This guideline is for patients ≥ 16 years of age with confirmed or strongly suspected COVID. Patients under 16 years old should be treated as per the interim guidelines.
For guidance on this, please see epidemiological criteria found here.
COVID-19 is the illness caused by infection with SARS-CoV-2. It has multisystem features, but upper and lower respiratory features are most prominent. Other clinical presentations include gastrointestinal illness, neurological dysfunction and cardiac dysfunction.
Confirmed or suspected COVID-positive patients must be fully assessed to exclude other serious conditions, particularly as the disease has the potential to cause or exacerbate other pathologies.
The Omicron variant is at high risk of becoming the dominant strain in WA. This strain is characterised by extremely high transmissibility via the airborne route and, in most patients, a milder clinical course than previous variants (although this finding may just reflect the very high vaccination rate in the community).
Other reported non-specific symptoms of COVID-19 include: fatigue, headache, runny nose, acute blocked nose (congestion), muscle pain, joint pain, diarrhoea, nausea/vomiting and loss of appetite.
Based on your assessment of the patient, they can be categorised into 4 groups:
|Mild||Moderate||Severe / Critical|
Hypoxia / Shock
If the patient has any significant risk factors (see below), they should be moved into the low risk category
Shortness of Breath (SOB):
Extreme fatigue preventing self-care
Dizziness (mild) that is momentary and self-resolving
Moderate GI symptoms likely to cause future severe dehydration
If the patient has any significant risk factors (see below), they should be moved into the high risk category
Shortness of Breath (SOB)
Syncope / severe dizziness
Significant risk factors with inadequate support
|Self-care||Timely medical review||Emergency department review||Urgent prehospital care|
Advise patient they require a medical review, and to call their GP as soon as possible,
if risks cannot be appropriately addressed, transport
VEM Ambulance referral (preferred)
Manage as per CPGs
Manage as per CPGs
Shortness of breath is one of the strongest predictors of deterioration to severe illness.
Many patients with COVID-19 will have typical viral gastrointestinal symptoms such as nausea, vomiting, diarrhoea and abdominal cramping. Abdominal pain is often related to diarrhoea and is typically benign. However, maintain a high index of suspicion for a surgical or gynaecological causes co-presenting with COVID-19.
There is no specific number or type of risk factors that dictates transport vs non-transport. The greater the number of risk factors, the higher the overall risk. Where there are multiple significant risk factors present and little support available, consider transport if there is no other way to address risk.