The Course of Illness

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Questionnaire MindMap - 5 November, 2020 - d



The course of an illness typically has two parts: how the patient is doing now, and everything that came before. 

It's severity is typically judged by a physician at time of presentation. Models have been developed to quantitate illness as well, and predict outcomes, typically in an ICU setting where illness is more severe.


But of course a respondent can usually offere whether her or his care involved a stay in an ICU for instance. So levels of severity can be obtained through the history. 


Here is how the topic is presented to respondents:


"Pick what best summarizes how ill you have been. Each may not be a perfect fit for you. Pick the closest:

- not very sick at all. Tested positive but no symptoms. 
- mild illness. Stayed home. Much like a flu.
- moderate illness. Stayed home but very sick, many symptoms, lasted longer than anticipated.
- severe illness. Hospitalized. Lots of interventions. As bad or worse than any prior illness. Very difficult time.
- critical illness. Treated in Intensive care. Many interventions, supplemental oxygen. Many IV meds. Horrible.
- life threatening illness. Intubated, mechanically ventilated, cardiovascular support, ECMO, in and out of consciousness, secondary infections, family told to expect the worse."



No one skipped this question, and grouped responses did in fact define a level of severity for those presenting with "long term" COVID-19.


Weight change is a part of many serious illnesses. It reflects the increased energy demands at a cellular level due to cellular responses aimed at many diseases, infectious and others. Trauma patients have no infection in most instances, at least initially, yet their energy demands for healig, are huge. BUrns ar the most impressive example of this hypermetabolic state. Most illnesses with such increased demands are associated with weight loss. Especially true if the energy demands are not met.


Again, although many viral illnesses are present in the Index of a text of Infectious Diseases, this is a novel coronavirus. It's impact on the tissues of the body are diffuse and may present surprises.


Studying the course of illness through this questionnaire may present several of these unanticipated results.


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