Inpatient Care during the COVID-19 Pandemic: A Survey of Italian Physicians.
Identifieur interne : 000814 ( Main/Curation ); précédent : 000813; suivant : 000815Inpatient Care during the COVID-19 Pandemic: A Survey of Italian Physicians.
Auteurs : Marina Attanasi [Italie] ; Simone Pasini [Italie] ; Antonio Caronni [Italie] ; Giulia Michela Pellegrino [Italie] ; Paola Faverio [Italie] ; Sabrina Di Pillo [Italie] ; Matteo Maria Cimino [Italie] ; Giuseppe Cipolla [Italie] ; Francesco Chiarelli [Italie] ; Stefano Centanni [Italie] ; Giuseppe Francesco Sferrazza Papa [Italie]Source :
- Respiration; international review of thoracic diseases [ 1423-0356 ] ; 2020.
Descripteurs français
- KwdFr :
- Adulte (MeSH), Adulte d'âge moyen (MeSH), Antibactériens (usage thérapeutique), Anticoagulants (usage thérapeutique), Antiviraux (usage thérapeutique), Azithromycine (usage thérapeutique), Betacoronavirus (MeSH), Canule (MeSH), Cardiologie (MeSH), Enquêtes et questionnaires (MeSH), Hospitalisation (MeSH), Humains (MeSH), Hydroxychloroquine (usage thérapeutique), Héparine bas poids moléculaire (usage thérapeutique), Infections à coronavirus (complications), Infections à coronavirus (diagnostic), Infections à coronavirus (thérapie), Infections à coronavirus (traitement médicamenteux), Inhibiteurs de protéases (usage thérapeutique), Insuffisance respiratoire (thérapie), Insuffisance respiratoire (étiologie), Italie (MeSH), Médecine interne (MeSH), Médecins (MeSH), Orientation vers un spécialiste (MeSH), Pandémies (MeSH), Pneumologie (MeSH), Pneumopathie virale (complications), Pneumopathie virale (diagnostic), Pneumopathie virale (thérapie), Poumon (imagerie diagnostique), Soins de réanimation (MeSH), Sujet âgé (MeSH), Tomodensitométrie (MeSH), Types de pratiques des médecins (MeSH), Unités de soins intensifs (MeSH), Ventilation artificielle (méthodes), Ventilation en pression positive continue (méthodes), Ventilation non effractive (méthodes).
- MESH :
- diagnostic : Infections à coronavirus, Pneumopathie virale.
- imagerie diagnostique : Poumon.
- méthodes : Ventilation artificielle, Ventilation en pression positive continue, Ventilation non effractive.
- thérapie : Infections à coronavirus, Insuffisance respiratoire, Pneumopathie virale.
- traitement médicamenteux : Infections à coronavirus.
- usage thérapeutique : Antibactériens, Anticoagulants, Antiviraux, Azithromycine, Hydroxychloroquine, Héparine bas poids moléculaire, Infections à coronavirus, Inhibiteurs de protéases, Pneumopathie virale.
- étiologie : Insuffisance respiratoire.
- Adulte, Adulte d'âge moyen, Betacoronavirus, Canule, Cardiologie, Enquêtes et questionnaires, Hospitalisation, Humains, Italie, Médecine interne, Médecins, Orientation vers un spécialiste, Pandémies, Pneumologie, Soins de réanimation, Sujet âgé, Tomodensitométrie, Types de pratiques des médecins, Unités de soins intensifs.
- Wicri :
- geographic : Italie.
English descriptors
- KwdEn :
- Adult (MeSH), Aged (MeSH), Anti-Bacterial Agents (therapeutic use), Anticoagulants (therapeutic use), Antiviral Agents (therapeutic use), Azithromycin (therapeutic use), Betacoronavirus (MeSH), Cannula (MeSH), Cardiology (MeSH), Continuous Positive Airway Pressure (methods), Coronavirus Infections (complications), Coronavirus Infections (diagnosis), Coronavirus Infections (drug therapy), Coronavirus Infections (therapy), Critical Care (MeSH), Heparin, Low-Molecular-Weight (therapeutic use), Hospitalization (MeSH), Humans (MeSH), Hydroxychloroquine (therapeutic use), Intensive Care Units (MeSH), Internal Medicine (MeSH), Italy (MeSH), Lung (diagnostic imaging), Middle Aged (MeSH), Noninvasive Ventilation (methods), Pandemics (MeSH), Physicians (MeSH), Pneumonia, Viral (complications), Pneumonia, Viral (diagnosis), Pneumonia, Viral (therapy), Practice Patterns, Physicians' (MeSH), Protease Inhibitors (therapeutic use), Pulmonary Medicine (MeSH), Referral and Consultation (MeSH), Respiration, Artificial (methods), Respiratory Insufficiency (etiology), Respiratory Insufficiency (therapy), Surveys and Questionnaires (MeSH), Tomography, X-Ray Computed (MeSH).
- MESH :
- chemical , therapeutic use : Anti-Bacterial Agents, Anticoagulants, Antiviral Agents, Azithromycin, Heparin, Low-Molecular-Weight, Hydroxychloroquine, Protease Inhibitors.
- geographic : Italy.
- complications : Coronavirus Infections, Pneumonia, Viral.
- diagnosis : Coronavirus Infections, Pneumonia, Viral.
- diagnostic imaging : Lung.
- drug therapy : Coronavirus Infections.
- etiology : Respiratory Insufficiency.
- methods : Continuous Positive Airway Pressure, Noninvasive Ventilation, Respiration, Artificial.
- therapy : Coronavirus Infections, Pneumonia, Viral, Respiratory Insufficiency.
- Adult, Aged, Betacoronavirus, Cannula, Cardiology, Critical Care, Hospitalization, Humans, Intensive Care Units, Internal Medicine, Middle Aged, Pandemics, Physicians, Practice Patterns, Physicians', Pulmonary Medicine, Referral and Consultation, Surveys and Questionnaires, Tomography, X-Ray Computed.
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.
DOI: 10.1159/000509007
PubMed: 32756065
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Fondazione Don Carlo Gnocchi Onlus, Milan, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>U.O. di Recupero e Rieducazione Funzionale, I.R.C.C.S. Fondazione Don Carlo Gnocchi Onlus, Milan</wicri:regionArea></affiliation></author><author><name sortKey="Pellegrino, Giulia Michela" sort="Pellegrino, Giulia Michela" uniqKey="Pellegrino G" first="Giulia Michela" last="Pellegrino">Giulia Michela Pellegrino</name><affiliation wicri:level="1"><nlm:affiliation>Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milan, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milan</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:affiliation>Casa Cura Policlinico, Department of Neurorehabilitation Sciences, Milan, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Casa Cura Policlinico, Department of Neurorehabilitation Sciences, Milan</wicri:regionArea></affiliation></author><author><name sortKey="Faverio, Paola" sort="Faverio, Paola" uniqKey="Faverio P" first="Paola" last="Faverio">Paola Faverio</name><affiliation wicri:level="1"><nlm:affiliation>School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>School of Medicine and Surgery, University of Milano-Bicocca, Monza</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:affiliation>Respiratory Unit, San Gerardo Hospital, ASST Monza, Monza, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Respiratory Unit, San Gerardo Hospital, ASST Monza, Monza</wicri:regionArea></affiliation></author><author><name sortKey="Di Pillo, Sabrina" sort="Di Pillo, Sabrina" uniqKey="Di Pillo S" first="Sabrina" last="Di Pillo">Sabrina Di Pillo</name><affiliation wicri:level="1"><nlm:affiliation>Department of Pediatrics, Pediatric Allergy and Pulmonology Unit, Research Center of Excellence on Aging, University of Chieti, Chieti, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Pediatrics, Pediatric Allergy and Pulmonology Unit, Research Center of Excellence on Aging, University of Chieti, Chieti</wicri:regionArea></affiliation></author><author><name sortKey="Cimino, Matteo Maria" sort="Cimino, Matteo Maria" uniqKey="Cimino M" first="Matteo Maria" last="Cimino">Matteo Maria Cimino</name><affiliation wicri:level="1"><nlm:affiliation>Division of Hepatobiliary and General Surgery, Department of Surgery, Humanitas Clinical and Research Hospital Center - IRCCS, Humanitas University, Rozzano, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Division of Hepatobiliary and General Surgery, Department of Surgery, Humanitas Clinical and Research Hospital Center - IRCCS, Humanitas University, Rozzano</wicri:regionArea></affiliation></author><author><name sortKey="Cipolla, Giuseppe" sort="Cipolla, Giuseppe" uniqKey="Cipolla G" first="Giuseppe" last="Cipolla">Giuseppe Cipolla</name><affiliation wicri:level="1"><nlm:affiliation>ASST Lodi, UOC Pneumologia, Lodi, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>ASST Lodi, UOC Pneumologia, Lodi</wicri:regionArea></affiliation></author><author><name sortKey="Chiarelli, Francesco" sort="Chiarelli, Francesco" uniqKey="Chiarelli F" first="Francesco" last="Chiarelli">Francesco Chiarelli</name><affiliation wicri:level="1"><nlm:affiliation>Department of Pediatrics, Pediatric Allergy and Pulmonology Unit, Research Center of Excellence on Aging, University of Chieti, Chieti, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Pediatrics, Pediatric Allergy and Pulmonology Unit, Research Center of Excellence on Aging, University of Chieti, Chieti</wicri:regionArea></affiliation></author><author><name sortKey="Centanni, Stefano" sort="Centanni, Stefano" uniqKey="Centanni S" first="Stefano" last="Centanni">Stefano Centanni</name><affiliation wicri:level="1"><nlm:affiliation>Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milan, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milan</wicri:regionArea></affiliation></author><author><name sortKey="Sferrazza Papa, Giuseppe Francesco" sort="Sferrazza Papa, Giuseppe Francesco" uniqKey="Sferrazza Papa G" first="Giuseppe Francesco" last="Sferrazza Papa">Giuseppe Francesco Sferrazza Papa</name><affiliation wicri:level="1"><nlm:affiliation>Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milan, Italy, giuseppe.sferrazza@unimi.it.</nlm:affiliation><country wicri:rule="url">Italie</country><wicri:regionArea>Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milan, Italy</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:affiliation>Casa Cura Policlinico, Department of Neurorehabilitation Sciences, Milan, Italy, giuseppe.sferrazza@unimi.it.</nlm:affiliation><country wicri:rule="url">Italie</country><wicri:regionArea>Casa Cura Policlinico, Department of Neurorehabilitation Sciences, Milan, Italy</wicri:regionArea></affiliation></author></analytic><series><title level="j">Respiration; international review of thoracic diseases</title><idno type="eISSN">1423-0356</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult (MeSH)</term><term>Aged (MeSH)</term><term>Anti-Bacterial Agents (therapeutic use)</term><term>Anticoagulants (therapeutic use)</term><term>Antiviral Agents (therapeutic use)</term><term>Azithromycin (therapeutic use)</term><term>Betacoronavirus (MeSH)</term><term>Cannula (MeSH)</term><term>Cardiology (MeSH)</term><term>Continuous Positive Airway Pressure (methods)</term><term>Coronavirus Infections (complications)</term><term>Coronavirus Infections (diagnosis)</term><term>Coronavirus Infections (drug therapy)</term><term>Coronavirus Infections (therapy)</term><term>Critical Care (MeSH)</term><term>Heparin, Low-Molecular-Weight (therapeutic use)</term><term>Hospitalization (MeSH)</term><term>Humans (MeSH)</term><term>Hydroxychloroquine (therapeutic use)</term><term>Intensive Care Units (MeSH)</term><term>Internal Medicine (MeSH)</term><term>Italy (MeSH)</term><term>Lung (diagnostic imaging)</term><term>Middle Aged (MeSH)</term><term>Noninvasive Ventilation (methods)</term><term>Pandemics (MeSH)</term><term>Physicians (MeSH)</term><term>Pneumonia, Viral (complications)</term><term>Pneumonia, Viral (diagnosis)</term><term>Pneumonia, Viral (therapy)</term><term>Practice Patterns, Physicians' (MeSH)</term><term>Protease Inhibitors (therapeutic use)</term><term>Pulmonary Medicine (MeSH)</term><term>Referral and Consultation (MeSH)</term><term>Respiration, Artificial (methods)</term><term>Respiratory Insufficiency (etiology)</term><term>Respiratory Insufficiency (therapy)</term><term>Surveys and Questionnaires (MeSH)</term><term>Tomography, X-Ray Computed (MeSH)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte (MeSH)</term><term>Adulte d'âge moyen (MeSH)</term><term>Antibactériens (usage thérapeutique)</term><term>Anticoagulants (usage thérapeutique)</term><term>Antiviraux (usage thérapeutique)</term><term>Azithromycine (usage thérapeutique)</term><term>Betacoronavirus (MeSH)</term><term>Canule (MeSH)</term><term>Cardiologie (MeSH)</term><term>Enquêtes et questionnaires (MeSH)</term><term>Hospitalisation (MeSH)</term><term>Humains (MeSH)</term><term>Hydroxychloroquine (usage thérapeutique)</term><term>Héparine bas poids moléculaire (usage thérapeutique)</term><term>Infections à coronavirus (complications)</term><term>Infections à coronavirus (diagnostic)</term><term>Infections à coronavirus (thérapie)</term><term>Infections à coronavirus (traitement médicamenteux)</term><term>Inhibiteurs de protéases (usage thérapeutique)</term><term>Insuffisance respiratoire (thérapie)</term><term>Insuffisance respiratoire (étiologie)</term><term>Italie (MeSH)</term><term>Médecine interne (MeSH)</term><term>Médecins (MeSH)</term><term>Orientation vers un spécialiste (MeSH)</term><term>Pandémies (MeSH)</term><term>Pneumologie (MeSH)</term><term>Pneumopathie virale (complications)</term><term>Pneumopathie virale (diagnostic)</term><term>Pneumopathie virale (thérapie)</term><term>Poumon (imagerie diagnostique)</term><term>Soins de réanimation (MeSH)</term><term>Sujet âgé (MeSH)</term><term>Tomodensitométrie (MeSH)</term><term>Types de pratiques des médecins (MeSH)</term><term>Unités de soins intensifs (MeSH)</term><term>Ventilation artificielle (méthodes)</term><term>Ventilation en pression positive continue (méthodes)</term><term>Ventilation non effractive (méthodes)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Anti-Bacterial Agents</term><term>Anticoagulants</term><term>Antiviral Agents</term><term>Azithromycin</term><term>Heparin, Low-Molecular-Weight</term><term>Hydroxychloroquine</term><term>Protease Inhibitors</term></keywords><keywords scheme="MESH" type="geographic" xml:lang="en"><term>Italy</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="diagnostic" xml:lang="fr"><term>Infections à coronavirus</term><term>Pneumopathie virale</term></keywords><keywords scheme="MESH" qualifier="diagnostic imaging" xml:lang="en"><term>Lung</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Coronavirus Infections</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Respiratory Insufficiency</term></keywords><keywords scheme="MESH" qualifier="imagerie diagnostique" xml:lang="fr"><term>Poumon</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Continuous Positive Airway Pressure</term><term>Noninvasive Ventilation</term><term>Respiration, Artificial</term></keywords><keywords scheme="MESH" qualifier="méthodes" xml:lang="fr"><term>Ventilation artificielle</term><term>Ventilation en pression positive continue</term><term>Ventilation non effractive</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term><term>Respiratory Insufficiency</term></keywords><keywords scheme="MESH" qualifier="thérapie" xml:lang="fr"><term>Infections à coronavirus</term><term>Insuffisance respiratoire</term><term>Pneumopathie virale</term></keywords><keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Infections à coronavirus</term></keywords><keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Antibactériens</term><term>Anticoagulants</term><term>Antiviraux</term><term>Azithromycine</term><term>Hydroxychloroquine</term><term>Héparine bas poids moléculaire</term><term>Infections à coronavirus</term><term>Inhibiteurs de protéases</term><term>Pneumopathie virale</term></keywords><keywords scheme="MESH" qualifier="étiologie" xml:lang="fr"><term>Insuffisance respiratoire</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Betacoronavirus</term><term>Cannula</term><term>Cardiology</term><term>Critical Care</term><term>Hospitalization</term><term>Humans</term><term>Intensive Care Units</term><term>Internal Medicine</term><term>Middle Aged</term><term>Pandemics</term><term>Physicians</term><term>Practice Patterns, Physicians'</term><term>Pulmonary Medicine</term><term>Referral and Consultation</term><term>Surveys and Questionnaires</term><term>Tomography, X-Ray Computed</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Betacoronavirus</term><term>Canule</term><term>Cardiologie</term><term>Enquêtes et questionnaires</term><term>Hospitalisation</term><term>Humains</term><term>Italie</term><term>Médecine interne</term><term>Médecins</term><term>Orientation vers un spécialiste</term><term>Pandémies</term><term>Pneumologie</term><term>Soins de réanimation</term><term>Sujet âgé</term><term>Tomodensitométrie</term><term>Types de pratiques des médecins</term><term>Unités de soins intensifs</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Italie</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>Coronavirus disease 2019 (COVID-19) is a potentially fatal disease that is of great global public health concern.</p></div><div type="abstract" xml:lang="en"><p><b>OBJECTIVE</b></p><p>We explored the clinical management of inpatients with COVID-19 in Italy.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>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.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>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%.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>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.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">32756065</PMID><DateCompleted><Year>2020</Year><Month>10</Month><Day>01</Day></DateCompleted><DateRevised><Year>2020</Year><Month>10</Month><Day>01</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1423-0356</ISSN><JournalIssue CitedMedium="Internet"><Volume>99</Volume><Issue>8</Issue><PubDate><Year>2020</Year></PubDate></JournalIssue><Title>Respiration; international review of thoracic diseases</Title><ISOAbbreviation>Respiration</ISOAbbreviation></Journal><ArticleTitle>Inpatient Care during the COVID-19 Pandemic: A Survey of Italian Physicians.</ArticleTitle><Pagination><MedlinePgn>667-677</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1159/000509007</ELocationID><Abstract><AbstractText Label="BACKGROUND">Coronavirus disease 2019 (COVID-19) is a potentially fatal disease that is of great global public health concern.</AbstractText><AbstractText Label="OBJECTIVE">We explored the clinical management of inpatients with COVID-19 in Italy.</AbstractText><AbstractText Label="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.</AbstractText><AbstractText Label="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%.</AbstractText><AbstractText Label="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.</AbstractText><CopyrightInformation>© 2020 S. Karger AG, Basel.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Attanasi</LastName><ForeName>Marina</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Pediatrics, Pediatric Allergy and Pulmonology Unit, Research Center of Excellence on Aging, University of Chieti, Chieti, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Pasini</LastName><ForeName>Simone</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Internal Medicine Unit, Ospedale Maggiore di Lodi, ASST Lodi, UOC Medicina, Lodi, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Caronni</LastName><ForeName>Antonio</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>U.O. di Recupero e Rieducazione Funzionale, I.R.C.C.S. Fondazione Don Carlo Gnocchi Onlus, Milan, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Pellegrino</LastName><ForeName>Giulia Michela</ForeName><Initials>GM</Initials><AffiliationInfo><Affiliation>Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milan, Italy.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Casa Cura Policlinico, Department of Neurorehabilitation Sciences, Milan, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Faverio</LastName><ForeName>Paola</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Respiratory Unit, San Gerardo Hospital, ASST Monza, Monza, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Di Pillo</LastName><ForeName>Sabrina</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Department of Pediatrics, Pediatric Allergy and Pulmonology Unit, Research Center of Excellence on Aging, University of Chieti, Chieti, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Cimino</LastName><ForeName>Matteo Maria</ForeName><Initials>MM</Initials><AffiliationInfo><Affiliation>Division of Hepatobiliary and General Surgery, Department of Surgery, Humanitas Clinical and Research Hospital Center - IRCCS, Humanitas University, Rozzano, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Cipolla</LastName><ForeName>Giuseppe</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>ASST Lodi, UOC Pneumologia, Lodi, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Chiarelli</LastName><ForeName>Francesco</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Department of Pediatrics, Pediatric Allergy and Pulmonology Unit, Research Center of Excellence on Aging, University of Chieti, Chieti, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Centanni</LastName><ForeName>Stefano</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milan, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sferrazza Papa</LastName><ForeName>Giuseppe Francesco</ForeName><Initials>GF</Initials><AffiliationInfo><Affiliation>Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milan, Italy, giuseppe.sferrazza@unimi.it.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Casa Cura Policlinico, Department of Neurorehabilitation Sciences, Milan, Italy, giuseppe.sferrazza@unimi.it.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><CollectiveName>Collaborators for the RECOVER Investigators Study Group</CollectiveName></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>08</Month><Day>05</Day></ArticleDate></Article><MedlineJournalInfo><Country>Switzerland</Country><MedlineTA>Respiration</MedlineTA><NlmUniqueID>0137356</NlmUniqueID><ISSNLinking>0025-7931</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D000900">Anti-Bacterial Agents</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D000925">Anticoagulants</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D000998">Antiviral Agents</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D006495">Heparin, Low-Molecular-Weight</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D011480">Protease Inhibitors</NameOfSubstance></Chemical><Chemical><RegistryNumber>4QWG6N8QKH</RegistryNumber><NameOfSubstance UI="D006886">Hydroxychloroquine</NameOfSubstance></Chemical><Chemical><RegistryNumber>83905-01-5</RegistryNumber><NameOfSubstance UI="D017963">Azithromycin</NameOfSubstance></Chemical></ChemicalList><SupplMeshList><SupplMeshName Type="Disease" UI="C000657245">COVID-19</SupplMeshName><SupplMeshName Type="Protocol" UI="C000705127">COVID-19 drug treatment</SupplMeshName><SupplMeshName Type="Organism" UI="C000656484">severe acute respiratory syndrome coronavirus 2</SupplMeshName></SupplMeshList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000900" MajorTopicYN="N">Anti-Bacterial Agents</DescriptorName><QualifierName UI="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000925" MajorTopicYN="N">Anticoagulants</DescriptorName><QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000998" MajorTopicYN="N">Antiviral Agents</DescriptorName><QualifierName UI="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D017963" MajorTopicYN="N">Azithromycin</DescriptorName><QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000073640" MajorTopicYN="N">Betacoronavirus</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000072601" MajorTopicYN="N">Cannula</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D002309" MajorTopicYN="N">Cardiology</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D045422" MajorTopicYN="N">Continuous Positive Airway Pressure</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="N">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D018352" MajorTopicYN="N">Coronavirus Infections</DescriptorName><QualifierName UI="Q000150" MajorTopicYN="N">complications</QualifierName><QualifierName UI="Q000175" MajorTopicYN="N">diagnosis</QualifierName><QualifierName UI="Q000188" MajorTopicYN="N">drug therapy</QualifierName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D003422" MajorTopicYN="N">Critical Care</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006495" MajorTopicYN="N">Heparin, Low-Molecular-Weight</DescriptorName><QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006760" MajorTopicYN="Y">Hospitalization</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006886" MajorTopicYN="N">Hydroxychloroquine</DescriptorName><QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D007362" MajorTopicYN="N">Intensive Care Units</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007388" MajorTopicYN="N">Internal Medicine</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007558" MajorTopicYN="N" Type="Geographic">Italy</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008168" MajorTopicYN="N">Lung</DescriptorName><QualifierName UI="Q000000981" MajorTopicYN="N">diagnostic imaging</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008875" 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MajorTopicYN="Y">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D015272" MajorTopicYN="N">Pulmonary Medicine</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012017" MajorTopicYN="N">Referral and Consultation</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012121" MajorTopicYN="N">Respiration, Artificial</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012131" MajorTopicYN="N">Respiratory Insufficiency</DescriptorName><QualifierName UI="Q000209" MajorTopicYN="N">etiology</QualifierName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011795" MajorTopicYN="N">Surveys and Questionnaires</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D014057" MajorTopicYN="N">Tomography, X-Ray Computed</DescriptorName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="Y">Acute respiratory failure</Keyword><Keyword MajorTopicYN="Y">COVID-19</Keyword><Keyword MajorTopicYN="Y">Mechanical ventilation</Keyword><Keyword MajorTopicYN="Y">Pandemic</Keyword><Keyword MajorTopicYN="Y">Pneumonia</Keyword><Keyword MajorTopicYN="Y">Rehabilitation</Keyword><Keyword MajorTopicYN="Y">Steroid</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year><Month>05</Month><Day>14</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2020</Year><Month>05</Month><Day>27</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>8</Month><Day>7</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>10</Month><Day>2</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate 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