1. Basic epidemiological data |
Age, years |
Sex |
Type of care activity |
A. Intensive care or first aid doctor |
B. Hospital internal medicine physicians |
C. Dentistry |
D. Doctor working with discharged patients during the pandemic |
E. General practitioner and pediatrician |
F. Outpatient specialist |
G. Other |
2. Did you receive the swab for COVID-19? |
3. If yes, indicate the result among these: |
Positive |
Negative |
4. Did you receive the serological examination for COVID-19? |
5. If yes, indicate the result among these: |
Negative |
Positive only for IgM |
Positive only for IgG |
Positive for both IgM and IgG |
6. Have you been infected by the new SARS-CoV2? (answer yes only in case of positive swab and/or serology) |
7. If yes, indicate the clinical feature among the following: |
Asymptomatic form |
Pauci-symptomatic form (fever> 37.5°, cough, and cooling symptoms) |
Pneumonia and/or respiratory distress |
8. Did you receive BCG vaccine? |
9. If yes, indicate the year of execution of the vaccine (if you do not remember the year, indicate the year of enrolment in the degree course) |