Ongoing patient symptom monitoring

The National COVID-19 Clinical Evidence Taskforce advises patients with COVID-19 and their caregivers or family members to look out for the development of new or worsening symptoms.5

GPs can provide reassurance that four out of five people with COVID-19 will have a mild illness, and will usually recover 2–3 weeks after the initial onset of symptoms.5

If symptoms do worsen, this is most likely to occur in the second or third week of illness.5 A checklist to monitor symptoms during follow-up consultations could include the following:

  • General observation
    • What is their general appearance?
    • What is their colour?
    • What is their level of comfort or distress?
  • Shortness of breath
    • What is the observed respiratory rate?
    • What is the SpO2?
    • Does the patient have any shortness of breath?
    • Is the patient able to speak in full sentences or are they pausing to catch their breath?
    • Has the patient’s breathing changed since yesterday?
    • Can they walk the same distance as yesterday?
    • Can they lie flat at night and sleep without any breathlessness?
    • Does the patient have any cough? Haemoptysis?
  • Fever, myalgia and lethargy
    • Does the patient have a fever?
    • Does the patient have myalgia?
    • Does the patient have any tiredness or lethargy?
    • Is the patient light-headed?
    • Is the patient well hydrated (drinking with clear urine output)?
    • Is the patient experiencing diarrhea, vomiting or loss of appetite?
  • Chest pain
    • Does the patient have any chest pain?
    • Can the patient breathe without chest pain?
  • New symptoms
    • Is the patient displaying/reporting new symptoms? (Refer to Box 6)
    • Is there any calf pain or swelling suggestive of deep vein thrombosis?
  • Confusion
    • Does the patient appear confused or have their caregivers observed any confusion?
  • Daily living
    • Is the patient eating, drinking and sleeping well?
    • Is the patient having increased difficulty with their activities of daily living?
  • Mental health
    • Is there evidence of
      • anxiety?
      • changes in mood or affect (eg depression)?
      • lethargy?
      • suicidal ideation?
  • Deterioration
    • Has the patient deteriorated in any way since the last review? How?
    • Does patient care need to be escalated/de-escalated or continued as is? – Refer to the Taskforce’s flowcharts on Pathways to care, available here.
  • Patients can record and track their symptoms using a symptom diary, and escalate care according to their action plan – available here.