Detailed information regarding the clinical management of COVID-19 patients according to physician expertise is displayed in Table ?Table33. Table 3 Knowledge of the management of COVID-19 infection disease = 294)= 188)value(%). cases, both as monotherapy (11.7%), and combined with protease inhibitors (43.6%) Thalidomide-O-amido-C3-NH2 (TFA) 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. = 1,215)= 297)= 188)value(%). ideals are from Pearson’s 2 test after correction with the Holm-Bonferroni method, comparing expert physicians versus sufficiently expert physicians. Bold ideals indicate 0.05. *value from post hoc 2 test. COVID-19, coronavirus disease 2019; CPAP; continuous positive airway pressure; NIV; non-invasive ventilation; ns, not significant. Rabbit polyclonal to STK6 In total, 188 participants (i.e., 15.5% of the total sample) were COVID-19 experts. Among the study specialists, more than half were internal medicine professionals or pulmonologists, were more than 40 years, and experienced completed their fellowship more than 15 years previously. Among the experts, 75.5% worked in Northern Italy, 17.0% in Central Italy, and 6.4% in Southern Italy, in adequate representation of the spread of SARS-CoV-2 in Italy. Overall, 42.0% of the experts worked in community private hospitals, and 22.9% in university hospitals. Nearly all of the experts (95.8%) worked inside a COVID center. Detailed medical management according to the level of physician experience is definitely summarized in Table ?Table22. Table 2 Knowledge of the management of COVID-19 illness disease = 294)= 188)value(%). ideals are from Pearson’s 2 test after correction with the Holm-Bonferroni method. Bold ideals indicate 0.05. *value from your post hoc 2 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 nose cannula; NIV, non-invasive air flow; LMWH, low-molecular-weight heparin; PI, protease inhibitors; AZT, azithromycin; ns, not significant. 1The whole question is explained in the questionnaire in the online supplementary material. When asked if they considered a analysis of COVID-19 illness in a patient with suggestive pneumonia for COVID-19 and one or more bad nasopharyngeal swabs, 86.7% of the experts considered the analysis of COVID-19 very likely (Fig. ?(Fig.1a).1a). About half of the experts (48.9%) Thalidomide-O-amido-C3-NH2 (TFA) used chest computed tomography (CT) check out and 36.7% of them used chest X-ray to diagnose COVID-19 pneumonia in hospitalized individuals (Fig. ?(Fig.1b).1b). Furthermore, chest CT scan (43.1%) and lung Thalidomide-O-amido-C3-NH2 (TFA) ultrasound (LUS; 35.6%) were the preferred imaging methods for follow-up (Fig. ?(Fig.1c).1c). When asked about the management of COVID-19 pneumonia associated with moderate/severe acute respiratory stress syndrome (ARDS), 56.4% of the experts reported using CPAP as first-line treatment, while 18.6% used HFNC and only 8% bilevel NIV. An ICU specialist’s evaluation for early intubation was requested in only 17% of the instances (Fig. ?(Fig.2a).2a). When CPAP was the preferred treatment, most of the specialists (67%) arranged the positive end-expiratory pressure between 10 and 12 cm H20, whilst 17.5% of them set it at 8 cm H2O, and 13.5% at values higher than 12 cm H2O. About 60% of the experts regarded as endotracheal intubation inside a timeframe between 1 and 8 h if initial treatment with CPAP or NIV failed to improve respiratory failure; 34% regarded as early intubation within 1 h and only 6% postponed intubation by 8 h. Open in a separate windowpane Fig. 1 The distribution of the expert physicians’ attitudes toward the interventions for the management of COVID-19 inpatients. a Expert physicians’ attitudes toward the likelihood of COVID-19 analysis in a patient with suggestive pneumonia for COVID-19 and one or.
