The Post-COVID-19 Functional Status scale: a tool to measure functional status over time after COVID-19

Abstract

Since the outbreak of the coronavirus disease 2019 (COVID-19) pandemic, most attention has focused on containing transmission of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and addressing the surge of critically ill patients in acute care settings. Indeed, as of 29 April 2020, over 3 million confirmed cases have been accounted for globally [1]. In the coming weeks and months, emphasis will gradually involve also post-acute care of COVID-19 survivors. It is anticipated that COVID-19 may have a major impact on physical, cognitive, mental and social health status, also in patients with mild disease presentation [2]. Previous outbreaks of coronaviruses have been associated with persistent pulmonary function impairment, muscle weakness, pain, fatigue, depression, anxiety, vocational problems, and reduced quality of life to various degrees [3-5]. Given the heterogeneity of COVID-19 in terms of clinical and radiological presentation, it is pivotal to have a simple tool to monitor the course of symptoms and the impact of symptoms on the functional status of patients, i.e. a scale that can measure the consequence of the disease beyond binary outcomes such as mortality. In view of the massive number of COVID-19 survivors that require follow-up, an easy and reproducible instrument to identify those patients suffering from slow or incomplete recovery would help in guiding considered use of medical resources and will also standardise research efforts.

Patient-reported outcome measures after COVID-19: a prospective cohort study

“…The most common pre-existing comorbidities identified by the CCI were diabetes (26%), pulmonary disease (8%), and history of myocardial infarction (8%), with 59% of patients not having any comorbidities. Patients were assessed a median of 13 (interquartile range, [11][12][13][14] weeks after symptom onset. At least one abnormal PROM was reported in 76% of patients, and 56% had at least 2 abnormal PROMs (Figure 1).…”

“…The importance of PROMs in understanding the impact of COVID-19 has been acknowledged with their inclusion in prospective registries. 13 A greater emphasis on integrating PROMs, in addition to increasing patient engagement, in future studies is needed to ensure that clinical and research efforts are truly patientcentered.…”

Respiratory function in patients post-infection by COVID-19: a systematic review and meta-analysis

“…Given the heterogeneity of the clinical presentation of COVID-19, it is essential to have simple tools to assess and monitor the impact of symptoms on the respiratory function of patients. 28 Considering the large number of COVID-19 survivors who require follow-up, the use of reproducible instruments to identify patients suffering from slow or incomplete recovery will help guide the reasonable use of medical resources. 28 …”

Management of post-acute covid-19 in primary care

“…Monitoring functional status in post-acute coivd-19 patients is not yet an exact science. A post-covid-19 functional status scale has been developed pragmatically but not formally validated27—a simplified version of this is reproduced in the supplementary material.…”