TABLE 4

Consensus statements derived from the Delphi process

Consensus statements1 (lowest relevance)2345 (highest relevance)Mean (sd)
n (%)
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 (peripheral capillary oxygen saturation (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 counts 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 remain 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 socio-economic 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)