Coronavirus anxiety scale (CAS)

coronavirus, coronavirus infection, COVID-19, covid

Ask the patient to choose an answer that best describes how they have felt and conducted themselves over the past 2 weeks:

I felt dizzy, lightheaded, or faint when I read or listened to news about the coronavirus:
Not at all
Rare, less than a day or two
Several days
More than 7 days
Nearly every day over the last 2 weeks

I had trouble falling or staying asleep because I was thinking about the coronavirus:
Not at all
Rare, less than a day or two
Several days
More than 7 days
Nearly every day over the last 2 weeks

I felt paralyzed or frozen when I thought about or was exposed to information about the coronavirus:
Not at all
Rare, less than a day or two
Several days
More than 7 days
Nearly every day over the last 2 weeks

I lost interest in eating when I thought about or was exposed to information about the coronavirus:
Not at all
Rare, less than a day or two
Several days
More than 7 days
Nearly every day over the last 2 weeks

I felt nauseous or had stomach problems when I thought about or was exposed to information about the coronavirus:
Not at all
Rare, less than a day or two
Several days
More than 7 days
Nearly every day over the last 2 weeks



Total patient’s points Values Result
0 0 0

Variable Points
I felt dizzy, lightheaded, or faint when I read or listened to news about the coronavirusNot at all0
 Rare, less than a day or two1
 Several days2
 More than 7 days3
 Nearly every day over the last 2 weeks4
I had trouble falling or staying asleep because I was thinking about the coronavirusNot at all0
 Rare, less than a day or two1
 Several days2
 More than 7 days 3
 Nearly every day over the last 2 weeks4
I felt paralyzed or frozen when I thought about or was exposed to information about the coronavirusNot at all 0
 Rare, less than a day or two1
 Several days2
 More than 7 days3
 Nearly every day over the last 2 weeks4
I lost interest in eating when I thought about or was exposed to information about the coronavirusNot at all0
 Rare, less than a day or two1
 Several days2
 More than 7 days3
 Nearly every day over the last 2 weeks4
I felt nauseous or had stomach problems when I thought about or was exposed to information about the coronavirusNot at all0
 Rare, less than a day or two1
 Several days2
 More than 7 days3
 Nearly every day over the last 2 weeks4

Result

Total pointsValuesResult
 < 9NEGATIVE
There is no COVID-19 pandemic alarm.
 ≥ 9POSITIVE.
Patient with dysfunctional anxiety (Youden score 75) associated with worsening condition amid the COVID-19 pandemic

Patients with score ≥9 are classified as having dysfunctional anxiety (Youden’s index of 75) associated with the COVID-19 crisis (90% sensitivity and 85% specificity). 

Elevated CAS scores were found to be associated with coronavirus diagnosis, impairment, alcohol/drug coping, negative religious coping, extreme hopelessness, suicidal ideation.

Literature:
Lee SA. Coronavirus Anxiety Scale: A brief mental health screener for COVID-19 related anxiety. Death Stud. 2020;44(7):393-401. doi: 10.1080/07481187.2020.1748481. Epub 2020 Apr 16. PMID: 32299304.

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Charlson Comorbidity Index predicts 10-year survival in patients with multiple comorbidities.

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History of definite or probable MI (EKG changes and/or enzyme changes)

Exertional or paroxysmal nocturnal dyspnea and has responded to digitalis, diuretics, or afterload reducing agents

Intermittent claudication or past bypass for chronic arterial insufficiency, history of gangrene or acute arterial insufficiency, or untreated thoracic or abdominal aneurysm (≥6 cm)

History of a cerebrovascular accident with minor or no residua and transient ischemic attacks

Chronic cognitive deficit

Any history of treatment for ulcer disease or history of ulcer bleeding

Severe = cirrhosis and portal hypertension with variceal bleeding history, moderate = cirrhosis and portal hypertension but no variceal bleeding history, mild = chronic hepatitis (or cirrhosis without portal hypertension)

Severe = on dialysis, status post kidney transplant, uremia, moderate = creatinine >3 mg/dL (0.27 mmol/L)


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VariablePointsAge <50…
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