Home-care guidelines for patients with COVID-19

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.

 
  1. Communicable Diseases Network Australia. Coronavirus Disease 2019 (COVID-19): CDNA National guidelines for public health units. Version 6.7. Canberra: Department of Health, 2022 Content/cdna-song-novel-coronavirus.htm [Accessed 13 May 2022].
  2. Australian Technical Advisory Group on Immunisation. Clinical guidance for COVID-19 vaccine providers. Canberra; ATAGI, 2022 [Accessed 13 May 2022].
  3. Department of Health. How COVID-19 vaccines work. Canberra, 2022 vaccines/how-they-work [Accessed 19 may 2022].
  4. Rees S, Fisher J. COVID-19 and the mental health of people from refugee backgrounds. Int J Health Serv 2021;50(4):415–17. doi: 10.1177/0020731420942475.
  5. National COVID-19 Clinical Evidence Taskforce. Management of adults with mild COVID-19 (version 42.1). Melbourne, 2022 [Accessed 19May 2022].
  6. Community Health Pathways – NSW Collaboration. COVID-19 Active Case Management, 2022.
  7. National COVID-19 Clinical Evidence Taskforce. Pathways to care for adults with COVID-19 (version 4.2). Melbourne: National COVID-19 Clinical Evidence Taskforce, 2022 [Accessed 19 May 2022].
  8. Agency for Clinical Innovation. Caring for adults and children in the community with COVID-19. Sydney: NSW Health, 2022 [Accessed 19 May 2022].
  9. National COVID-19 Clinical Evidence Taskforce. Pathways to care for children and adolescents with COVID-19 (version 2.1). Melbourne: National COVID-19 Clinical Evidence Taskforce, 2022 [Accessed 19 May 2022].
  10. National COVID-19 Clinical Evidence Taskforce. Steroids for people with asthma or COPD and COVID-19. Melbourne: National COVID-19 Clinical Evidence Taskforce, 2022 [Accessed 19 May 2022].
  11. National COVID-19 Clinical Evidence Taskforce. ACEIs/ARBs in patients with COVID-19. Melbourne: National COVID-19 Clinical Evidence Taskforce, 2022 [Accessed 19 May 2022].
  12. National COVID-19 Clinical Evidence Taskforce. Oestrogen-containing therapies. Melbourne: National COVID-19 Clinical Evidence Taskforce, 2022 [Accessed 10 June 2022].
  13. Cagnacci A, Bonaccorsi G, Gambacciani M, Board of the Italian Menopause Society Collaborators. Reflections and recommendations on the COVID-19 pandemic: Should hormone therapy be discontinued? Maturitas, 2020;138:76–77. doi: 10.1016/j.maturitas.2020.05.022.
  14. Australian Government Department of Health. Lagevrio (molnupiravir) PBS Factsheet. Canberra: DoH, 2022 [Accessed 15 June 2022]
  15. Australian Government Department of Health. Paxlovid® (nirmatrelvir and ritonavir) Pharmaceutical Benefits Scheme Factsheet. Canberra: DoH, 2022 [Accessed 15 June 2022]
  16. National COVID-19 Clinical Evidence Taskforce. Corticosteriods (systemic) for adults. Melbourne: National COVID-19 Clinical Evidence Taskforce, 2022 [Accessed 19 May 2022].
  17. Australian Government Department of Health. Guidance on the use of personal protective equipment (PPE) for health care workers in the context of COVID-19. Canberra: DoH, 2021 [Accessed 19 May 2022].
  18. Infection Control Expert Group. Information about cleaning and disinfection for health and residential care facilities. Canberra: Australian Government, 2020 coronavirus-covid-19-environmental-cleaning-and-disinfection-principles-for- health-and-residential-care-facilities-coronavirus-covid-19-environmental- cleaning-and-disinfection-principles-for-health-and-residential-care-fac.pdf [Accessed 19 May 2022].
  19. The Royal Australian and New Zealand College of Obstetricians and Gynaecologists. Melbourne: RACGP, 2021. A message for pregnant women and their families information-for-pregnant-women [Accessed 19 May 2022]
  20. National COVID-19 Clinical Evidence Taskforce. Pregnancy and Perinatal care. Melbourne: National COVID-19 Clinical Evidence Taskforce, 2022 [Accessed 19 May 2022].
  21. The Royal Children’s Hospital Melbourne. Clinical Practice Guidelines – COVID-19. Melbourne: The Royal Children’s Hospital Melbourne, 2021 [Accessed 19 May 2022].
  22. National COVID-19 Clinical Evidence Taskforce. Management of people with COVD-19 who are older and living with frailty and/or cognitive impairment (version 5.0). Melbourne: National COVID-19 Clinical Evidence Taskforce, 2021 [Accessed 18 May 2022].

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