Newcastle Post-COVID Syndrome Follow Up Screening Questionnaire

The purpose of the questionnaire is to identify patients who may benefit from a comprehensive face to face multi-disciplinary assessment if symptoms persist 10-12 weeks after the acute illness.

Post-COVID Syndrome Follow Up Questionnaire

Post-COVID Syndrome Follow Up Questionnaire

Section

Have you made a full recovery or are you still troubled by symptoms?
Are you more breathless now than you were before your COVID illness?
Do you feel fatigued (worn out/lacking energy or zest) compared with how you were before your COVID illness?
Do you have a cough (different from any cough you may have had before COVID19)?
Do you get any palpitations? (sense that you can feel your heart pounding or racing)
How is your physical strength? Do you feel so weak that it still limiting what you can do (more than you were pre your COVID illness)?
Do you have any myalgia (‘aching in your muscles’)?
Do you have anosmia (‘no sense of smell’)?
Have you lost your sense of taste?
Is your sleep disturbed (more than it was pre-COVID)?
Have you had any nightmares or flashbacks?
Regarding your mood, is your mood low/do you feel down in the dumps/lacking in motivation/no pleasure in anything?
Do you find yourself feeling anxious/worrying more than you used to?
Have you lost weight (more than 1/2 stone, 3 Kg) since your COVID illness?