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Transparent symptom burden score for COVID-19 and overlapping viral illnesses: breathing difficulty, chest pain, confusion, cyanosis, optional pulse oximeter band, dehydration signs, fever, cough, and weakness. An emergency pattern flag mirrors common call emergency services teaching—not PCR diagnosis, WHO staging, or treatment prescribing. See also flu risk and CDC COVID guidance.
Last updated: June 4, 2026
Mild burden (educational)
3
Breathing
0
Chest
0
Confusion
0
Cyanosis
0
SpO₂
0
Fluids
0
Fever
2
Cough/throat
1
Weakness
0
Lower burden on this checklist: continue routine monitoring; seek care if symptoms escalate, new red-flag signs appear, or you cannot maintain fluids.
Pulse oximeters can misread with cold fingers, nail polish, or poor fit. Follow device instructions and local public health testing guidance—this page does not tell you whether you have COVID-19.
Default (fever + cough)
3 pts
Mild burden
Moderate stack + SpO₂ 90–93%
12 pts
High burden
Breathing + SpO₂ below 90%
17 pts
Emergency flag: yes
| Domain | Points | Teaching note |
|---|---|---|
| Severe trouble breathing | 5 | Highest single weight; hypoxic respiratory failure theme |
| New confusion / hard to arouse | 5 | Altered perfusion or hypoxia—emergency pattern |
| Bluish lips or face | 5 | Cyanosis—emergency pattern |
| Persistent chest pain or pressure | 4 | ACS, PE, myocarditis in differential—emergency pattern |
| SpO₂ 90–93% (room air) | 4 | Urgent evaluation often advised; flag not auto-set here |
| SpO₂ below 90% | 10 | Triggers emergency pattern when selected |
| Unable to keep fluids down | 3 | Dehydration risk; overlaps with other viral illness |
| Fever or shaking chills | 2 | Systemic inflammatory symptom |
| Severe weakness or dizziness | 2 | May reflect dehydration, sepsis, or hypoxia |
| Persistent cough or severe sore throat | 1 | Common but lower weight alone |
| SpO₂ ≥94% or not measured | 0 | No SpO₂ points; severe symptoms still possible |
| Condition | Points | Tier | Teaching action |
|---|---|---|---|
| Any emergency-pattern item OR SpO₂ below 90% | Any | Emergency pattern (teaching) | Immediate emergency medical evaluation in teaching scenarios |
| No emergency pattern | 0–3 | Mild burden | Monitor; seek care if worsening |
| No emergency pattern | 4–8 | Moderate burden | Same-day or urgent clinic contact often reasonable in teaching |
| No emergency pattern | 9+ | High burden | Urgent evaluation especially with low SpO₂ trend or dehydration |
| Item | Points | Sets emergency flag |
|---|---|---|
| Severe trouble breathing | 5 | Yes |
| Persistent chest pain or pressure | 4 | Yes |
| New confusion or hard to arouse | 5 | Yes |
| Bluish lips or face (cyanosis) | 5 | Yes |
| SpO₂ below 90% on room air (if measured) | 10 | Yes |
| Band | Pts | Note |
|---|---|---|
| Not measured | 0 | Absence of a number does not rule out hypoxia if breathing is labored |
| ≥94% room air | 0 | Reassuring if accurate and patient feels well; trend matters |
| 90–93% room air | 4 | Many clinicians want same-day assessment; not auto-emergency flag here |
| Below 90% room air | 10 | Triggers emergency pattern; confirm technique and seek care |
| Feature | WHO | This tool |
|---|---|---|
| Purpose | Surveillance / hospital severity staging (mild, moderate, severe, critical) | Home symptom checklist with transparent points |
| SpO₂ thresholds | Clinical context, oxygen therapy, hospital criteria | Fixed teaching bands; not individualized for COPD baseline |
| Diagnosis | Requires clinical + often laboratory confirmation | Symptom-only; influenza/RSV can score similarly |
| Treatment decisions | Antivirals, steroids, admission per guidelines | No prescribing or isolation rules |
Fever 2 + cough/throat 1 = 3 points
Tier: Mild burden. Emergency pattern: no.
Lower burden on this checklist: continue routine monitoring; seek care if symptoms escalate, new red-flag signs appear, or you cannot maintain fluids.
Breathing 5 + SpO₂ below 90% 10 + fever 2 = 17 points
Emergency pattern: yes (breathing OR SpO₂ below 90% sufficient alone).
Possible emergency pattern on this teaching checklist: trouble breathing, chest pain, confusion, bluish discoloration, or SpO₂ under 90% (if measured) should prompt immediate emergency medical evaluation—not home isolation advice from a website.
Education only. If you think you are having a medical emergency, call your local emergency number immediately. This tool does not diagnose COVID-19, prescribe oxygen, or replace clinician or public health triage.
For public health teaching and home monitoring education