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Table 1 PACS questionnaire

From: Mitigating the risks of post-acute sequelae of SARS-CoV-2 infection (PASC) with intranasal chlorpheniramine: perspectives from the ACCROS studies

Ā 

Questions

Ā Ā 

1

Have you previously tested positive for COVID-19?

Yes

No

2

Have you fully recovered from your COVID-19 illness?

Yes

No

Are you currently experiencing any of the following

3

Fatigue or tiredness that persists even after rest or sleep?

Yes

No

4

Difficulty breathing or shortness of breath?

Yes

No

5

Pain or pressure in the chest?

Yes

No

6

Joint or muscle pain?

Yes

No

7

Headaches?

Yes

No

8

Difficulty concentrating or mental confusion?

Yes

No

9

Loss of taste or smell?

Yes

No

10

Digestive problems such as nausea, vomiting, or diarrhea?

Yes

No

11

Skin rashes or lesions?

Yes

No

12

Mood changes such as depression, anxiety, or irritability?

Yes

No

13

If you answered yes to any of the above symptoms, how long have you been experiencing these symptoms?

< 1wk

1–3 wk

3–6 wk

> 6 wk

14

Have these symptoms affected your ability to perform daily activities or work?

Yes

No

15

Have you sought medical attention for these symptoms?

Yes

No

16

Have you received any treatment for these symptoms?

Yes

No

17

Is there anything else you would like to share about your symptoms or experience with COVID-19?

Yes

No