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COVID-19: Eight key insights from a short & small survey with Spanish doctors

COVID-19 clinical course, testing and treatments used in hospitalized and ambulatory patients

1. Timing of COVID-19 could be improved:

Our insight:

  • 5-7 days delay between first symptoms & healthcare intervention could be improved.

  • This delay could significantly affect the evolution, prognosis and outcome in some patients.

  • Probably this time-frame will be shorten in future as the patients and doctors are more vigilant and aware about the disease.

  • Delay between symptoms presentation and healthcare seek: 6-7 days in patients hospitalized versus 5 days in mild-patients attended with at-home follow-up system.

  • 2-4 days between general hospitalization and ICU hospitalization.

  • Average of 11-14 days of hospital stay in hospitalized patients.

2. Increase testing in patients followed at-home is needed:

Our insight:

  • Massive testing must be implemented to at least all the patients showing symptoms.

  • Only 22% of patients with mild disease were tested to confirm the diagnosis of COVID-19.

3. At-home follow-up system for mild-patients is good but need some improvement:

Our insight:

  • At-home follow-up has resulted efficient but improvement in communication systems has to be implemented, specially to allow the doctor to verify the symptoms referred by the patients on the phone.

  • The at-home system must facilitate doctors the use of new technologies to contact and follow the patients: real-time audio-video technology must be available to primary care doctors.

  • 3 demands from doctors following patients by phone:

    • Increase testing.

    • Facilitate protective equipment.

    • Improve communication systems.

4. Risk factors (HT and Diabetes) are correlated to severity:

Our insight:

  • Several studies have confirmed the association of certain risk factors to severity.

  • In clinical practice, our study confirm that the presence of hypertension and diabetes increases dramatically with severity and ICU hospitalization.

  • 75% of patients in ICU had hypertension vs only 39% of total patients COVID-19 treated by doctors.

  • 56% of patients in ICU had Diabetes vs only 26% of total patients with COVID-19.

  • ERC, ECV and EPOC seems to be less correlated with severity.

5. Some prognostic markers are used in clinical practice and correlated to severe course:

Our insight:

  • Several studies have established the early markers of severe clinical course.

  • Our study confirm that more severe patients (ICU) had higher lymphopenia, higher D-Dimer levels and higher IL-6 levels vs global.

  • Low lymphocytes count is highly correlated with severity as well as D-Dimer and IL-6.

6. Few treatments are used in clinical practice:

Our insight:

  • Specialists are using treatments in higher % of patients.

  • Hydroxichloroquine & Azitromicin are used in 80-84% of patients treated by specialists.

  • Lopinavir-Ritonavir combination is used in 61% of patients treated by specialists.

7. Doctors have suffered moderate to extreme stress:

Our insight:

  • 100% of participants have some level of stress.

  • 69% of doctors treating COVID-19 in hospitals had moderate-extreme stress.

  • 50% of specialists doctors suffered extreme stress.

  • 38% of primary care doctors suffered extreme stress.

8. Scientific information is demanded by doctors:

Our insight:

  • 81% of doctors request more information and updates about treatment efficacy.

  • 75% of hospital specialists demand more information about other hospital’s protocols of treatment.

  • 63% of hospital specialists demand more information about prognostic factors used in other hospitals.

  • 69% of all doctors demand more information about epidemiology and risk factors.


Online survey performed by Axis Pharma between 15 and 27 April 2020. Sample size is 24 doctors (16 hospital and 8 primary care doctors doing at-home and phone follow-up).


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