28 Feb 2023

The CovPall study, has recently been recognised as the most successful response to the Covid-19 pandemic informed by applied research by judges at NIHR ARC South London’s Know your ARC awards.

The new measure, Integrated Palliative care Outcome Scale adapted for Covid (IPOS-COV) is designed to support clinical decisions, inform case management and monitoring of patients severely ill with Covid. It was validated in 572 patients with severe Covid-19 seen by 25 NHS and non-NHS palliative care services across England and Wales, including a large cohort of patients seen by south London palliative care teams.  

patient with Covid

IPOS COV is the first patient-centred measure adapted for severe Covid to support timely management.   It is a 14-item brief multi-dimensional tool, adapted for reporting by health or social care staff.

IPOS-COV has four clinically relevant subscales:

(1) the Breathlessness-agitation (agitation, anxiety and breathlessness)

(2) Gastro-intestinal (nausea and vomiting)

(3) Drowsiness-delirium (drowsiness, weakness or lack of energy, confusion or delirium)

(4) Flu (Sore or dry mouth or throat, fever, cough, shivering, pain)

Individual item scores can also be used to monitor certain symptoms or identify predictors of clinical outcomes such as deterioration.  The paper has been accepted for publication in Health and Quality of Life Outcomes. IPOS-COV is available to download from Palliative care Outcome Scale website (www.pos-pal.org ).


More people are aware of the impact of Covid-19 on related respiratory conditions and the importance of receiving necessary care and resources to aid those most affected

Rashmi Kumar

Rashmi Kumar, a patient and public involvement member at the Cicely Saunders Institute

IPOS-COV is a useful tool to assess patients' symptoms and collect data in the inpatient unit. Clinicians can use it confidently to make better decisions to address these. To provide patient centred care and impeccable symptom management, clinicians need validated tools to assess patients and identify the best treatment available. During Covid times, IPOS COV has been successfully used to assess very symptomatic patients, identifying and scoring their symptoms and treating them in a timely manner during the first wave of the pandemic.

Monica Oancea, a pre-doctoral academic fellow and a clinical nurse, who implemented IPOS-COV at her setting