Clinical examination practices and perceptions in the era of COVID-19

ABSTRACT

Introduction The art of clinical examination has been the cornerstone of medical practices since ancient years. Recent technological achievements and their overuse have led falsely to underestimation of their significance, which has been further questioned during the coronavirus disease 2019 (COVID-19) pandemic, due to concerns regarding exposure risk and use of personal protective equipment.

Areas covered The role of clinical examination (namely chest examination) during the pandemic is discussed. Emerging evidence is being accumulated concerning alternatives to traditional practices. Telemedicine stands out as a promising tool, allowing inspection and interaction between physicians and patients, proved to be useful for many medical specialties but not enough for some others. Medical practices cannot remain the same in the era of the COVID-19 pandemic, yet realistic strategies should be adopted for their optimal and safe implementation.

Expert opinion The experiences of a dedicated Reference Center for COVID-19 along with a suggested algorithm for conducting clinical examinations are presented. According to our experience, an initial detailed clinical examination upon admission of each COVID-19 patient appears to be necessary. Then, vital signs and signs of respiratory distress using inspection should be checked frequently. A focused examination approach should be adopted, in case of new onset clinical problems.

KEYWORDS:

• Auscultation
• chest examination
• clinical examination
• COVID-19
• physical examination
• telemedicine

Article highlights

• Clinical examination has been the cornerstone of medical practices since ancient years

• The importance of clinical examination (namely chest examination) has been underestimated during COVID-19 pandemic due to concerns regarding exposure risk and use of personal protective equipment

• Telemedicine has been widely implemented to offer alternatives to traditional practices

• Inspection and interaction offered through telemedicine is useful for some medical specialties, not enough for some others

• The experience along with a suggested algorithm for clinical examination implementation from a COVID-19 Reference Center are presented

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers in this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.