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.