4) | |
| Which imaging method do you use to monitor COVID-19 respiratory consequences? | ns | ||
| Chest CT | 147 (49.5) | 81 (43.1) | |
| LUS | 86 (29.0) | 67 (35.6) | |
| Thorax X-ray | 64 (21.5) | 40 (21.3) | |
| What do you recommend as a first-line treatment in a patient with COVID-19 pneumonia associated with moderate/severe ARDS?1 | ns | ||
| CPAP | 137 (46.1) | 106 (56.4) | |
| HFNC | 44 (14,8) | 35 (18.6) | |
| Urgent endotracheal intubation | 85 (28.6) | 32 (17.0) | |
| NIV | 31 (10.4) | 15 (8.0) | |
| When do you request and/or perform endotracheal intubation if respiratory failure does not improve/worsens after using CPAP/NIV? | ns | ||
| 1–8 h | 177 (59.6) | 106 (56.4) | |
| Within 1 h | 101 (34.0) | 62 (33.0) | |
| >8 h | 19 (6.4) | 20 (10.6) | |
| Do you use LMWH in high-risk patients with COVID-19 pneumonia without contraindications? | ns | ||
| Yes, always | 270 (91.0) | 185 (98.4) | |
| Yes, most of the time | 25 (8.4) | 2 (1.1) | |
| No | 2 (0.6) | 1 (0.5) | |
| If yes, what dose do you use? | 0.018 | ||
| Higher dosages than standard dosages | 105 (35.4) | 97 (51.6) | 0.002* |
| Standard dosages | 192 (64.6) | 91 (48.4) | |
| Do you use corticosteroids in the treatment of acute moderate/severe ARDS?1 | ns | ||
| Yes, since the early phases | 137 (46.1) | 90 (47,9) | |
| Yes, in select cases (resolution of fever ≥72 h or absence of symptoms ≥7 days) | 120 (40.4) | 79 (42.0) | |
| No | 40 (13.5) | 19 (10.1) | |
| Do you use antiviral experimental therapy? | ns | ||
| Chloroquine/hydroxychloroquine + PI | 106 (35.7) | 82 (43.6) | |
| Chloroquine/hydroxychloroquine + AZT | 120 (40.4) | 68 (36.2) | |
| Chloroquine/hydroxychloroquine | 34 (11.4) | 22 (11.7) | |
| Remdesivir | 4 (1.4) | 8 (4.3) | |
| Other | 12 (4.0) | 6 (3.1) | |
| No therapy | 21 (7.1) | 2 (1.1) | |
| Do you request physiotherapy for patients with COVID-19? | ns | ||
| No, the service is not available | 126 (42.4) | 59 (31.4) | |
| No, I don't find it useful | 5 (1.7) | 4 (2.1) | |
| Yes, both | 93 (31.3) | 70 (37.2) | |
| Yes, motor physiotherapy | 39 (13.1) | 29 (15.4) | |
| Yes, respiratory physiotherapy | 34 (11.5) | 26 (13.8) | |
| Do you use the anti-IL6 monoclonal antibody in patients with COVID-19?1 | 0.001 | ||
| In the initial phases of the infection in the presence of risk factors | 86 (29.0) | 77 (41.0) | 0.045* |
| In the advanced phases of the infection <24 h from intubation | 53 (17.8) | 49 (26.1) | |
| In the advanced phases of the infection > 24 h from intubation | 22 (7.4) | 17 (9.0) | |
| I do not use it | 136 (45.8) | 45 (23.9) | |
| Is psychological support for the medical personnel offered in your workplace? | ns | ||
| Yes | 196 (66.0) | 130 (69.1) | |
| No | 101 (34.0) | 58 (30.9) | |
| If yes, did you use it? | |||
| No, I didn't feel the need for it | 165 (55.6) | 103 (54.8) | |
| No, I had no time to attend it | 109 (36.7) | 70 (37.2) | |
| Yes, and it was useful | 19 (6.4) | 12 (6.4) | |
| Yes, but it was useless | 4 (1.3) | 3 (1.6) | |
| Is there a follow-up program for inpatients with pneumonia after discharge?1 | ns | ||
| Yes, by specific territorial outsourcing | 93 (31.3) | 49 (26.1) | |
| Yes, by evaluation of the general practitioner | 80 (27.0) | 36 (19.1) | |
| Yes, by outpatient clinical evaluation shortly | 39 (13.1) | 35 (18.6) | |
| Yes, by telephone service | 26 (8.8) | 19 (10.1) | |
| Yes, by telemedicine | 6 (2.0) | 8 (4.3) | |
| No, it was not expected | 53 (17.8) | 41 (21.8) | |
| Have you reported “sequelae” in hospitalized patients with pneumonia after discharge?1 | ns | ||
| Very serious for both | 16 (5.4) | 12 (6.4) | |
| Modest respiratory consequences | 106 (35.7) | 74 (39.4) | |
| Relevant respiratory consequences | 84 (28.3) | 53 (28.2) | |
| Modest motor consequences | 17 (5.7) | 20 (10.6) | |
| Relevant motor consequences | 33 (11.1) | 12 (6.4) | |
| Negligible | 41 (13.8) | 17 (9.0) |
Values are presented as absolute n (%). p values are from Pearson's χ2 test after correction with the Holm-Bonferroni method. Bold values indicate p < 0.05.
*
p value from the post hoc χ2 test. COVID-19, coronavirus disease 2019; NPS, nasopharyngeal swabs; LUS, lung ultrasound; CT, computed tomography; ARDS, acute respiratory distress syndrome; CPAP, continuous positive airway pressure; HFNC, high-flow nasal cannula; NIV, non-invasive ventilation; LMWH, low-molecular-weight heparin; PI, protease inhibitors; AZT, azithromycin; ns, not significant.
1
The whole question is explained in the questionnaire in the online supplementary material.