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44442

Description

This CRF is set up in modules to be used for recording data on the ISARIC COVID-19 Core Database or for independent studies. Module 1 and Module 2 complete on the first day of presentation/admission or on first day of COVID-19 assessment. Module 2 also complete on first day of admission to ICU or high dependency unit. In addition, complete daily for as many days as resources allow up to a maximum of 14 days. Continue to follow-up patients who transfer between wards. Module 3 (Outcome) complete at discharge or death General Guidance: - The CRF is designed to collect data obtained through examination, interview and review of hospital notes. Data may be collected retrospectively if the patient is enrolled after the admission date. - For more detailed guidance on how to complete these forms, please refer to the CRF Completion Guideline - Participant Identification Numbers consist of a 3 digit site code and a 4 digit participant number. You can obtain a site code and registering on the data management system by contacting ISARIC. Participant numbers should be assigned sequentially for each site beginning with 0001. In the case of a single site recruiting participants on different wards, or where it is otherwise difficult to assign sequential numbers, it is acceptable to assign numbers in blocks or incorporating alpha characters. E.g. Ward X will assign numbers from 0001 or A001 onwards and Ward Y will assign numbers from 5001 or B001 onwards. Enter the Participant Identification Number at the top of every page. - Printed paper CRFs may be used for later transfer of the data onto the electronic database. - For participants who return for re-admission to the same site, start a new form with a different Participant Identification Number. Please check “YES-admitted previously” in the ONSET & ADMISSION section. Enter as 2 separate entries in the electronic database. - For participants who transfer between two sites that are both collecting data on this form, it is preferred to have the data entered by a single site as a single admission, under the same Participant Identification Number. When this is not possible, the first site should record “Transfer to other facility” as an OUTCOME, and the second site should start a new form with a new patient number and indicate “YES-transferred” in ONSET & ADMISSION. - Complete every line of every section, except for where the instructions say to skip a section based on certain responses. - Mark ‘Not done’ for any results of laboratory values that are not available, not applicable or unknown. - Avoid recording data outside of the dedicated areas. Sections are available for recording additional information. - If using paper CRFs, we recommend writing clearly in ink, using BLOCK-CAPITAL LETTERS. - Place an (X) when you choose the corresponding answer. To make corrections, strike through (-------) the data you wish to delete and write the correct data above it. Please initial and date all corrections. - Please keep all of the sheets for a single participant together e.g. with a staple or participant-unique folder. - ISARIC would like the centers to enter data directly into their electronic data capture system. Please contact ISARIC about access. If your site would like to collect data independently, ISARIC can support you in the estabilishment of locally hosted databases. This version may serve as a basis for locally hosted databases. - Please contact ISARIC, if you need help with databases, have comments or to let ISARIC know that you are using the CRF. - Please let us know if you find any mistakes in the MDM Portal's version. FURTHER GUIDANCE AND DEFINITIONS (from the Completion guideline) Comorbidities: Comorbidities present before the onset of COVID-19 and are still present. Do not include those that developed following the onset of COVID-19 symptoms. More detailed guidance is provided. Hospital admission: For patients who were admitted to hospital with COVID-19 or symptoms consistent with possible COVID-19 infection, please enter details for the date of hospital admission. For patients with a clear alternative diagnosis leading to admission who subsequently acquired COVID-19, original admission date should be provided, but all subsequent references to admission should be taken as referring to day COVID-19 was first clinically suspected (or within the first 24 hours after first day of suspected or confirmed COVID-19 infection). Where a patient was admitted via multiple hospital departments, count admission from the time they came to the first department during the visit that led to their admission (e.g. arrival at the Emergency Department). Oxygen therapy: Include any form of supplemental oxygen received using any methods. Invasive ventilation: Please include any mechanical ventilation delivered following intubation or via a tracheostomy. Do not include patients who are breathing independently via a tracheostomy. Non-invasive ventilation: Please include any positive-pressure treatment given via a tight-fitted mask. This can be continuous positive pressure (CPAP) or bi-level positive pressure (BIPAP). Renal replacement therapy or dialysis: Please include any form of continuous renal replacement therapy or intermittent haemodialysis. Worst result: References to ‘worst result’ refer to those furthest from the normal physiological range or laboratory normal range. Results that were rejected by the clinical team (e.g. pulse oximetry on poorly perfused extremities, haemolysed blood samples, contaminated microbiology results) should not be reported. The following measures should be considered as a single observation and entered together: Blood gas results: Please report the measures from the blood gas with the lowest pH (most acidotic). Blood pressure: Please report the systolic and diastolic blood pressure from the observation with the lowest mean arterial pressure (if mean arterial pressure has not been calculated, report the measurement with lowest systolic blood pressure). Respiratory rate: If both abnormal low and high rate observed, record the abnormally high rate. General information about ISARIC ISARIC has developed a portfolio of resources to accelerate outbreak research and response. All resources are designed to address the most critical public health questions, have undergone extensive review by international clinical experts, and are free to use. ISARIC should be acknowledged and informed if you implement the protocol. Ethical apporval of the protocol and all necessary operational and financial arrangements are the responsibility of the investigators. This form refers to the CoV CASE RECORD FORM Version 1.3 25 Aug 2020. See https://isaric.tghn.org/COVID-19-CRF/

Link

https://isaric.tghn.org/COVID-19-CRF/

Keywords

Versions (2)
  1. 1/18/21 1/18/21 -
  2. 9/20/21 9/20/21 -
Copyright Holder

ISARIC on behalf of Oxford University

Uploaded on

September 20, 2021

DOI

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License

Creative Commons BY-SA 4.0
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    ISARIC/WHO Novel Coronavirus (nCoV) / COVID-19 Case Record Form

    English

    MODULE 3: OUTCOME CASE REPORT FORM

    1 forms  
    Participant Identification
    Description

    Participant Identification

    Alias
    UMLS CUI-1
    C3165543
    Participant Identification Numbers
    Description

    Participant Identification Numbers consist of a 3 digit site code and a 4 digit participant number. You can obtain a site code and registering on the data management system by contacting ncov@isaric.org. Participant numbers should be assigned sequentially for each site beginning with 0001. In the case of a single site recruiting participants on different wards, or where it is otherwise difficult to assign sequential numbers, it is acceptable to assign numbers in blocks or incorporating alpha characters. E.g. Ward X will assign numbers from 0001 or A001 onwards and Ward Y will assign numbers from 5001 or B001 onwards. Enter the Participant Identification Number at the top of every page.

    Data type

    text

    Alias
    UMLS CUI [1]
    C3165543
    At ANY time during hospitalisation, did the patient receive/undergo:
    Description

    At ANY time during hospitalisation, did the patient receive/undergo:

    Alias
    UMLS CUI-1
    C0087111
    Any Oxygen therapy?
    Description

    Complete this field for all patients. If the patient received any form of supplementary oxygen, via nose cannula, mask or non-invasive or invasive ventilation tick ‘yes’ and indicate the total days they received any form of oxygen (O2) therapy. If any supplemental oxygen (at any concentration) was given by any means of delivery at any point during the patient’s hospital stay, place a cross in the box marked ‘yes’. This includes any supplementary oxygen (O2) delivered via non-invasive facemasks/nasal cannula/mask or via invasive mechanical ventilation. Please also indicate the maximum O2 flow volume. If it is not possible to access record of the absolute highest O2 volume delivered during the admission indicate the highest known.

    Data type

    integer

    Alias
    UMLS CUI [1]
    C0184633
    If YES, total duration:
    Description

    Complete this field for all patients. If the patient received any form of supplementary oxygen, via nose cannula, mask or non-invasive or invasive ventilation tick ‘yes’ and indicate the total days they received any form of oxygen (O2) therapy. If any supplemental oxygen (at any concentration) was given by any means of delivery at any point during the patient’s hospital stay, place a cross in the box marked ‘yes’. This includes any supplementary oxygen (O2) delivered via non-invasive facemasks/nasal cannula/mask or via invasive mechanical ventilation. Please also indicate the maximum O2 flow volume. If it is not possible to access record of the absolute highest O2 volume delivered during the admission indicate the highest known. For all questions of duration, please count the number of calendar days that the patient received the treatment. For treatments that were stopped and restarted, count those days on which the treatment was given but don’t count any calendar days on which it was not given at all.

    Data type

    integer

    Measurement units
    • days
    Alias
    UMLS CUI [1,1]
    C0184633
    UMLS CUI [1,2]
    C0449238
    UMLS CUI [1,3]
    C2348235
    days
    Total duration: unknown
    Description

    Complete this field for all patients. If the patient received any form of supplementary oxygen, via nose cannula, mask or non-invasive or invasive ventilation tick ‘yes’ and indicate the total days they received any form of oxygen (O2) therapy. If any supplemental oxygen (at any concentration) was given by any means of delivery at any point during the patient’s hospital stay, place a cross in the box marked ‘yes’. This includes any supplementary oxygen (O2) delivered via non-invasive facemasks/nasal cannula/mask or via invasive mechanical ventilation. Please also indicate the maximum O2 flow volume. If it is not possible to access record of the absolute highest O2 volume delivered during the admission indicate the highest known.

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C0184633
    UMLS CUI [1,2]
    C0449238
    UMLS CUI [1,3]
    C0439673
    Maximum O2 flow volume:
    Description

    Maximum O2 flow volume

    Data type

    integer

    Alias
    UMLS CUI [1]
    C1960999
    Non-invasive ventilation? (Any)
    Description

    If the patient received non-invasive ventilation (NIV), defined as the provision of ventilatory support through the patient's upper airway using a mask or similar device, at any time during their hospital stay, place tick ‘yes’ and enter the total duration in days if known.

    Data type

    integer

    Alias
    UMLS CUI [1]
    C1997883
    If YES, total duration:
    Description

    If the patient received non-invasive ventilation (NIV), defined as the provision of ventilatory support through the patient's upper airway using a mask or similar device, at any time during their hospital stay, place tick ‘yes’ and enter the total duration in days if known. For all questions of duration, please count the number of calendar days that the patient received the treatment. For treatments that were stopped and restarted, count those days on which the treatment was given but don’t count any calendar days on which it was not given at all.

    Data type

    integer

    Measurement units
    • days
    Alias
    UMLS CUI [1,1]
    C1997883
    UMLS CUI [1,2]
    C0449238
    UMLS CUI [1,3]
    C2348235
    days
    Total duration: unknown
    Description

    If the patient received non-invasive ventilation (NIV), defined as the provision of ventilatory support through the patient's upper airway using a mask or similar device, at any time during their hospital stay, place tick ‘yes’ and enter the total duration in days if known.

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C1997883
    UMLS CUI [1,2]
    C0449238
    UMLS CUI [1,3]
    C0439673
    Invasive ventilation (Any)?
    Description

    Invasive ventilation means that patient has undergone tracheal intubation, for the purpose of invasive mechanical ventilation. Invasive ventilation is a method to mechanically assist or replace spontaneous breathing in patients by use of a powered device that forces oxygenated air into the lungs. The mode of intubation may be orotracheal, nasotracheal, or via a cricothyrotomy or tracheotomy.

    Data type

    integer

    Alias
    UMLS CUI [1]
    C1868981
    If YES, total duration:
    Description

    For all questions of duration, please count the number of calendar days that the patient received the treatment. For treatments that were stopped and restarted, count those days on which the treatment was given but don’t count any calendar days on which it was not given at all.

    Data type

    integer

    Measurement units
    • days
    Alias
    UMLS CUI [1,1]
    C1868981
    UMLS CUI [1,2]
    C0449238
    days
    Total duration: unknown
    Description

    Invasive ventilation means that patient has undergone tracheal intubation, for the purpose of invasive mechanical ventilation. Invasive ventilation is a method to mechanically assist or replace spontaneous breathing in patients by use of a powered device that forces oxygenated air into the lungs. The mode of intubation may be orotracheal, nasotracheal, or via a cricothyrotomy or tracheotomy.

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C1868981
    UMLS CUI [1,2]
    C0439673
    Prone Positioning?
    Description

    Prone ventilation refers to ventilation with the patient lying in the prone position. If the patient received prone ventilation at any time during their hospital stay, please tick ‘yes’ and indicate the total duration in days.

    Data type

    integer

    Alias
    UMLS CUI [1,1]
    C0808387
    UMLS CUI [1,2]
    C0033422
    If YES, total duration:
    Description

    Prone ventilation refers to ventilation with the patient lying in the prone position. If the patient received prone ventilation at any time during their hospital stay, please tick ‘yes’ and indicate the total duration in days. For all questions of duration, please count the number of calendar days that the patient received the treatment. For treatments that were stopped and restarted, count those days on which the treatment was given but don’t count any calendar days on which it was not given at all.

    Data type

    integer

    Measurement units
    • days
    Alias
    UMLS CUI [1,1]
    C0808387
    UMLS CUI [1,2]
    C0033422
    UMLS CUI [1,3]
    C0449238
    UMLS CUI [1,4]
    C2348235
    days
    Total duration: unknown
    Description

    Prone ventilation refers to ventilation with the patient lying in the prone position. If the patient received prone ventilation at any time during their hospital stay, please tick ‘yes’ and indicate the total duration in days.

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C0808387
    UMLS CUI [1,2]
    C0033422
    UMLS CUI [1,3]
    C0449238
    UMLS CUI [1,4]
    C0439673
    Inhaled Nitric Oxide?
    Description

    If the patient received inhaled nitric oxide at any time during their hospital stay, place a cross (X) in the box marked ‘yes’. If they did not, place a cross in the box marked ‘no’. If the answer is not known, place a cross in the box marked ‘N/A’.

    Data type

    integer

    Alias
    UMLS CUI [1]
    C1135443
    Tracheostomy inserted?
    Description

    If the patient received a tracheostomy, place a cross (X) in the box marked ‘yes’. If they did not, place a cross in the box marked ‘no’. If the answer is not known, place a cross in the box marked ‘N/A’.

    Data type

    integer

    Alias
    UMLS CUI [1]
    C0040590
    Extracorporeal support?
    Description

    Extracorporeal Life Support (ECLS), also known as Extracorporeal membrane oxygenation (ECMO) is a variation of cardiopulmonary bypass, it maintains tissue oxygenation for days to weeks in patients with life threatening respiratory or cardiac failure (or both). N/A’).

    Data type

    integer

    Alias
    UMLS CUI [1]
    C4068956
    If YES, total duration:
    Description

    Extracorporeal Life Support (ECLS), also known as Extracorporeal membrane oxygenation (ECMO) is a variation of cardiopulmonary bypass, it maintains tissue oxygenation for days to weeks in patients with life threatening respiratory or cardiac failure (or both). N/A’). For all questions of duration, please count the number of calendar days that the patient received the treatment. For treatments that were stopped and restarted, count those days on which the treatment was given but don’t count any calendar days on which it was not given at all.

    Data type

    integer

    Measurement units
    • days
    Alias
    UMLS CUI [1,1]
    C4068956
    UMLS CUI [1,2]
    C0449238
    UMLS CUI [1,3]
    C2348235
    days
    Total duration: unknown
    Description

    Extracorporeal Life Support (ECLS), also known as Extracorporeal membrane oxygenation (ECMO) is a variation of cardiopulmonary bypass, it maintains tissue oxygenation for days to weeks in patients with life threatening respiratory or cardiac failure (or both). N/A’).

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C4068956
    UMLS CUI [1,2]
    C0439673
    Renal replacement therapy (RRT) or dialysis?
    Description

    Renal replacement therapy includes haemodialysis, peritoneal dialysis (PD), intermittent haemodialysis (IHD), on-line intermittent haemofiltration (IHF), on-line haemodiafiltration (IHDF), continuous haemofiltration (CHF) and continuous haemodiafiltration (CHDF), continuous venovenous haemofiltration (CVVH), continuous venovenous haemodialysis (CVVHD), continuous venovenous haemodiafiltration (CVVHDF), slow continuous ultrafiltration (SCUF), continuous arteriovenous haemofiltration (CAVHD) and sustained low- efficiency dialysis (SLED).

    Data type

    integer

    Alias
    UMLS CUI [1]
    C0206074
    UMLS CUI [2]
    C0011946
    Inotropes/vasopressors?
    Description

    A vasopressor is a pharmaceutical agent that causes vasoconstriction. Agents include norepinephrine, epinephrine, vasopressin, terlipressin and phenylephrine. An inotrope is a pharmaceutical agent that alters the force of myocardial contractility. Commonly used ‘positive’ inotropes include dobutamine, dopamine, milrinone and adrenaline (epinephrine). If the patient received a vasopressor or inotrope for at least one hour during their hospital stay, place tick ‘yes’ and the total duration in days if known.

    Data type

    integer

    Alias
    UMLS CUI [1]
    C0304509
    UMLS CUI [2]
    C0042397
    If YES, total duration:
    Description

    A vasopressor is a pharmaceutical agent that causes vasoconstriction. Agents include norepinephrine, epinephrine, vasopressin, terlipressin and phenylephrine. An inotrope is a pharmaceutical agent that alters the force of myocardial contractility. Commonly used ‘positive’ inotropes include dobutamine, dopamine, milrinone and adrenaline (epinephrine). If the patient received a vasopressor or inotrope for at least one hour during their hospital stay, place tick ‘yes’ and the total duration in days if known. For all questions of duration, please count the number of calendar days that the patient received the treatment. For treatments that were stopped and restarted, count those days on which the treatment was given but don’t count any calendar days on which it was not given at all.

    Data type

    integer

    Measurement units
    • days
    Alias
    UMLS CUI [1,1]
    C0042397
    UMLS CUI [1,2]
    C0449238
    UMLS CUI [1,3]
    C2348235
    UMLS CUI [2,1]
    C0304509
    UMLS CUI [2,2]
    C0449238
    UMLS CUI [2,3]
    C2348235
    days
    Total duration: unknown
    Description

    A vasopressor is a pharmaceutical agent that causes vasoconstriction. Agents include norepinephrine, epinephrine, vasopressin, terlipressin and phenylephrine. An inotrope is a pharmaceutical agent that alters the force of myocardial contractility. Commonly used ‘positive’ inotropes include dobutamine, dopamine, milrinone and adrenaline (epinephrine). If the patient received a vasopressor or inotrope for at least one hour during their hospital stay, place tick ‘yes’ and the total duration in days if known.

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C0304509
    UMLS CUI [1,2]
    C0439673
    UMLS CUI [2,1]
    C0042397
    UMLS CUI [2,2]
    C0439673
    ICU or High Dependency Unit admission?
    Description

    Place a cross (X) in the appropriate box: yes, (if admitted) or no (if this is not the case).

    Data type

    integer

    Alias
    UMLS CUI [1]
    C0583239
    UMLS CUI [2]
    C1301858
    If YES, total duration:
    Description

    Please enter the total number of days the patient was admitted to the ICU/HDU, this should include all ICU/HDU admissions if there were more than one. Count any day in which the patient was in ICU/HDU during that 24 hour period (please note this number could be significantly shorter than indicated by the two dates indicated in the first and last day field if the patient was discharged to another ward/unit and readmitted to the ICU/HDU during their hospital stay). For all questions of duration, please count the number of calendar days that the patient received the treatment. For treatments that were stopped and restarted, count those days on which the treatment was given but don’t count any calendar days on which it was not given at all.

    Data type

    integer

    Measurement units
    • days
    Alias
    UMLS CUI [1,1]
    C1627345
    UMLS CUI [1,2]
    C0444921
    UMLS CUI [1,3]
    C2348235
    UMLS CUI [2,1]
    C0021708
    UMLS CUI [2,2]
    C0444921
    UMLS CUI [2,3]
    C2348235
    days
    Total duration: unknown
    Description

    Please enter the total number of days the patient was admitted to the ICU/HDU, this should include all ICU/HDU admissions if there were more than one. Count any day in which the patient was in ICU/HDU during that 24 hour period (please note this number could be significantly shorter than indicated by the two dates indicated in the first and last day field if the patient was discharged to another ward/unit and readmitted to the ICU/HDU during their hospital stay).

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C1627345
    UMLS CUI [1,2]
    C0449238
    UMLS CUI [1,3]
    C0439673
    UMLS CUI [2,1]
    C0021708
    UMLS CUI [2,2]
    C0449238
    UMLS CUI [2,3]
    C0439673
    If YES, date of ICU admission
    Description

    Date of most recent admission from ICU/ HDU. This section may need to be revised if the patient has more than one ICU/HDU admission during a single hospital admission.

    Data type

    date

    Alias
    UMLS CUI [1,1]
    C0583239
    UMLS CUI [1,2]
    C1302393
    UMLS CUI [2,1]
    C1301858
    UMLS CUI [2,2]
    C1302393
    Date of ICU admission: unknown
    Description

    If the answer is YES, please indicate the date on which the patient was first admitted to the intensive care unit / High Dependence Unit (ICU/HDU).

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C0583239
    UMLS CUI [1,2]
    C1302393
    UMLS CUI [1,3]
    C0439673
    UMLS CUI [2,1]
    C1301858
    UMLS CUI [2,2]
    C1302393
    UMLS CUI [2,3]
    C0439673
    If YES, date of ICU discharge:
    Description

    Date of most recent discharge from ICU/ HDU. This section may need to be revised if the patient has more than one ICU/HDU admission during a single hospital admission.

    Data type

    date

    Alias
    UMLS CUI [1,1]
    C1627345
    UMLS CUI [1,2]
    C2361123
    UMLS CUI [2,1]
    C0021708
    UMLS CUI [2,2]
    C2361123
    Date of ICU discharge: unknown
    Description

    Date of most recent discharge from ICU/ HDU. This section may need to be revised if the patient has more than one ICU/HDU admission during a single hospital admission.

    Data type

    date

    Alias
    UMLS CUI [1,1]
    C1627345
    UMLS CUI [1,2]
    C2361123
    UMLS CUI [1,3]
    C0439673
    UMLS CUI [2,1]
    C0021708
    UMLS CUI [2,2]
    C2361123
    UMLS CUI [2,3]
    C0439673
    At any time during hospitalisation did the patient experience
    Description

    At any time during hospitalisation did the patient experience

    Alias
    UMLS CUI-1
    C0009566
    Viral pneumonitis
    Description

    Clinically or radiologically diagnosed viral pneumonitis/pneumonia. For all items in this group: Please select all that were clinically identified at any time during the hospital admission. Do not include known comorbidities (e.g. previous atrial fibrillation should not be included but new onset during this admission should). Record physician diagnosed complications.

    Data type

    integer

    Alias
    UMLS CUI [1]
    C0032310
    Bacterial pneumonia
    Description

    Clinically or radiologically diagnosed bacterial pneumonia (including community, hospital and ventilator acquired) managed with antimicrobials. Bacteriological confirmation not required.

    Data type

    integer

    Alias
    UMLS CUI [1]
    C0004626
    Acute Respiratory Distress Syndrome
    Description

    Defined according to Berlin criteria as: - Occurring within 1 week of a known clinical insult or worsening respiratory symptoms - Bilateral radiological opacities not fully explained by effusions, lobar/lung collapse, or nodules - Respiratory failure not fully explained by cardiac failure or fluid overload

    Data type

    integer

    Alias
    UMLS CUI [1]
    C4534309
    If you ticked "Yes" on Acute Respiratory Distress Syndrome, please specify the severity:
    Description

    Defined according to Berlin criteria as: - Occurring within 1 week of a known clinical insult or worsening respiratory symptoms - Bilateral radiological opacities not fully explained by effusions, lobar/lung collapse, or nodules - Respiratory failure not fully explained by cardiac failure or fluid overload The severity of the hypoxaemia defines the severity of the ARDS: Mild ARDS: The PaO2/FiO2 is >200 mmHg, but ≤300 mmHg, on ventilator settings that include positive end- expiratory pressure (PEEP) or continuous positive airway pressure (CPAP) ≥5 cm H2O. Moderate ARDS: The PaO2/FiO2 is >100 mmHg, but ≤200 mmHg, on ventilator settings that include PEEP ≥5 cm H2O. Severe ARDS: The PaO2/FiO2 is ≤100 mmHg on ventilators setting that include PEEP ≥5 cm H2O. To determine the PaO2/FiO2 ratio, the PaO2 is measured in mmHg and the FiO2 is expressed as a decimal between 0.21 and 1. As an example, if a patient has a PaO2 of 60 mmHg while receiving 60% oxygen, then the PaO2/FiO2 is 60/0.6 = 100 mmHg.

    Data type

    integer

    Alias
    UMLS CUI [1,1]
    C4534309
    UMLS CUI [1,2]
    C0439793
    Pneumothorax
    Description

    Is defined as the abnormal presence of air in the pleural cavity (between the lungs and the chest wall), causing collapse of the lung. It may be diagnosed clinically, usually with radiological confirmation.

    Data type

    integer

    Alias
    UMLS CUI [1]
    C0032326
    Pleural effusion
    Description

    Is defined as increased amounts of fluid within the pleural cavity. It may be diagnosed clinically, with or without radiological or interventional confirmation.

    Data type

    integer

    Alias
    UMLS CUI [1]
    C1253943
    Cryptogenic organizing pneumonia (COP)
    Description

    Idiopathic diffuse interstitial lung disease, diagnosed radiologically (multiple consolidative or ground glass opacities) or histologically (granulation tissue and chronic inflammatory infiltrate in alveoli). Formerly known as bronchiolitis obliterans organizing pneumonia (BOOP)

    Data type

    integer

    Alias
    UMLS CUI [1]
    C0242770
    Bronchiolitis
    Description

    This is a clinical diagnosis.

    Data type

    integer

    Alias
    UMLS CUI [1]
    C0006271
    Cardiac arrest
    Description

    Sudden cessation of cardiac activity with no normal breathing and no signs of circulation.

    Data type

    integer

    Alias
    UMLS CUI [1]
    C0018790
    Myocardial infarction
    Description

    Myocardial ischaemia (MI) leading to injury/necrosis, diagnosed by clinical findings, altered electrocardiography and elevated cardiac enzymes.

    Data type

    integer

    Alias
    UMLS CUI [1]
    C0027051
    Cardiac ischaemia
    Description

    Is defined as diminished blood and oxygen supply to the heart muscle, also known as myocardial ischemia, It is confirmed by an electrocardiogram (showing ischaemic changes, e.g. ST depression or elevation) and/or cardiac enzyme elevation.

    Data type

    integer

    Alias
    UMLS CUI [1]
    C0151744
    Cardiac arrhythmia
    Description

    If a cardiac arrhythmia is identified and there is no previous record of it, select ‘yes’.

    Data type

    integer

    Alias
    UMLS CUI [1]
    C0003811
    Myocarditis / Pericarditis
    Description

    Myocarditis / pericarditis refers to an inflammation of the heart or pericardium (outer lining of the heart). Diagnosis can be clinical, biochemical (cardiac enzymes) or radiological.

    Data type

    integer

    Alias
    UMLS CUI [1]
    C0027059
    UMLS CUI [2]
    C0031046
    Endocarditis
    Description

    Endocarditis is an inflammation of the endocardium (inner lining of the heart). Diagnosis is according to modified Duke criteria, using evidence from microbiological results, echocardiogram and clinical signs.

    Data type

    integer

    Alias
    UMLS CUI [1]
    C0014118
    Cardiomyopathy
    Description

    Structural and functional disorders of myocardium commonly diagnosed by echocardiography. Can be primary (genetic) or secondary (e.g. following myocardial infarction).

    Data type

    integer

    Alias
    UMLS CUI [1]
    C0878544
    Congestive heart failure
    Description

    Is defined as failure of the heart to pump a sufficient amount of blood to meet the needs of the body tissues, resulting in tissue congestion and oedema.

    Data type

    integer

    Alias
    UMLS CUI [1]
    C0018802
    Seizure
    Description

    Select ‘yes’ for any seizure regardless of cause (e.g. febrile or due to epilepsy)

    Data type

    integer

    Alias
    UMLS CUI [1]
    C0036572
    Stroke / Cerebrovascular accident
    Description

    Stroke may be a clinical diagnosis, with or without supportive radiological findings.

    Data type

    integer

    Alias
    UMLS CUI [1]
    C0038454
    Meningitis / Encephalitis
    Description

    Inflammation of the meninges or the brain parenchyma. Select yes if diagnosed clinically, radiologically or microbiologically.

    Data type

    integer

    Alias
    UMLS CUI [1]
    C0497299
    Bacteremia
    Description

    Growth of bacteria on a blood culture. Select ‘no’ if the only bacteria grown were believed to be skin contaminants (e.g. coagulase negative Staphylococci or diphtheroids).

    Data type

    integer

    Alias
    UMLS CUI [1]
    C0004610
    Coagulation disorder / Disseminated Intravascular Coagulation
    Description

    Abnormal coagulation identified by abnormal prothrombin time or activated partial thromboplastin time. Disseminated intravascular coagulation (DIC; consumption coagulopathy; defibrination syndrome) is defined by thrombocytopenia, prolonged prothrombin time, low fibrinogen, elevated D-dimer and thrombotic microangiopathy.

    Data type

    integer

    Alias
    UMLS CUI [1]
    C0012739
    UMLS CUI [2]
    C0005779
    Pulmonary embolism
    Description

    Obstruction of pulmonary artery by thrombus, air or fat. Physician diagnosis based on clinical signs, computed tomographic pulmonary angiography and/or ventilation/perfusion scanning.

    Data type

    integer

    Alias
    UMLS CUI [1]
    C0034065
    Anemia
    Description

    Select ‘yes’ if haemoglobin levels were lower than age- and sex-specific thresholds listed in https://media.tghn.org/medialibrary/2020/04/ISARIC_nCoV_CRF_Completion_Guide_V1.3_24Feb2020.pdf (Page 15 of 22)

    Data type

    integer

    Alias
    UMLS CUI [1]
    C0002871
    Rhabdomyolysis / Myositis
    Description

    Rhabdomyolysis is a syndrome characterised by muscle necrosis and the release of myoglobin into the blood. Muscle biopsy, electromyography, radiological imaging and the presence of myoglobinuria are not required for the diagnosis. Myositis may be a clinical diagnosis with supporting evidence from laboratory tests e.g. elevated serum creatine kinase; histological confirmation is not required to make the diagnosis. Myositis can occur without progression to rhabdomyolysis.

    Data type

    integer

    Alias
    UMLS CUI [1]
    C0035410
    UMLS CUI [2]
    C0027121
    Acute renal injury/ Acute renal failure
    Description

    Acute renal injury is defined as any of: - Increase in serum creatinine by ≥0.3 mg/dL (≥26.5 μmol/L) within 48 hours - Increase in serum creatinine to ≥1.5 times baseline, which is known or presumed to have occurred within the prior 7 days - Urine volume <0.5 mL/kg/hour for 6 hours

    Data type

    integer

    Alias
    UMLS CUI [1]
    C0022660
    UMLS CUI [2]
    C2609414
    Gastrointestinal haemorrhage
    Description

    Refers to bleeding originating from any part of the gastrointestinal tract (from the oropharynx to the rectum).

    Data type

    integer

    Alias
    UMLS CUI [1]
    C0017181
    Pancreatitis
    Description

    Inflammation of the pancreas, diagnosed from clinical, biochemical, radiological or histological evidence.

    Data type

    integer

    Alias
    UMLS CUI [1]
    C0030305
    Liver dysfunction
    Description

    A finding that indicates abnormal liver function, may refer to any of the following: - Clinical jaundice - Hyperbilirubinaemia (blood bilirubin level twice the upper limit of the normal range) - An increase in alanine transaminase or aspartate transaminase that is twice the upper limit of the normal range

    Data type

    integer

    Alias
    UMLS CUI [1]
    C0086565
    Hyperglycemia
    Description

    For adults, is defined as an abnormally high level of glucose in the blood, blood glucose level that is consistently above 126mg/dL or 7 mmol/L. For children, is defined as a blood glucose level consistently above 8.3 mmol/L.

    Data type

    integer

    Alias
    UMLS CUI [1]
    C0020456
    Hypoglycemia
    Description

    For adults, is defined as an abnormally low level of glucose in the blood, a blood glucose level that is consistently below 70mg/dL or 4 mmol/L. For children, is defined as a blood glucose level below 3 mmol/L.

    Data type

    integer

    Alias
    UMLS CUI [1]
    C0020615
    Other Complications
    Description

    Please specify other complications in the space provided.

    Data type

    integer

    Alias
    UMLS CUI [1,1]
    C0009566
    UMLS CUI [1,2]
    C0205394
    If you ticked "Yes" on Other Complications, please specify:
    Description

    Other Complications Specification

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C0205394
    UMLS CUI [1,2]
    C0009566
    UMLS CUI [1,3]
    C2348235
    Diagnostics
    Description

    Diagnostics

    Alias
    UMLS CUI-1
    C0430022
    Was patient clinically diagnosed with COVID-19?
    Description

    Please record if the patient was clinically diagnosed with COVID-19, even if resources did not allow testing or if laboratory results were negative but the clinician judged that based on symptoms, onset and clinical case definitions COVID-19 infection was the most likely cause of the symptoms experienced. Please complete all of the Diagnostics section even if results were negative, to monitor co-infection risk and rates.

    Data type

    integer

    Alias
    UMLS CUI [1,1]
    C5203670
    UMLS CUI [1,2]
    C0332140
    Was pathogen testing done during this illness episode?
    Description

    If laboratory testing was done, complete the section Select YES – Confirmed if the test was positive, Yes – Probable if there was a clinical diagnosis but no positive lab test and NO if the lab test was negative. If the lab test was not done or there is no clinical diagnosis please leave blank.

    Data type

    integer

    Alias
    UMLS CUI [1,1]
    C0450254
    UMLS CUI [1,2]
    C0022885
    UMLS CUI [1,3]
    C0347984
    UMLS CUI [1,4]
    C0012634
    UMLS CUI [1,5]
    C1948053
    Coronavirus
    Description

    If patient diagnosed with COVID-19 either confirmed or probable per definition above mark an 'X' in the box for Novel CoV.

    Data type

    integer

    Alias
    UMLS CUI [1]
    C0206422
    If positive, specify:
    Description

    If patient diagnosed with COVID-19 either confirmed or probable per definition above mark an 'X' in the box for Novel CoV.

    Data type

    integer

    Alias
    UMLS CUI [1,1]
    C0206422
    UMLS CUI [1,2]
    C0449560
    If you ticked "Other", please specify the subtype:
    Description

    Other Coronavirus Subtype

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C0205394
    UMLS CUI [1,2]
    C0206422
    UMLS CUI [1,3]
    C0449560
    UMLS CUI [1,4]
    C2348235
    Influenza
    Description

    Influenza

    Data type

    integer

    Alias
    UMLS CUI [1]
    C0021400
    If positive, specify:
    Description

    Influenza subtype

    Data type

    integer

    Alias
    UMLS CUI [1,1]
    C0021400
    UMLS CUI [1,2]
    C0449560
    If you ticked "other", please specify the subtype:
    Description

    Other Influenza subtype

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C0021400
    UMLS CUI [1,2]
    C0449560
    UMLS CUI [1,3]
    C2348235
    RSV
    Description

    RSV

    Data type

    integer

    Alias
    UMLS CUI [1]
    C0035236
    Adenovirus
    Description

    Adenovirus

    Data type

    integer

    Alias
    UMLS CUI [1]
    C0001483
    Bacteria
    Description

    Bacteria

    Data type

    integer

    Alias
    UMLS CUI [1]
    C0004611
    If positive, specify:
    Description

    Bacteria specification

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C0004611
    UMLS CUI [1,2]
    C2348235
    UMLS CUI [1,3]
    C0370003
    Bacteria: unknown
    Description

    Bacteria specimen unknown

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C0004611
    UMLS CUI [1,2]
    C2348235
    UMLS CUI [1,3]
    C0439673
    Other pathogen/s detected:
    Description

    Other pathogen/s detected

    Data type

    integer

    Alias
    UMLS CUI [1,1]
    C0205394
    UMLS CUI [1,2]
    C0450254
    UMLS CUI [1,3]
    C0243095
    If positive, specify:
    Description

    Other pathogen/s detected - specification

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C0205394
    UMLS CUI [1,2]
    C0450254
    UMLS CUI [1,3]
    C2348235
    Pathogen: unknown
    Description

    Other pathogen/s detected - specimen unknown

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C0205394
    UMLS CUI [1,2]
    C0450254
    UMLS CUI [1,3]
    C0370003
    UMLS CUI [1,4]
    C0439673
    Clinical pneumonia diagnosed?
    Description

    Tick ‘yes’ f this was a Physician diagnosis.

    Data type

    integer

    Alias
    UMLS CUI [1]
    C0543829
    Chest X-Ray performed?
    Description

    Record if X-ray and/or CT were performed, even if no infiltrates were present.

    Data type

    integer

    Alias
    UMLS CUI [1,1]
    C0039985
    UMLS CUI [1,2]
    C0884358
    If Chest X-Ray was performed: Were infiltrates present?
    Description

    Chest X-Ray: infiltrates present

    Data type

    integer

    Alias
    UMLS CUI [1]
    C2073654
    CT performed?
    Description

    Record if X-ray and/or CT were performed, even if no infiltrates were present.

    Data type

    integer

    Alias
    UMLS CUI [1,1]
    C0040405
    UMLS CUI [1,2]
    C0884358
    If CT was performed: Were infiltrates present?
    Description

    CT performed: infiltrates present

    Data type

    integer

    Alias
    UMLS CUI [1]
    C2073654
    Biospecimen Testing
    Description

    Biospecimen Testing

    Alias
    UMLS CUI-1
    C2347026
    UMLS CUI-2
    C0022885
    Collection Date
    Description

    Collection Date

    Data type

    date

    Alias
    UMLS CUI [1]
    C1302413
    Biospecimen Type
    Description

    If the patient had samples taken for pathogen detection testing during their hospital stay, please complete a row for every type of sample collected (e.g. nasal/NP swab, sputum, etc.). Where both positive and negative results for a particular sample type exist (from samples taken at different time points during the patient’s hospital stay) please record the earliest positive result. If only multiple negative results exist for a particular sample type (from samples taken at different time points during the patient’s hospital stay), please document the earliest negative result.

    Data type

    text

    Alias
    UMLS CUI [1]
    C2347029
    If other biospecimen type, please specify
    Description

    Other Biospecimen Type

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C0205394
    UMLS CUI [1,2]
    C2347029
    UMLS CUI [1,3]
    C2348235
    Laboratory test method
    Description

    Laboratory test Method

    Data type

    integer

    Alias
    UMLS CUI [1]
    C2826902
    Other laboratory test method, please specify:
    Description

    Other laboratory test method

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C0205394
    UMLS CUI [1,2]
    C2826902
    UMLS CUI [1,3]
    C2348235
    Laboratory Test Result
    Description

    Laboratory Test Result

    Data type

    integer

    Alias
    UMLS CUI [1]
    C0587081
    Pathogen Tested/Detected
    Description

    Pathogen Tested/Detected

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C0450254
    UMLS CUI [1,2]
    C1511790
    Medication: While hospitalised or at discharge, were any of the following administered? Antiviral therapy
    Description

    Medication: While hospitalised or at discharge, were any of the following administered? Antiviral therapy

    Alias
    UMLS CUI-1
    C0280274
    Antiviral or COVID-19 targeted agent?
    Description

    Record all antivirals administered from date of admission or during the hospitalisation. Record the total number of days the treatment was given. For other antiviral or COVID-19 targeted agents record any medications given to treat COVID-19 that are not already pre-specified elsewhere in this section. Additional space is available under ‘Other treatments...’ at the end of this section if required.

    Data type

    integer

    Alias
    UMLS CUI [1]
    C0003451
    UMLS CUI [2,1]
    C5203670
    UMLS CUI [2,2]
    C2985566
    If YES, specify all agents and duration:
    Description

    Antiviral agents administered

    Data type

    integer

    Alias
    UMLS CUI [1,1]
    C0003451
    UMLS CUI [1,2]
    C2348235
    UMLS CUI [2,1]
    C5203670
    UMLS CUI [2,2]
    C2985566
    UMLS CUI [2,3]
    C2348235
    If another antiviral agent was administered, please specify:
    Description

    Other Antiviral agent

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C0205394
    UMLS CUI [1,2]
    C0003451
    Date commenced:
    Description

    Antiviral agent - Start date

    Data type

    date

    Alias
    UMLS CUI [1,1]
    C0003451
    UMLS CUI [1,2]
    C0808070
    Duration:
    Description

    ‘Antiviral Agent’ refers to any agent(s) prescribed to treat or prevent viral infections by interfering with the viral replication cycle. If the patient received antivirals at any time during their hospital stay, place a cross in the box marked ‘yes’ and also indicate the type of antiviral agent.

    Data type

    integer

    Measurement units
    • days
    Alias
    UMLS CUI [1,1]
    C0003451
    UMLS CUI [1,2]
    C0449238
    days
    Duration: unknown
    Description

    Antiviral treatment duration unknown

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C0003451
    UMLS CUI [1,2]
    C0449238
    UMLS CUI [1,3]
    C0439673
    Medication: While hospitalised or at discharge, were any of the following administered? Antibiotic therapy
    Description

    Medication: While hospitalised or at discharge, were any of the following administered? Antibiotic therapy

    Alias
    UMLS CUI-1
    C0338237
    Antibiotic?
    Description

    ‘Antibiotic’ refers to any agent(s) are substances naturally produced by microorganisms or their derivatives that selectively target microorganisms. These substances are used in the treatment of bacterial and other microbial infections. Topical preparations are not included.

    Data type

    integer

    Alias
    UMLS CUI [1]
    C0338237
    Agent:
    Description

    ‘Antibiotic’ refers to any agent(s) are substances naturally produced by microorganisms or their derivatives that selectively target microorganisms. These substances are used in the treatment of bacterial and other microbial infections. Topical preparations are not included.

    Data type

    text

    Alias
    UMLS CUI [1]
    C0338237
    Date commenced:
    Description

    Antibiotic therapy - Date commenced

    Data type

    date

    Alias
    UMLS CUI [1,1]
    C0808070
    UMLS CUI [1,2]
    C0338237
    Duration:
    Description

    Antibiotic therapy - duration

    Data type

    integer

    Measurement units
    • days
    Alias
    UMLS CUI [1,1]
    C0338237
    UMLS CUI [1,2]
    C0449238
    days
    Duration: unknown
    Description

    Antibiotic therapy duration unknown

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C0338237
    UMLS CUI [1,2]
    C0449238
    UMLS CUI [1,3]
    C0439673
    While hospitalised or at discharge, were any of the following administered? Corticosteriods
    Description

    While hospitalised or at discharge, were any of the following administered? Corticosteriods

    Alias
    UMLS CUI-1
    C0001617
    Corticosteroid?
    Description

    ‘Corticosteroids’ (commonly referred to as ‘steroids’) refers to all types of therapeutic corticosteroid, made in the adrenal cortex (the outer part of the adrenal gland). They are also made in the laboratory. Examples include: prednisolone, prednisone, methyl- prednisolone, dexamethasone, hydrocortisone, fluticasone, betamethasone (note that other examples exist). Topical preparations are not included, but inhaled preparations are included. The indication for administering corticosteroids does not need to be directly related to the treatment of COVID-19.

    Data type

    integer

    Alias
    UMLS CUI [1]
    C0239126
    If YES, Route: Oral
    Description

    Corticosteroid: oral route of administration

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C1527415
    UMLS CUI [1,2]
    C0239126
    If YES, Route: Intravenous
    Description

    Corticosteroid: intravenous route of administration

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C0239126
    UMLS CUI [1,2]
    C1522726
    f YES, Route: Inhaled
    Description

    Corticosteroid: inhaled route of administration

    Data type

    boolean

    Alias
    UMLS CUI [1]
    C0586793
    If YES, Route: unknown
    Description

    Corticosteroid: unknown route of administration

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C0239126
    UMLS CUI [1,2]
    C1521803
    If YES Oral or IV, please provide agent:
    Description

    Oral oder IV Corticosteroid: agent

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C1527415
    UMLS CUI [1,2]
    C0149783
    UMLS CUI [1,3]
    C2348235
    UMLS CUI [2,1]
    C0149783
    UMLS CUI [2,2]
    C2348235
    UMLS CUI [2,3]
    C1621368
    If YES Oral or IV, please provide max. daily dose & unit:
    Description

    Oral oder IV Corticosteroid: dosage and unit

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C1527415
    UMLS CUI [1,2]
    C0239126
    UMLS CUI [1,3]
    C0806909
    UMLS CUI [1,4]
    C2348070
    UMLS CUI [2,1]
    C0239126
    UMLS CUI [2,2]
    C1621368
    UMLS CUI [2,3]
    C0806909
    UMLS CUI [2,4]
    C2348070
    UMLS CUI [3,1]
    C1527415
    UMLS CUI [3,2]
    C0239126
    UMLS CUI [3,3]
    C2348328
    UMLS CUI [4,1]
    C0239126
    UMLS CUI [4,2]
    C1621368
    UMLS CUI [4,3]
    C2348328
    Date commenced:
    Description

    Corticosteroid - Start date

    Data type

    date

    Alias
    UMLS CUI [1,1]
    C0808070
    UMLS CUI [1,2]
    C0149783
    Date of commencement: unknown
    Description

    Corticosteroid - Start date unknown

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C0808070
    UMLS CUI [1,2]
    C0149783
    UMLS CUI [1,3]
    C0439673
    Duration:
    Description

    Corticosteroid therapy duration

    Data type

    integer

    Measurement units
    • days
    Alias
    UMLS CUI [1,1]
    C0149783
    UMLS CUI [1,2]
    C0449238
    days
    Duration: unknown
    Description

    Corticosteroid therapy duration unknown

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C0449238
    UMLS CUI [1,2]
    C0149783
    UMLS CUI [1,3]
    C0439673
    Medication: While hospitalised or at discharge, were any of the following administered? Heparin
    Description

    Medication: While hospitalised or at discharge, were any of the following administered? Heparin

    Alias
    UMLS CUI-1
    C0019134
    Heparin?
    Description

    Heparin

    Data type

    integer

    Alias
    UMLS CUI [1,1]
    C0019134
    UMLS CUI [1,2]
    C1533734
    If YES, Route: Subcutaneous
    Description

    Heparin - Subcutaneous route of administration

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C0019134
    UMLS CUI [1,2]
    C1522438
    If YES, Route: Intravenous (IV)
    Description

    Heparin - Intravenous (IV) route of administration

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C0019134
    UMLS CUI [1,2]
    C1522726
    If YES, Route: Unknown
    Description

    Heparin - unknown route of administration

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C0019134
    UMLS CUI [1,2]
    C1521803
    If YES: Unfractionated
    Description

    Unfractionated heparin

    Data type

    boolean

    Alias
    UMLS CUI [1]
    C2825026
    If YES: Low molecular weight heparin
    Description

    Heparin type - Low molecular weight

    Data type

    boolean

    Alias
    UMLS CUI [1]
    C0019139
    If YES: Fondaparinux
    Description

    Fondaparinux

    Data type

    boolean

    Alias
    UMLS CUI [1]
    C1098510
    If YES: Heparin type unknown
    Description

    Heparin type unknown

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C0332307
    UMLS CUI [1,2]
    C0019134
    UMLS CUI [1,3]
    C0439673
    If Heparin was administered, please provide max. daily dose & unit:
    Description

    Heparin dosage and unit

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C0806909
    UMLS CUI [1,2]
    C2348070
    UMLS CUI [1,3]
    C0019134
    UMLS CUI [2,1]
    C2348328
    UMLS CUI [2,2]
    C0019134
    Date commenced:
    Description

    Heparin - Start date

    Data type

    date

    Alias
    UMLS CUI [1,1]
    C0808070
    UMLS CUI [1,2]
    C0019134
    Date of commencement: unknown
    Description

    Heparin - Start date unknown

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C0808070
    UMLS CUI [1,2]
    C0019134
    UMLS CUI [1,3]
    C0439673
    Duration:
    Description

    Heparin therapy duration

    Data type

    integer

    Measurement units
    • days
    Alias
    UMLS CUI [1,1]
    C0449238
    UMLS CUI [1,2]
    C0019134
    days
    Duration: unknown
    Description

    Heparin therapy duration unknown

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C0449238
    UMLS CUI [1,2]
    C0019134
    UMLS CUI [1,3]
    C0439673
    Medication: While hospitalised or at discharge, were any of the following administered? Antifungal therapy
    Description

    Medication: While hospitalised or at discharge, were any of the following administered? Antifungal therapy

    Alias
    UMLS CUI-1
    C0678026
    Antifungal agent?
    Description

    ‘Antifungal agent’ refers to any agent(s) prescribed specifically to treat systemic or topical infections caused by fungi. Examples include fluconazole, amphotericin, caspofungin, anidulafungin, posaconazole, itraconazole (note that other examples exist). Topical preparations should not be recorded.

    Data type

    integer

    Alias
    UMLS CUI [1]
    C0003308
    Medication: While hospitalised or at discharge, were any of the following administered? Other treatments administered for COVID-19
    Description

    Medication: While hospitalised or at discharge, were any of the following administered? Other treatments administered for COVID-19

    Alias
    UMLS CUI-1
    C5203670
    UMLS CUI-2
    C0205394
    UMLS CUI-3
    C0013227
    Other treatments administered for COVID-19 including experimental or compassionate use?
    Description

    Record any other medications, experimental or re-purposed, administered to modify the course of COVID-19 during the admission (including as part of a clinical trial). This could include convalescent plasma, immuno-modulatory agents and anti-viral agents not already recorded above.

    Data type

    integer

    Alias
    UMLS CUI [1,1]
    C5203670
    UMLS CUI [1,2]
    C0205394
    UMLS CUI [1,3]
    C0013227
    UMLS CUI [2,1]
    C0304229
    UMLS CUI [2,2]
    C5203670
    UMLS CUI [3,1]
    C0013227
    UMLS CUI [3,2]
    C2718016
    UMLS CUI [3,3]
    C5203670
    If yes, specify agent:
    Description

    Other treatments administered for COVID-19

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C5203670
    UMLS CUI [1,2]
    C0205394
    UMLS CUI [1,3]
    C0013227
    If another treatment was administered, please provide max. daily dose & unit:
    Description

    Other treatment for COVID-19: dosage and unit

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C5203670
    UMLS CUI [1,2]
    C0205394
    UMLS CUI [1,3]
    C0013227
    UMLS CUI [1,4]
    C0806909
    UMLS CUI [1,5]
    C2348070
    UMLS CUI [2,1]
    C5203670
    UMLS CUI [2,2]
    C0205394
    UMLS CUI [2,3]
    C0013227
    UMLS CUI [2,4]
    C2348328
    Date of commencement
    Description

    Other treatment for COVID-19: Date of commencement

    Data type

    date

    Alias
    UMLS CUI [1,1]
    C5203670
    UMLS CUI [1,2]
    C0205394
    UMLS CUI [1,3]
    C0013227
    UMLS CUI [1,4]
    C0808070
    Date of commencement: unknown
    Description

    Other treatment for COVID-19: Date of commencement known

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C5203670
    UMLS CUI [1,2]
    C0205394
    UMLS CUI [1,3]
    C0013227
    UMLS CUI [1,4]
    C0808070
    UMLS CUI [1,5]
    C0439673
    Duration of other treatment for COVID-19
    Description

    Other treatment for COVID-19: Duration of therapy

    Data type

    integer

    Measurement units
    • days
    Alias
    UMLS CUI [1,1]
    C5203670
    UMLS CUI [1,2]
    C0205394
    UMLS CUI [1,3]
    C0013227
    UMLS CUI [1,4]
    C0449238
    days
    Duration of other treatment for COVID-19 known
    Description

    Other treatment for COVID-19: Duration of therapy known

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C5203670
    UMLS CUI [1,2]
    C0205394
    UMLS CUI [1,3]
    C0013227
    UMLS CUI [1,4]
    C0449238
    Outcome
    Description

    Outcome

    Alias
    UMLS CUI-1
    C1547647
    Please select only one outcome
    Description

    Discharged alive can mean discharge to their usual place of residence before their illness, to the home of a relative or friend, or to a social care facility, because their illness is no longer severe enough to warrant treatment in a medical facility. Hospitalized means they are still in hospital but have recovered from COVID-19 infection and the form has been completed as the patient is in a part of the hospital for care of other conditions and where the form will not be completed at a later date. Transfer to other facility means they have been transferred to another facility that provides medical care. This could be a specialist centre for more intensive treatment or a step-down for rehabilitation. It does not include facilities that solely provide social care (these patients should be listed as discharged alive). Death means the patient died in the hospital. Palliative discharge means the patient has been discharged with the expectation that they will not recover from this or other co-existing illness. This could be to a specialist hospice facility, or to their usual home address with anticipatory end of life medications.

    Data type

    integer

    Alias
    UMLS CUI [1]
    C1547647
    Outcome date
    Description

    Please state the date for the outcome listed above.

    Data type

    date

    Alias
    UMLS CUI [1,1]
    C1547647
    UMLS CUI [1,2]
    C0011008
    Outcome date: unknown
    Description

    Please state the date for the outcome listed above.

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C1547647
    UMLS CUI [1,2]
    C0011008
    UMLS CUI [1,3]
    C0439673
    If Discharged alive: Ability to self-care at discharge versus before illness
    Description

    Ability to self-care at discharge versus before illness: the patient is able to care for themselves at discharge (in terms of activities of daily living) at the same level as before they developed illness then tick ‘same as before illness’. If their ability to self-care has decreased or increased, then tick the appropriate circle (‘worse’ or ‘better’).

    Data type

    integer

    Alias
    UMLS CUI [1,1]
    C0562734
    UMLS CUI [1,2]
    C3871203
    If Discharged alive: Post-discharge treatment - Oxygen therapy?
    Description

    (Complete this section only if the patient is alive) Oxygen therapy includes, NIV or home ventilation (respiratory support/treatment).

    Data type

    integer

    Alias
    UMLS CUI [1,1]
    C0586003
    UMLS CUI [1,2]
    C0687676
    UMLS CUI [1,3]
    C0184633
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    Similar models

    MODULE 3: OUTCOME CASE REPORT FORM

    1 forms
    Name
    Type
    Description | Question | Decode (Coded Value)
    Data type
    Alias
    Item Group
    Participant Identification
    C3165543 (UMLS CUI-1)
    Participant Identification Numbers
    Item
    Participant Identification Numbers
    text
    C3165543 (UMLS CUI [1])
    Item Group
    At ANY time during hospitalisation, did the patient receive/undergo:
    C0087111 (UMLS CUI-1)
    Item
    Any Oxygen therapy?
    integer
    C0184633 (UMLS CUI [1])
    ICU or High Dependency Unit admission
    Code List
    Any Oxygen therapy?
    CL Item
    Yes (1)
    CL Item
    No (2)
    CL Item
    Unknown (3)
    Oxygen therapy duration
    Item
    If YES, total duration:
    integer
    C0184633 (UMLS CUI [1,1])
    C0449238 (UMLS CUI [1,2])
    C2348235 (UMLS CUI [1,3])
    Oxygen therapy duration unknown
    Item
    Total duration: unknown
    boolean
    C0184633 (UMLS CUI [1,1])
    C0449238 (UMLS CUI [1,2])
    C0439673 (UMLS CUI [1,3])
    Item
    Maximum O2 flow volume:
    integer
    C1960999 (UMLS CUI [1])
    Maximum O2 flow volume
    Code List
    Maximum O2 flow volume:
    CL Item
    <2 L/min (1)
    CL Item
    2-5 L/min (2)
    CL Item
    6-10 L/min (3)
    CL Item
    11-15 L/min (4)
    CL Item
    >15 L/min (5)
    Item
    Non-invasive ventilation? (Any)
    integer
    C1997883 (UMLS CUI [1])
    ICU or High Dependency Unit admission
    Code List
    Non-invasive ventilation? (Any)
    CL Item
    Yes (1)
    CL Item
    No (2)
    CL Item
    Unknown (3)
    Non-invasive ventilation duration
    Item
    If YES, total duration:
    integer
    C1997883 (UMLS CUI [1,1])
    C0449238 (UMLS CUI [1,2])
    C2348235 (UMLS CUI [1,3])
    Non-invasive ventilation duration unknown
    Item
    Total duration: unknown
    boolean
    C1997883 (UMLS CUI [1,1])
    C0449238 (UMLS CUI [1,2])
    C0439673 (UMLS CUI [1,3])
    Item
    Invasive ventilation (Any)?
    integer
    C1868981 (UMLS CUI [1])
    ICU or High Dependency Unit admission
    Code List
    Invasive ventilation (Any)?
    CL Item
    Yes (1)
    CL Item
    No (2)
    CL Item
    Unknown (3)
    Invasive ventilation duration
    Item
    If YES, total duration:
    integer
    C1868981 (UMLS CUI [1,1])
    C0449238 (UMLS CUI [1,2])
    Invasive ventilation duration unknown
    Item
    Total duration: unknown
    boolean
    C1868981 (UMLS CUI [1,1])
    C0439673 (UMLS CUI [1,2])
    Item
    Prone Positioning?
    integer
    C0808387 (UMLS CUI [1,1])
    C0033422 (UMLS CUI [1,2])
    ICU or High Dependency Unit admission
    Code List
    Prone Positioning?
    CL Item
    Yes (1)
    CL Item
    No (2)
    CL Item
    Unknown (3)
    Prone positioning duration
    Item
    If YES, total duration:
    integer
    C0808387 (UMLS CUI [1,1])
    C0033422 (UMLS CUI [1,2])
    C0449238 (UMLS CUI [1,3])
    C2348235 (UMLS CUI [1,4])
    Prone positioning duration unknown
    Item
    Total duration: unknown
    boolean
    C0808387 (UMLS CUI [1,1])
    C0033422 (UMLS CUI [1,2])
    C0449238 (UMLS CUI [1,3])
    C0439673 (UMLS CUI [1,4])
    Item
    Inhaled Nitric Oxide?
    integer
    C1135443 (UMLS CUI [1])
    ICU or High Dependency Unit admission
    Code List
    Inhaled Nitric Oxide?
    CL Item
    Yes (1)
    CL Item
    No (2)
    CL Item
    Unknown (3)
    Item
    Tracheostomy inserted?
    integer
    C0040590 (UMLS CUI [1])
    ICU or High Dependency Unit admission
    Code List
    Tracheostomy inserted?
    CL Item
    Yes (1)
    CL Item
    No (2)
    CL Item
    Unknown (3)
    Item
    Extracorporeal support?
    integer
    C4068956 (UMLS CUI [1])
    ICU or High Dependency Unit admission
    Code List
    Extracorporeal support?
    CL Item
    Yes (1)
    CL Item
    No (2)
    CL Item
    Unknown (3)
    Extracorporeal support duration
    Item
    If YES, total duration:
    integer
    C4068956 (UMLS CUI [1,1])
    C0449238 (UMLS CUI [1,2])
    C2348235 (UMLS CUI [1,3])
    Extracorporeal support duration unknown
    Item
    Total duration: unknown
    boolean
    C4068956 (UMLS CUI [1,1])
    C0439673 (UMLS CUI [1,2])
    Item
    Renal replacement therapy (RRT) or dialysis?
    integer
    C0206074 (UMLS CUI [1])
    C0011946 (UMLS CUI [2])
    ICU or High Dependency Unit admission
    Code List
    Renal replacement therapy (RRT) or dialysis?
    CL Item
    Yes (1)
    CL Item
    No (2)
    CL Item
    Unknown (3)
    Item
    Inotropes/vasopressors?
    integer
    C0304509 (UMLS CUI [1])
    C0042397 (UMLS CUI [2])
    ICU or High Dependency Unit admission
    Code List
    Inotropes/vasopressors?
    CL Item
    Yes (1)
    CL Item
    No (2)
    CL Item
    Unknown (3)
    Inotropes/vasopressors duration
    Item
    If YES, total duration:
    integer
    C0042397 (UMLS CUI [1,1])
    C0449238 (UMLS CUI [1,2])
    C2348235 (UMLS CUI [1,3])
    C0304509 (UMLS CUI [2,1])
    C0449238 (UMLS CUI [2,2])
    C2348235 (UMLS CUI [2,3])
    Inotropes/vasopressors duration unknown
    Item
    Total duration: unknown
    boolean
    C0304509 (UMLS CUI [1,1])
    C0439673 (UMLS CUI [1,2])
    C0042397 (UMLS CUI [2,1])
    C0439673 (UMLS CUI [2,2])
    Item
    ICU or High Dependency Unit admission?
    integer
    C0583239 (UMLS CUI [1])
    C1301858 (UMLS CUI [2])
    ICU or High Dependency Unit admission
    Code List
    ICU or High Dependency Unit admission?
    CL Item
    Yes (1)
    CL Item
    No (2)
    CL Item
    Unknown (3)
    Total duration of ICU/High Dependency stay
    Item
    If YES, total duration:
    integer
    C1627345 (UMLS CUI [1,1])
    C0444921 (UMLS CUI [1,2])
    C2348235 (UMLS CUI [1,3])
    C0021708 (UMLS CUI [2,1])
    C0444921 (UMLS CUI [2,2])
    C2348235 (UMLS CUI [2,3])
    Total duration of ICU/High Dependency stay unknown
    Item
    Total duration: unknown
    boolean
    C1627345 (UMLS CUI [1,1])
    C0449238 (UMLS CUI [1,2])
    C0439673 (UMLS CUI [1,3])
    C0021708 (UMLS CUI [2,1])
    C0449238 (UMLS CUI [2,2])
    C0439673 (UMLS CUI [2,3])
    Date of ICU admission
    Item
    If YES, date of ICU admission
    date
    C0583239 (UMLS CUI [1,1])
    C1302393 (UMLS CUI [1,2])
    C1301858 (UMLS CUI [2,1])
    C1302393 (UMLS CUI [2,2])
    Date of ICU admission unknown
    Item
    Date of ICU admission: unknown
    boolean
    C0583239 (UMLS CUI [1,1])
    C1302393 (UMLS CUI [1,2])
    C0439673 (UMLS CUI [1,3])
    C1301858 (UMLS CUI [2,1])
    C1302393 (UMLS CUI [2,2])
    C0439673 (UMLS CUI [2,3])
    Date of ICU discharge
    Item
    If YES, date of ICU discharge:
    date
    C1627345 (UMLS CUI [1,1])
    C2361123 (UMLS CUI [1,2])
    C0021708 (UMLS CUI [2,1])
    C2361123 (UMLS CUI [2,2])
    Date of ICU discharge unknown
    Item
    Date of ICU discharge: unknown
    date
    C1627345 (UMLS CUI [1,1])
    C2361123 (UMLS CUI [1,2])
    C0439673 (UMLS CUI [1,3])
    C0021708 (UMLS CUI [2,1])
    C2361123 (UMLS CUI [2,2])
    C0439673 (UMLS CUI [2,3])
    Item Group
    At any time during hospitalisation did the patient experience
    C0009566 (UMLS CUI-1)
    Item
    Viral pneumonitis
    integer
    C0032310 (UMLS CUI [1])
    Viral pneumonitis
    Code List
    Viral pneumonitis
    CL Item
    Yes (1)
    CL Item
    No (2)
    CL Item
    Unknown (3)
    Item
    Bacterial pneumonia
    integer
    C0004626 (UMLS CUI [1])
    Viral pneumonitis
    Code List
    Bacterial pneumonia
    CL Item
    Yes (1)
    CL Item
    No (2)
    CL Item
    Unknown (3)
    Item
    Acute Respiratory Distress Syndrome
    integer
    C4534309 (UMLS CUI [1])
    Viral pneumonitis
    Code List
    Acute Respiratory Distress Syndrome
    CL Item
    Yes (1)
    CL Item
    No (2)
    CL Item
    Unknown (3)
    Item
    If you ticked "Yes" on Acute Respiratory Distress Syndrome, please specify the severity:
    integer
    C4534309 (UMLS CUI [1,1])
    C0439793 (UMLS CUI [1,2])
    Viral pneumonitis
    Code List
    If you ticked "Yes" on Acute Respiratory Distress Syndrome, please specify the severity:
    CL Item
    Mild (1)
    CL Item
    Moderate (2)
    CL Item
    Severe  (3)
    CL Item
    Unknown (4)
    Item
    Pneumothorax
    integer
    C0032326 (UMLS CUI [1])
    Viral pneumonitis
    Code List
    Pneumothorax
    CL Item
    Yes (1)
    CL Item
    No (2)
    CL Item
    Unknown (3)
    Item
    Pleural effusion
    integer
    C1253943 (UMLS CUI [1])
    Viral pneumonitis
    Code List
    Pleural effusion
    CL Item
    Yes (1)
    CL Item
    No (2)
    CL Item
    Unknown (3)
    Item
    Cryptogenic organizing pneumonia (COP)
    integer
    C0242770 (UMLS CUI [1])
    Viral pneumonitis
    Code List
    Cryptogenic organizing pneumonia (COP)
    CL Item
    Yes (1)
    CL Item
    No (2)
    CL Item
    Unknown (3)
    Item
    Bronchiolitis
    integer
    C0006271 (UMLS CUI [1])
    Viral pneumonitis
    Code List
    Bronchiolitis
    CL Item
    Yes (1)
    CL Item
    No (2)
    CL Item
    Unknown (3)
    Item
    Cardiac arrest
    integer
    C0018790 (UMLS CUI [1])
    Viral pneumonitis
    Code List
    Cardiac arrest
    CL Item
    Yes (1)
    CL Item
    No (2)
    CL Item
    Unknown (3)
    Item
    Myocardial infarction
    integer
    C0027051 (UMLS CUI [1])
    Viral pneumonitis
    Code List
    Myocardial infarction
    CL Item
    Yes (1)
    CL Item
    No (2)
    CL Item
    Unknown (3)
    Item
    Cardiac ischaemia
    integer
    C0151744 (UMLS CUI [1])
    Viral pneumonitis
    Code List
    Cardiac ischaemia
    CL Item
    Yes (1)
    CL Item
    No (2)
    CL Item
    Unknown (3)
    Item
    Cardiac arrhythmia
    integer
    C0003811 (UMLS CUI [1])
    Viral pneumonitis
    Code List
    Cardiac arrhythmia
    CL Item
    Yes (1)
    CL Item
    No (2)
    CL Item
    Unknown (3)
    Item
    Myocarditis / Pericarditis
    integer
    C0027059 (UMLS CUI [1])
    C0031046 (UMLS CUI [2])
    Viral pneumonitis
    Code List
    Myocarditis / Pericarditis
    CL Item
    Yes (1)
    CL Item
    No (2)
    CL Item
    Unknown (3)
    Item
    Endocarditis
    integer
    C0014118 (UMLS CUI [1])
    Viral pneumonitis
    Code List
    Endocarditis
    CL Item
    Yes (1)
    CL Item
    No (2)
    CL Item
    Unknown (3)
    Item
    Cardiomyopathy
    integer
    C0878544 (UMLS CUI [1])
    Viral pneumonitis
    Code List
    Cardiomyopathy
    CL Item
    Yes (1)
    CL Item
    No (2)
    CL Item
    Unknown (3)
    Item
    Congestive heart failure
    integer
    C0018802 (UMLS CUI [1])
    Viral pneumonitis
    Code List
    Congestive heart failure
    CL Item
    Yes (1)
    CL Item
    No (2)
    CL Item
    Unknown (3)
    Item
    Seizure
    integer
    C0036572 (UMLS CUI [1])
    Viral pneumonitis
    Code List
    Seizure
    CL Item
    Yes (1)
    CL Item
    No (2)
    CL Item
    Unknown (3)
    Item
    Stroke / Cerebrovascular accident
    integer
    C0038454 (UMLS CUI [1])
    Viral pneumonitis
    Code List
    Stroke / Cerebrovascular accident
    CL Item
    Yes (1)
    CL Item
    No (2)
    CL Item
    Unknown (3)
    Item
    Meningitis / Encephalitis
    integer
    C0497299 (UMLS CUI [1])
    Viral pneumonitis
    Code List
    Meningitis / Encephalitis
    CL Item
    Yes (1)
    CL Item
    No (2)
    CL Item
    Unknown (3)
    Item
    Bacteremia
    integer
    C0004610 (UMLS CUI [1])
    Viral pneumonitis
    Code List
    Bacteremia
    CL Item
    Yes (1)
    CL Item
    No (2)
    CL Item
    Unknown (3)
    Item
    Coagulation disorder / Disseminated Intravascular Coagulation
    integer
    C0012739 (UMLS CUI [1])
    C0005779 (UMLS CUI [2])
    Viral pneumonitis
    Code List
    Coagulation disorder / Disseminated Intravascular Coagulation
    CL Item
    Yes (1)
    CL Item
    No (2)
    CL Item
    Unknown (3)
    Item
    Pulmonary embolism
    integer
    C0034065 (UMLS CUI [1])
    Viral pneumonitis
    Code List
    Pulmonary embolism
    CL Item
    Yes (1)
    CL Item
    No (2)
    CL Item
    Unknown (3)
    Item
    Anemia
    integer
    C0002871 (UMLS CUI [1])
    Viral pneumonitis
    Code List
    Anemia
    CL Item
    Yes (1)
    CL Item
    No (2)
    CL Item
    Unknown (3)
    Item
    Rhabdomyolysis / Myositis
    integer
    C0035410 (UMLS CUI [1])
    C0027121 (UMLS CUI [2])
    Viral pneumonitis
    Code List
    Rhabdomyolysis / Myositis
    CL Item
    Yes (1)
    CL Item
    No (2)
    CL Item
    Unknown (3)
    Item
    Acute renal injury/ Acute renal failure
    integer
    C0022660 (UMLS CUI [1])
    C2609414 (UMLS CUI [2])
    Viral pneumonitis
    Code List
    Acute renal injury/ Acute renal failure
    CL Item
    Yes (1)
    CL Item
    No (2)
    CL Item
    Unknown (3)
    Item
    Gastrointestinal haemorrhage
    integer
    C0017181 (UMLS CUI [1])
    Viral pneumonitis
    Code List
    Gastrointestinal haemorrhage
    CL Item
    Yes (1)
    CL Item
    No (2)
    CL Item
    Unknown (3)
    Item
    Pancreatitis
    integer
    C0030305 (UMLS CUI [1])
    Viral pneumonitis
    Code List
    Pancreatitis
    CL Item
    Yes (1)
    CL Item
    No (2)
    CL Item
    Unknown (3)
    Item
    Liver dysfunction
    integer
    C0086565 (UMLS CUI [1])
    Viral pneumonitis
    Code List
    Liver dysfunction
    CL Item
    Yes (1)
    CL Item
    No (2)
    CL Item
    Unknown (3)
    Item
    Hyperglycemia
    integer
    C0020456 (UMLS CUI [1])
    Viral pneumonitis
    Code List
    Hyperglycemia
    CL Item
    Yes (1)
    CL Item
    No (2)
    CL Item
    Unknown (3)
    Item
    Hypoglycemia
    integer
    C0020615 (UMLS CUI [1])
    Viral pneumonitis
    Code List
    Hypoglycemia
    CL Item
    Yes (1)
    CL Item
    No (2)
    CL Item
    Unknown (3)
    Item
    Other Complications
    integer
    C0009566 (UMLS CUI [1,1])
    C0205394 (UMLS CUI [1,2])
    Viral pneumonitis
    Code List
    Other Complications
    CL Item
    Yes (1)
    CL Item
    No (2)
    CL Item
    Unknown (3)
    Other Complications Specification
    Item
    If you ticked "Yes" on Other Complications, please specify:
    text
    C0205394 (UMLS CUI [1,1])
    C0009566 (UMLS CUI [1,2])
    C2348235 (UMLS CUI [1,3])
    Item Group
    Diagnostics
    C0430022 (UMLS CUI-1)
    Item
    Was patient clinically diagnosed with COVID-19?
    integer
    C5203670 (UMLS CUI [1,1])
    C0332140 (UMLS CUI [1,2])
    Pathogen testing during illness episode
    Code List
    Was patient clinically diagnosed with COVID-19?
    CL Item
    Yes  (1)
    CL Item
    No (2)
    CL Item
    Unknown (3)
    Item
    Was pathogen testing done during this illness episode?
    integer
    C0450254 (UMLS CUI [1,1])
    C0022885 (UMLS CUI [1,2])
    C0347984 (UMLS CUI [1,3])
    C0012634 (UMLS CUI [1,4])
    C1948053 (UMLS CUI [1,5])
    Pathogen testing during illness episode
    Code List
    Was pathogen testing done during this illness episode?
    CL Item
    Yes (complete section) (1)
    CL Item
    No (2)
    CL Item
    Unknown (3)
    Item
    Coronavirus
    integer
    C0206422 (UMLS CUI [1])
    Coronavirus
    Code List
    Coronavirus
    CL Item
    Positive (1)
    CL Item
    Negative (2)
    CL Item
    Not done (3)
    Item
    If positive, specify:
    integer
    C0206422 (UMLS CUI [1,1])
    C0449560 (UMLS CUI [1,2])
    Coronavirus
    Code List
    If positive, specify:
    CL Item
    COVID-2019/ SARS-CoV2 (1)
    CL Item
    MERS CoV (2)
    CL Item
    Other CoV (3)
    CL Item
    Unknown (4)
    Other Coronavirus Subtype
    Item
    If you ticked "Other", please specify the subtype:
    text
    C0205394 (UMLS CUI [1,1])
    C0206422 (UMLS CUI [1,2])
    C0449560 (UMLS CUI [1,3])
    C2348235 (UMLS CUI [1,4])
    Item
    Influenza
    integer
    C0021400 (UMLS CUI [1])
    Pathogen testing during illness episode
    Code List
    Influenza
    CL Item
    Positive (1)
    CL Item
    Negative (2)
    CL Item
    Not done (3)
    Item
    If positive, specify:
    integer
    C0021400 (UMLS CUI [1,1])
    C0449560 (UMLS CUI [1,2])
    Pathogen testing during illness episode
    Code List
    If positive, specify:
    CL Item
    A/H3N2 (1)
    CL Item
    A/H1N1pdm09 (2)
    CL Item
    A/H7N9 (3)
    CL Item
    A/H5N1 (4)
    CL Item
    A, not typed (5)
    CL Item
    B (6)
    CL Item
    Other (7)
    CL Item
    Unknown (8)
    Other Influenza subtype
    Item
    If you ticked "other", please specify the subtype:
    text
    C0021400 (UMLS CUI [1,1])
    C0449560 (UMLS CUI [1,2])
    C2348235 (UMLS CUI [1,3])
    Item
    RSV
    integer
    C0035236 (UMLS CUI [1])
    Pathogen testing during illness episode
    Code List
    RSV
    CL Item
    Positive (1)
    CL Item
    Negative (2)
    CL Item
    Not done (3)
    Item
    Adenovirus
    integer
    C0001483 (UMLS CUI [1])
    Pathogen testing during illness episode
    Code List
    Adenovirus
    CL Item
    Positive (1)
    CL Item
    Negative (2)
    CL Item
    Not done (3)
    Item
    Bacteria
    integer
    C0004611 (UMLS CUI [1])
    Pathogen testing during illness episode
    Code List
    Bacteria
    CL Item
    Positive (1)
    CL Item
    Negative (2)
    CL Item
    Not done (3)
    Bacteria specification
    Item
    If positive, specify:
    text
    C0004611 (UMLS CUI [1,1])
    C2348235 (UMLS CUI [1,2])
    C0370003 (UMLS CUI [1,3])
    Bacteria specimen unknown
    Item
    Bacteria: unknown
    boolean
    C0004611 (UMLS CUI [1,1])
    C2348235 (UMLS CUI [1,2])
    C0439673 (UMLS CUI [1,3])
    Item
    Other pathogen/s detected:
    integer
    C0205394 (UMLS CUI [1,1])
    C0450254 (UMLS CUI [1,2])
    C0243095 (UMLS CUI [1,3])
    Coronavirus
    Code List
    Other pathogen/s detected:
    CL Item
    Yes (1)
    CL Item
    No (2)
    CL Item
    Unknown (3)
    Other pathogen/s detected - specification
    Item
    If positive, specify:
    text
    C0205394 (UMLS CUI [1,1])
    C0450254 (UMLS CUI [1,2])
    C2348235 (UMLS CUI [1,3])
    Other pathogen/s detected - specimen unknown
    Item
    Pathogen: unknown
    boolean
    C0205394 (UMLS CUI [1,1])
    C0450254 (UMLS CUI [1,2])
    C0370003 (UMLS CUI [1,3])
    C0439673 (UMLS CUI [1,4])
    Item
    Clinical pneumonia diagnosed?
    integer
    C0543829 (UMLS CUI [1])
    Clinical pneumonia
    Code List
    Clinical pneumonia diagnosed?
    CL Item
    Yes (1)
    CL Item
    No (2)
    CL Item
    Unknown (3)
    Item
    Chest X-Ray performed?
    integer
    C0039985 (UMLS CUI [1,1])
    C0884358 (UMLS CUI [1,2])
    Clinical pneumonia
    Code List
    Chest X-Ray performed?
    CL Item
    Yes (1)
    CL Item
    No (2)
    CL Item
    Unknown (3)
    Item
    If Chest X-Ray was performed: Were infiltrates present?
    integer
    C2073654 (UMLS CUI [1])
    Clinical pneumonia
    Code List
    If Chest X-Ray was performed: Were infiltrates present?
    CL Item
    Yes (1)
    CL Item
    No (2)
    CL Item
    Unknown (3)
    Item
    CT performed?
    integer
    C0040405 (UMLS CUI [1,1])
    C0884358 (UMLS CUI [1,2])
    Clinical pneumonia
    Code List
    CT performed?
    CL Item
    Yes (1)
    CL Item
    No (2)
    CL Item
    Unknown (3)
    Item
    If CT was performed: Were infiltrates present?
    integer
    C2073654 (UMLS CUI [1])
    Clinical pneumonia
    Code List
    If CT was performed: Were infiltrates present?
    CL Item
    Yes (1)
    CL Item
    No (2)
    CL Item
    Unknown (3)
    Item Group
    Biospecimen Testing
    C2347026 (UMLS CUI-1)
    C0022885 (UMLS CUI-2)
    Collection Date
    Item
    Collection Date
    date
    C1302413 (UMLS CUI [1])
    Item
    Biospecimen Type
    text
    C2347029 (UMLS CUI [1])
    Biospecimen Type
    Code List
    Biospecimen Type
    CL Item
    Nasal/NP swab (1)
    CL Item
    Throat swab (2)
    CL Item
    Combined nasal/NP+throat swab (3)
    CL Item
    Sputum (4)
    CL Item
    BAL (5)
    CL Item
    ETA (6)
    CL Item
    Urine (7)
    CL Item
    Feces/rectal swab (8)
    CL Item
    Blood (9)
    CL Item
    Other (10)
    Other Biospecimen Type
    Item
    If other biospecimen type, please specify
    text
    C0205394 (UMLS CUI [1,1])
    C2347029 (UMLS CUI [1,2])
    C2348235 (UMLS CUI [1,3])
    Item
    Laboratory test method
    integer
    C2826902 (UMLS CUI [1])
    Biospecimen Type
    Code List
    Laboratory test method
    CL Item
    PCR (1)
    CL Item
    Culture (2)
    CL Item
    Other (3)
    Other laboratory test method
    Item
    Other laboratory test method, please specify:
    text
    C0205394 (UMLS CUI [1,1])
    C2826902 (UMLS CUI [1,2])
    C2348235 (UMLS CUI [1,3])
    Item
    Laboratory Test Result
    integer
    C0587081 (UMLS CUI [1])
    Laboratory Test Result
    Code List
    Laboratory Test Result
    CL Item
    Positive (1)
    CL Item
    Negative (2)
    CL Item
    Unknown (3)
    Pathogen Tested/Detected
    Item
    Pathogen Tested/Detected
    text
    C0450254 (UMLS CUI [1,1])
    C1511790 (UMLS CUI [1,2])
    Item Group
    Medication: While hospitalised or at discharge, were any of the following administered? Antiviral therapy
    C0280274 (UMLS CUI-1)
    Item
    Antiviral or COVID-19 targeted agent?
    integer
    C0003451 (UMLS CUI [1])
    C5203670 (UMLS CUI [2,1])
    C2985566 (UMLS CUI [2,2])
    ICU or High Dependency Unit admission
    Code List
    Antiviral or COVID-19 targeted agent?
    CL Item
    Yes (1)
    CL Item
    No (2)
    CL Item
    Unknown (3)
    Item
    If YES, specify all agents and duration:
    integer
    C0003451 (UMLS CUI [1,1])
    C2348235 (UMLS CUI [1,2])
    C5203670 (UMLS CUI [2,1])
    C2985566 (UMLS CUI [2,2])
    C2348235 (UMLS CUI [2,3])
    Ribavirin
    Code List
    If YES, specify all agents and duration:
    CL Item
    Ribavirin (1)
    CL Item
    Lopinavir/Ritonavir (2)
    CL Item
    Remdesivir (3)
    CL Item
    Interferon alpha (4)
    CL Item
    Interferon beta (5)
    CL Item
    Chloroquine/hydroxychloroquine (6)
    CL Item
    Other (7)
    Other Antiviral agent
    Item
    If another antiviral agent was administered, please specify:
    text
    C0205394 (UMLS CUI [1,1])
    C0003451 (UMLS CUI [1,2])
    Antiviral agent - Start date
    Item
    Date commenced:
    date
    C0003451 (UMLS CUI [1,1])
    C0808070 (UMLS CUI [1,2])
    Antiviral treatment duration
    Item
    Duration:
    integer
    C0003451 (UMLS CUI [1,1])
    C0449238 (UMLS CUI [1,2])
    Antiviral treatment duration unknown
    Item
    Duration: unknown
    boolean
    C0003451 (UMLS CUI [1,1])
    C0449238 (UMLS CUI [1,2])
    C0439673 (UMLS CUI [1,3])
    Item Group
    Medication: While hospitalised or at discharge, were any of the following administered? Antibiotic therapy
    C0338237 (UMLS CUI-1)
    Item
    Antibiotic?
    integer
    C0338237 (UMLS CUI [1])
    ICU or High Dependency Unit admission
    Code List
    Antibiotic?
    CL Item
    Yes (1)
    CL Item
    No (2)
    CL Item
    Unknown (3)
    Antibiotic
    Item
    Agent:
    text
    C0338237 (UMLS CUI [1])
    Antibiotic therapy - Date commenced
    Item
    Date commenced:
    date
    C0808070 (UMLS CUI [1,1])
    C0338237 (UMLS CUI [1,2])
    Antibiotic therapy - duration
    Item
    Duration:
    integer
    C0338237 (UMLS CUI [1,1])
    C0449238 (UMLS CUI [1,2])
    Antibiotic therapy duration unknown
    Item
    Duration: unknown
    boolean
    C0338237 (UMLS CUI [1,1])
    C0449238 (UMLS CUI [1,2])
    C0439673 (UMLS CUI [1,3])
    Item Group
    While hospitalised or at discharge, were any of the following administered? Corticosteriods
    C0001617 (UMLS CUI-1)
    Item
    Corticosteroid?
    integer
    C0239126 (UMLS CUI [1])
    ICU or High Dependency Unit admission
    Code List
    Corticosteroid?
    CL Item
    Yes (1)
    CL Item
    No (2)
    CL Item
    Unknown (3)
    Corticosteroid: oral route of administration
    Item
    If YES, Route: Oral
    boolean
    C1527415 (UMLS CUI [1,1])
    C0239126 (UMLS CUI [1,2])
    Corticosteroid: intravenous route of administration
    Item
    If YES, Route: Intravenous
    boolean
    C0239126 (UMLS CUI [1,1])
    C1522726 (UMLS CUI [1,2])
    Corticosteroid: inhaled route of administration
    Item
    f YES, Route: Inhaled
    boolean
    C0586793 (UMLS CUI [1])
    Corticosteroid: unknown route of administration
    Item
    If YES, Route: unknown
    boolean
    C0239126 (UMLS CUI [1,1])
    C1521803 (UMLS CUI [1,2])
    Oral oder IV Corticosteroid: agent
    Item
    If YES Oral or IV, please provide agent:
    text
    C1527415 (UMLS CUI [1,1])
    C0149783 (UMLS CUI [1,2])
    C2348235 (UMLS CUI [1,3])
    C0149783 (UMLS CUI [2,1])
    C2348235 (UMLS CUI [2,2])
    C1621368 (UMLS CUI [2,3])
    Oral oder IV Corticosteroid: dosage and unit
    Item
    If YES Oral or IV, please provide max. daily dose & unit:
    text
    C1527415 (UMLS CUI [1,1])
    C0239126 (UMLS CUI [1,2])
    C0806909 (UMLS CUI [1,3])
    C2348070 (UMLS CUI [1,4])
    C0239126 (UMLS CUI [2,1])
    C1621368 (UMLS CUI [2,2])
    C0806909 (UMLS CUI [2,3])
    C2348070 (UMLS CUI [2,4])
    C1527415 (UMLS CUI [3,1])
    C0239126 (UMLS CUI [3,2])
    C2348328 (UMLS CUI [3,3])
    C0239126 (UMLS CUI [4,1])
    C1621368 (UMLS CUI [4,2])
    C2348328 (UMLS CUI [4,3])
    Corticosteroid - Start date
    Item
    Date commenced:
    date
    C0808070 (UMLS CUI [1,1])
    C0149783 (UMLS CUI [1,2])
    Corticosteroid - Start date unknown
    Item
    Date of commencement: unknown
    boolean
    C0808070 (UMLS CUI [1,1])
    C0149783 (UMLS CUI [1,2])
    C0439673 (UMLS CUI [1,3])
    Corticosteroid therapy duration
    Item
    Duration:
    integer
    C0149783 (UMLS CUI [1,1])
    C0449238 (UMLS CUI [1,2])
    Corticosteroid therapy duration unknown
    Item
    Duration: unknown
    boolean
    C0449238 (UMLS CUI [1,1])
    C0149783 (UMLS CUI [1,2])
    C0439673 (UMLS CUI [1,3])
    Item Group
    Medication: While hospitalised or at discharge, were any of the following administered? Heparin
    C0019134 (UMLS CUI-1)
    Item
    Heparin?
    integer
    C0019134 (UMLS CUI [1,1])
    C1533734 (UMLS CUI [1,2])
    ICU or High Dependency Unit admission
    Code List
    Heparin?
    CL Item
    Yes (1)
    CL Item
    No (2)
    CL Item
    Unknown (3)
    Heparin - Subcutaneous route of administration
    Item
    If YES, Route: Subcutaneous
    boolean
    C0019134 (UMLS CUI [1,1])
    C1522438 (UMLS CUI [1,2])
    Heparin - Intravenous (IV) route of administration
    Item
    If YES, Route: Intravenous (IV)
    boolean
    C0019134 (UMLS CUI [1,1])
    C1522726 (UMLS CUI [1,2])
    Heparin - unknown route of administration
    Item
    If YES, Route: Unknown
    boolean
    C0019134 (UMLS CUI [1,1])
    C1521803 (UMLS CUI [1,2])
    Unfractionated heparin
    Item
    If YES: Unfractionated
    boolean
    C2825026 (UMLS CUI [1])
    Heparin type - Low molecular weight
    Item
    If YES: Low molecular weight heparin
    boolean
    C0019139 (UMLS CUI [1])
    Fondaparinux
    Item
    If YES: Fondaparinux
    boolean
    C1098510 (UMLS CUI [1])
    Heparin type unknown
    Item
    If YES: Heparin type unknown
    boolean
    C0332307 (UMLS CUI [1,1])
    C0019134 (UMLS CUI [1,2])
    C0439673 (UMLS CUI [1,3])
    Heparin dosage and unit
    Item
    If Heparin was administered, please provide max. daily dose & unit:
    text
    C0806909 (UMLS CUI [1,1])
    C2348070 (UMLS CUI [1,2])
    C0019134 (UMLS CUI [1,3])
    C2348328 (UMLS CUI [2,1])
    C0019134 (UMLS CUI [2,2])
    Heparin - Start date
    Item
    Date commenced:
    date
    C0808070 (UMLS CUI [1,1])
    C0019134 (UMLS CUI [1,2])
    Heparin - Start date unknown
    Item
    Date of commencement: unknown
    boolean
    C0808070 (UMLS CUI [1,1])
    C0019134 (UMLS CUI [1,2])
    C0439673 (UMLS CUI [1,3])
    Heparin therapy duration
    Item
    Duration:
    integer
    C0449238 (UMLS CUI [1,1])
    C0019134 (UMLS CUI [1,2])
    Heparin therapy duration unknown
    Item
    Duration: unknown
    boolean
    C0449238 (UMLS CUI [1,1])
    C0019134 (UMLS CUI [1,2])
    C0439673 (UMLS CUI [1,3])
    Item Group
    Medication: While hospitalised or at discharge, were any of the following administered? Antifungal therapy
    C0678026 (UMLS CUI-1)
    Item
    Antifungal agent?
    integer
    C0003308 (UMLS CUI [1])
    ICU or High Dependency Unit admission
    Code List
    Antifungal agent?
    CL Item
    Yes (1)
    CL Item
    No (2)
    CL Item
    Unknown (3)
    Item Group
    Medication: While hospitalised or at discharge, were any of the following administered? Other treatments administered for COVID-19
    C5203670 (UMLS CUI-1)
    C0205394 (UMLS CUI-2)
    C0013227 (UMLS CUI-3)
    Item
    Other treatments administered for COVID-19 including experimental or compassionate use?
    integer
    C5203670 (UMLS CUI [1,1])
    C0205394 (UMLS CUI [1,2])
    C0013227 (UMLS CUI [1,3])
    C0304229 (UMLS CUI [2,1])
    C5203670 (UMLS CUI [2,2])
    C0013227 (UMLS CUI [3,1])
    C2718016 (UMLS CUI [3,2])
    C5203670 (UMLS CUI [3,3])
    Other treatments administered for COVID-19 including experimental or compassionate use
    Code List
    Other treatments administered for COVID-19 including experimental or compassionate use?
    CL Item
    Yes (1)
    CL Item
    No (2)
    CL Item
    Unknown (3)
    Other treatments administered for COVID-19
    Item
    If yes, specify agent:
    text
    C5203670 (UMLS CUI [1,1])
    C0205394 (UMLS CUI [1,2])
    C0013227 (UMLS CUI [1,3])
    Other treatment for COVID-19: dosage and unit
    Item
    If another treatment was administered, please provide max. daily dose & unit:
    text
    C5203670 (UMLS CUI [1,1])
    C0205394 (UMLS CUI [1,2])
    C0013227 (UMLS CUI [1,3])
    C0806909 (UMLS CUI [1,4])
    C2348070 (UMLS CUI [1,5])
    C5203670 (UMLS CUI [2,1])
    C0205394 (UMLS CUI [2,2])
    C0013227 (UMLS CUI [2,3])
    C2348328 (UMLS CUI [2,4])
    Other treatment for COVID-19: Date of commencement
    Item
    Date of commencement
    date
    C5203670 (UMLS CUI [1,1])
    C0205394 (UMLS CUI [1,2])
    C0013227 (UMLS CUI [1,3])
    C0808070 (UMLS CUI [1,4])
    Other treatment for COVID-19: Date of commencement known
    Item
    Date of commencement: unknown
    boolean
    C5203670 (UMLS CUI [1,1])
    C0205394 (UMLS CUI [1,2])
    C0013227 (UMLS CUI [1,3])
    C0808070 (UMLS CUI [1,4])
    C0439673 (UMLS CUI [1,5])
    Other treatment for COVID-19: Duration of therapy
    Item
    Duration of other treatment for COVID-19
    integer
    C5203670 (UMLS CUI [1,1])
    C0205394 (UMLS CUI [1,2])
    C0013227 (UMLS CUI [1,3])
    C0449238 (UMLS CUI [1,4])
    Other treatment for COVID-19: Duration of therapy known
    Item
    Duration of other treatment for COVID-19 known
    boolean
    C5203670 (UMLS CUI [1,1])
    C0205394 (UMLS CUI [1,2])
    C0013227 (UMLS CUI [1,3])
    C0449238 (UMLS CUI [1,4])
    Item Group
    Outcome
    C1547647 (UMLS CUI-1)
    Item
    Please select only one outcome
    integer
    C1547647 (UMLS CUI [1])
    Outcome
    Code List
    Please select only one outcome
    CL Item
    Discharged alive (1)
    CL Item
    Hospitalization (2)
    CL Item
    Transfer to other facility (3)
    CL Item
    Death (4)
    CL Item
    Palliative discharge (5)
    CL Item
    Unknown (6)
    Outcome date
    Item
    Outcome date
    date
    C1547647 (UMLS CUI [1,1])
    C0011008 (UMLS CUI [1,2])
    Outcome date unknown
    Item
    Outcome date: unknown
    boolean
    C1547647 (UMLS CUI [1,1])
    C0011008 (UMLS CUI [1,2])
    C0439673 (UMLS CUI [1,3])
    Item
    If Discharged alive: Ability to self-care at discharge versus before illness
    integer
    C0562734 (UMLS CUI [1,1])
    C3871203 (UMLS CUI [1,2])
    Ability to self-care at discharge
    Code List
    If Discharged alive: Ability to self-care at discharge versus before illness
    CL Item
    Same as before illness (1)
    CL Item
    Worse (2)
    CL Item
    Better (3)
    CL Item
    Unknown (4)
    Item
    If Discharged alive: Post-discharge treatment - Oxygen therapy?
    integer
    C0586003 (UMLS CUI [1,1])
    C0687676 (UMLS CUI [1,2])
    C0184633 (UMLS CUI [1,3])
    ICU or High Dependency Unit admission
    Code List
    If Discharged alive: Post-discharge treatment - Oxygen therapy?
    CL Item
    Yes (1)
    CL Item
    No (2)
    CL Item
    Unknown (3)
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