Post-COVID-19 Functional Status scale
Last reviewed
PCFS: a 0–4 grading of how much daily life is affected
The PCFS scale was proposed by Klok and colleagues in 2020 as a common yardstick for functional status after COVID-19. It gives you a single grade from 0 (no functional limitations) to 4 (severe limitations). It is widely used in long COVID research and rehabilitation, with versions in more than 25 languages.
Its strength is simplicity. It measures consequences for daily life rather than symptoms, so it works as a quick, repeatable tracking measure. Answer the four questions below to find your grade. It takes well under a minute.
Want more detail? The FUNCAP questionnaire profiles what 27 specific activities cost you, and the Bell scale gives a 0–100 functional rating. If your symptoms flare after activity, see the post-exertional malaise questionnaire.
1. Can you live alone without any assistance from another person?
For example: independently washing, dressing, eating, and using the toilet.
2. Are there duties or activities at home or at work that you are no longer able to perform yourself?
Things you did before the infection that you now cannot do at all.
3. Do you suffer from persistent symptoms, pain, depression, or anxiety related to the infection?
For example: fatigue, breathlessness, brain fog, loss of taste or smell, palpitations.
4. Do you need to avoid or reduce your usual duties or activities, or spread them over time?
You can still do everything, but you have to pace, cut back, or plan around symptoms.
Your PCFS grade
Your results over time
Complete this again in a few weeks and the change will show here.
Symptom scores change slowly. A monthly retake is enough to see a trend.
Your results are stored only in this browser, on this device. Nothing is sent to us or to anyone else. They will be lost if you clear this site's data, use a private window, or switch browser or device. You can delete them at any time.
Understanding your PCFS grade
What the score measures
The Post-COVID-19 Functional Status (PCFS) scale grades how much your everyday life is limited, from 0 (no functional limitations) to 4 (severe functional limitations). Klok and colleagues proposed it in 2020, adapting a scale for recovery after blood clots, and it now has more than 25 translations. You grade the average of the past week.
It covers duties and activities at home, work or study, including sport and social life. The four questions follow the flowchart in the manual (PCFS manual (OSF)) and the original paper (Klok et al. 2020).
PCFS grade interpretation
The grades are the bands; there are no other cut-offs.
Grade 0: no symptoms and no limitations. Grade 1: symptoms, pain, depression or anxiety, but all usual activities at the same intensity. Grade 2: usual activities at a lower intensity, or occasionally avoided, reduced or spread out, but all done without help. Grade 3: some usual activities can no longer be done and have been cut back or taken over by others, but you can look after yourself. Grade 4: you need help with daily living, such as eating, washing or using the toilet. If two grades seem to fit, choose the higher one.
No. It records what symptoms do to your daily life, not the symptoms themselves, and it does not ask what causes the limitation. In a study of 1,939 people about three months after COVID-19, symptoms and quality of life got steadily worse from grade 2 to grade 4, while people at grades 0 and 1 did not differ.
That study (Machado et al. 2021) was self-selected and 85% women, with few people at grades 0 and 1; the authors suggest grade 1 still separates incomplete from full recovery.
What a change in score means
No minimal important change has been published. With only five grades, a move from one grade to another is a clear change in what you report, but a steady grade can hide smaller changes. The manual suggests regular checks, such as 4 and 8 weeks after leaving hospital and at 6 months; grade yourself on what you are able to do, not just what you happen to do.
For more detail, pair it with the FUNCAP, the Bell scale or a symptom diary.
What it does not measure
No. It grades how limited you are, whatever the cause, and the manual notes that limitations may or may not be linked to COVID-19. Its authors intend it to be used alongside other measures, not instead of them.
It does not measure fatigue, breathlessness or post-exertional malaise.
Taking this to your GP or consultant
Bring your grade, the date and your saved grades over time, with a note of which activities you have cut back or handed over. Describe it as the Post-COVID-19 Functional Status scale, recommended in the World Health Organization's guideline on clinical management of COVID-19 (de Jong et al. 2023). A grade that is not improving over months is a concrete basis for asking about a long COVID service. It shows how limited you are, not why. See preparing for a GP appointment.
Sources and licence
Based on: Klok FA, Boon GJAM, Barco S, et al. The Post-COVID-19 Functional Status scale: a tool to measure functional status over time after COVID-19. Eur Respir J. 2020;56:2001494 (CC BY-NC 4.0).
- Klok FA, Boon GJAM, Barco S, et al. The Post-COVID-19 Functional Status scale: a tool to measure functional status over time after COVID-19. Eur Respir J 2020;56(1):2001494. Full text
- Post-COVID-19 Functional Status Scale manual, version 2. July 2020. PCFS manual (OSF)
- Machado FVC, Meys R, Delbressine JM, et al. Construct validity of the Post-COVID-19 Functional Status Scale in adult subjects with COVID-19. Health Qual Life Outcomes 2021;19:40. Full text
- de Jong CMM, Le YNJ, Boon GJAM, Barco S, Klok FA, Siegerink B. Eight lessons from 2 years of use of the Post-COVID-19 Functional Status scale. Eur Respir J 2023;61(5):2300416. Full text