The Patient's History
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The History of illness obtained in the setting of "long-term" COVID-19 has elements that are usual, but many that must now reflect events and findings specific to this transmissible illness.
The impact of any illness will be more severe if pre-existing morbidity is present in a given person.
The characteristics of where and how this viral illness was transmitted are important and ill likely relate, to the degree that they are know, to severity of illness. If being quarantined is a part of therapy, potential or actual, that is diffrent from most other illnesses. How difficult is that? Does duration of confinement correlate with difficulty and with other aspects of outcome?
Symptoms obtained from the patient are usually and most usefully done by first asking one leading question that introduces the topic, then listening quietly but attentively to what and how the patient responds.
Subsequently, a process guided by the questionner, keeps responses on target, and allows further exposition or dismissal of information that is forthcoming. That process was not possible in applying the questionnaire.
One goal was to distinguish symptoms present before illness, at its start, and during its primary course.
That requires an accurate memory. So symptoms on the day of response to the questionnaire were also included.
A total of 54 symptoms were responded to at each of thes 4 periods, and as being present or absent.
That may seem a daunting feat, but no respondent skipped these 4 questions. While a "shopping list" of questions is less desireable than the usual pursuit of relevant symptoms in a guided interview related to chief complaint and history, distinct patterns of response nevertheless emerged and have seemed useful for understanding this illness. Those will be presented subsequently.
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