PANDAS & COVID-19 Surveillance Form
This form is only to be completed by parents who have a child with confirmed PANDAS and confirmed or suspected COVID-19
Greater than 18
Does your child have a diagnosis of PANDAS
Does your child have a confirmed diagnosis of COVID-19
Suspected (Highly Likely)
Did your Child show an increase in PANDAS symptoms following COVID-19 infection
If they did show an increase in symptoms, how long did this last for?
less than 24 hours
More than 14 days
If there was an increase in symptoms, what treatments did you use?
Addition or increase of antibiotics
Which treatments did your child improve on?
Did your child experience any side effects to treatment? (Give detail below)
Details of side effects (if applicable)
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This form was created inside of Children's e-Hospital.