Information:
Error:
MODULE 1: PRESENTATION/ADMISSION CASE REPORT FORM
- StudyEvent: ODMjoin
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Participant Identification Numbers
Item
Participant Identification Numbers
text
C3165543 (UMLS CUI [1])
Item Group
Clinical Inclusion Criteria
C1512693 (UMLS CUI-1)
C0243161 (UMLS CUI-2)
C0243161 (UMLS CUI-2)
Suspected or proven Coronavirus infection
Item
Suspected or confirmed novel coronavirus (COVID-19) infection:
boolean
C0392360 (UMLS CUI [1,1])
C0030673 (UMLS CUI [1,2])
C3838696 (UMLS CUI [1,3])
C0392360 (UMLS CUI [2,1])
C0030673 (UMLS CUI [2,2])
C0206750 (UMLS CUI [2,3])
C0456369 (UMLS CUI [2,4])
C0030673 (UMLS CUI [1,2])
C3838696 (UMLS CUI [1,3])
C0392360 (UMLS CUI [2,1])
C0030673 (UMLS CUI [2,2])
C0206750 (UMLS CUI [2,3])
C0456369 (UMLS CUI [2,4])
Clinical centre name
Item
Clinical centre name
text
C1552416 (UMLS CUI [1,1])
C0027365 (UMLS CUI [1,2])
C0027365 (UMLS CUI [1,2])
Country
Item
Country
text
C0454664 (UMLS CUI [1])
Enrollment date / first covid-19 assessment
Item
Enrolment date /first COVID-19 assessment date:
date
C1516879 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
C0205435 (UMLS CUI [2,1])
C5203670 (UMLS CUI [2,2])
C2985720 (UMLS CUI [2,3])
C0011008 (UMLS CUI [1,2])
C0205435 (UMLS CUI [2,1])
C5203670 (UMLS CUI [2,2])
C2985720 (UMLS CUI [2,3])
Ethnic group: Arab
Item
Ethnic group: Arab
boolean
C0282540 (UMLS CUI [1])
Ethnic group: Black
Item
Ethnic group: Black
boolean
C0005680 (UMLS CUI [1])
Ethnic group: East Asian
Item
Ethnic group: East Asian
boolean
C4540996 (UMLS CUI [1])
Ethnic group: South Asian
Item
Ethnic group: South Asian
boolean
C1519427 (UMLS CUI [1])
Ethnic group: West Asian
Item
Ethnic group: West Asian
boolean
C0003984 (UMLS CUI [1,1])
C0015031 (UMLS CUI [1,2])
C0015031 (UMLS CUI [1,2])
Ethnic group: Latin American
Item
Ethnic group: Latin American
boolean
C1553378 (UMLS CUI [1])
Ethnic group: White
Item
Ethnic group: White
boolean
C0007457 (UMLS CUI [1])
Ethnic group: Aboriginal/First Nations
Item
Ethnic group: Aboriginal/First Nations
boolean
C0935542 (UMLS CUI [1])
Other ethnic group
Item
Other ethnic group
boolean
C0205394 (UMLS CUI [1,1])
C0015031 (UMLS CUI [1,2])
C0015031 (UMLS CUI [1,2])
Other ethnic group Specification
Item
If Other ethnic group, please specify:
text
C0205394 (UMLS CUI [1,1])
C0015031 (UMLS CUI [1,2])
C2348235 (UMLS CUI [1,3])
C0015031 (UMLS CUI [1,2])
C2348235 (UMLS CUI [1,3])
Unknown ethnic group
Item
Unknown ethnic group
boolean
C0439673 (UMLS CUI [1,1])
C0015031 (UMLS CUI [1,2])
C0015031 (UMLS CUI [1,2])
Item
Employed as a Healthcare Worker?
integer
C0557351 (UMLS CUI [1,1])
C0018724 (UMLS CUI [1,2])
C0018724 (UMLS CUI [1,2])
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Employed in a microbiology laboratory?
integer
C0557351 (UMLS CUI [1,1])
C0181826 (UMLS CUI [1,2])
C0181826 (UMLS CUI [1,2])
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
CL Item
Male (1)
CL Item
Female (2)
CL Item
Not specified/Unknown (3)
Estimated Age in years
Item
Estimated age in years
integer
C0750572 (UMLS CUI [1,1])
C1510829 (UMLS CUI [1,2])
C1510829 (UMLS CUI [1,2])
Estimated Age in months
Item
Estimated age in months
integer
C0750572 (UMLS CUI [1,1])
C1510828 (UMLS CUI [1,2])
C1510828 (UMLS CUI [1,2])
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Gestational week assessment
Item
If YES: Gestational weeks assessment:
integer
C2825545 (UMLS CUI [1])
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
CL Item
Live birth (1)
CL Item
Still birth (2)
Delivery date
Item
If post partum, delivery date:
date
C2053594 (UMLS CUI [1])
Item
If post partum, baby tested for COVID-19/SARS-CoV-2 infection?
integer
C0021270 (UMLS CUI [1,1])
C0022885 (UMLS CUI [1,2])
C0884358 (UMLS CUI [1,3])
C5203676 (UMLS CUI [1,4])
C0022885 (UMLS CUI [1,2])
C0884358 (UMLS CUI [1,3])
C5203676 (UMLS CUI [1,4])
Code List
If post partum, baby tested for COVID-19/SARS-CoV-2 infection?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
If baby got tested, result of the test:
integer
C0021270 (UMLS CUI [1,1])
C1254360 (UMLS CUI [1,2])
C5203676 (UMLS CUI [1,3])
C1254360 (UMLS CUI [1,2])
C5203676 (UMLS CUI [1,3])
CL Item
Positive (1)
(Comment:en)
CL Item
Negative (2)
(Comment:en)
CL Item
Unknown (3)
(Comment:en)
Infant
Item
Infant – Less than 1 year old?
boolean
C0021270 (UMLS CUI [1])
Birth weight
Item
Birth weight
float
C0005612 (UMLS CUI [1])
Item
Birth weight unit/unknown
integer
C0005612 (UMLS CUI [1,1])
C0439148 (UMLS CUI [1,2])
C0005612 (UMLS CUI [2,1])
C0439673 (UMLS CUI [2,2])
C0005612 (UMLS CUI [3,1])
C0439148 (UMLS CUI [3,2])
C0439673 (UMLS CUI [3,3])
C0439148 (UMLS CUI [1,2])
C0005612 (UMLS CUI [2,1])
C0439673 (UMLS CUI [2,2])
C0005612 (UMLS CUI [3,1])
C0439148 (UMLS CUI [3,2])
C0439673 (UMLS CUI [3,3])
CL Item
kg (1)
CL Item
lbs (2)
CL Item
unknown (3)
CL Item
Term birth (≥37wk GA) (1)
CL Item
Preterm birth (<37wk GA) (2)
CL Item
Unknown (3)
CL Item
Yes - currently breastfeeding (1)
CL Item
Yes - breastfeeding discontinued (2)
CL Item
No (3)
CL Item
Unknown (4)
Item
Vaccinations appropriate for age/country?
integer
C1443394 (UMLS CUI [1,1])
C1548787 (UMLS CUI [1,2])
C0001779 (UMLS CUI [1,3])
C1443394 (UMLS CUI [2,1])
C1548787 (UMLS CUI [2,2])
C0454664 (UMLS CUI [2,3])
C1548787 (UMLS CUI [1,2])
C0001779 (UMLS CUI [1,3])
C1443394 (UMLS CUI [2,1])
C1548787 (UMLS CUI [2,2])
C0454664 (UMLS CUI [2,3])
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Onset date of first/earliest symptom
Item
Onset date of first/earliest symptom:
date
C0574845 (UMLS CUI [1,1])
C0205435 (UMLS CUI [1,2])
C1457887 (UMLS CUI [1,3])
C0205435 (UMLS CUI [1,2])
C1457887 (UMLS CUI [1,3])
Admission date at this facility
Item
Most recent presentation/admission date at this facility
date
C1302393 (UMLS CUI [1])
Item
Was the patient admitted previously or transferred from any other facility during this illness episode?
integer
C4264524 (UMLS CUI [1])
Code List
Was the patient admitted previously or transferred from any other facility during this illness episode?
CL Item
YES - admitted previously to this facility (1)
CL Item
YES - transferred from other facility (2)
CL Item
No (3)
CL Item
Unknown (4)
Item
Has this patient’s data been previously collected under a different patient number?
integer
C3165543 (UMLS CUI [1,1])
C4264524 (UMLS CUI [1,2])
C4264524 (UMLS CUI [1,2])
Code List
Has this patient’s data been previously collected under a different patient number?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Participant ID at transferring facility
Item
If YES, Participant Identification number (PIN):
text
C3165543 (UMLS CUI [1,1])
C4264524 (UMLS CUI [1,2])
C2348235 (UMLS CUI [1,3])
C4264524 (UMLS CUI [1,2])
C2348235 (UMLS CUI [1,3])
Item Group
Signs and symptoms at hospital admission
C0037088 (UMLS CUI-1)
C0184666 (UMLS CUI-2)
C0184666 (UMLS CUI-2)
Body temperature
Item
Body temperature
float
C0005903 (UMLS CUI [1])
CL Item
Celsius (1)
CL Item
Fahrenheit (2)
Heart Rate
Item
Heart Rate (HR):
integer
C0018810 (UMLS CUI [1])
Respiratory rate
Item
Respiratory rate (RR)
integer
C0231832 (UMLS CUI [1])
Systolic BP
Item
Systolic blood pressure
integer
C0871470 (UMLS CUI [1])
Diastolic BP
Item
Diastolic blood pressure
integer
C0428883 (UMLS CUI [1])
Oxygen saturation
Item
Oxygen saturation
integer
C0523807 (UMLS CUI [1])
Item
Oxygen saturation under which condition?
integer
C0523807 (UMLS CUI [1,1])
C0449438 (UMLS CUI [1,2])
C0449438 (UMLS CUI [1,2])
CL Item
Room air (1)
CL Item
Oxygen therapy (2)
CL Item
N/A (3)
Item
Sternal capillary refill time >2seconds
integer
C1714880 (UMLS CUI [1])
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Height
Item
Height:
integer
C0005890 (UMLS CUI [1])
Weight
Item
Weight:
integer
C0005910 (UMLS CUI [1])
Item Group
Admission signs and symptoms
C0037088 (UMLS CUI-1)
C0184666 (UMLS CUI-2)
C0184666 (UMLS CUI-2)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
CL Item
YES-non-productive (1)
CL Item
YES-productive (2)
CL Item
YES-with haemoptysis (3)
CL Item
No (4)
CL Item
Unknown (5)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Lower chest wall indrawing
integer
C0205076 (UMLS CUI [1,1])
C0425469 (UMLS CUI [1,2])
C0425469 (UMLS CUI [1,2])
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Altered consciousness/confusion
integer
C0150450 (UMLS CUI [1])
C0009676 (UMLS CUI [2])
C0009676 (UMLS CUI [2])
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Haemorrhage Site
Item
If Bleeding: specify site(s):
text
C0019080 (UMLS CUI [1,1])
C1515974 (UMLS CUI [1,2])
C1515974 (UMLS CUI [1,2])
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Other symptom(s)
Item
If YES, specify:
text
C1457887 (UMLS CUI [1,1])
C0205394 (UMLS CUI [1,2])
C0205394 (UMLS CUI [1,2])
Item Group
Pre-admission medication (taken within 14 days of admission/presentation at healthcare facility)
C0559269 (UMLS CUI-1)
C0013227 (UMLS CUI-2)
C0332285 (UMLS CUI-3)
C5142984 (UMLS CUI-4)
C0013227 (UMLS CUI-2)
C0332285 (UMLS CUI-3)
C5142984 (UMLS CUI-4)
Item
Angiotensin converting enzyme inhibitors (ACE inhibitors)
integer
C0003015 (UMLS CUI [1])
Code List
Angiotensin converting enzyme inhibitors (ACE inhibitors)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Angiotensin II receptor blockers (ARBs)
integer
C0521942 (UMLS CUI [1])
Code List
Angiotensin II receptor blockers (ARBs)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Non-steroidalanti-inflammatory(NSAIDs)
integer
C0003211 (UMLS CUI [1])
Code List
Non-steroidalanti-inflammatory(NSAIDs)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Oral steroids - Specification
Item
Oral steroids - If Yes, agent(s):
text
C0038317 (UMLS CUI [1,1])
C1527415 (UMLS CUI [1,2])
C2348235 (UMLS CUI [1,3])
C1527415 (UMLS CUI [1,2])
C2348235 (UMLS CUI [1,3])
Item
Other immunosuppressant agents (not oral steroids)
integer
C0021081 (UMLS CUI [1,1])
C0205394 (UMLS CUI [1,2])
C0205394 (UMLS CUI [1,2])
Code List
Other immunosuppressant agents (not oral steroids)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Other immunosuppressant agents - Specification
Item
Other immunosuppressant agents (not oral steroids) - If Yes, agent(s):
text
C0021081 (UMLS CUI [1,1])
C0205394 (UMLS CUI [1,2])
C2348235 (UMLS CUI [1,3])
C0205394 (UMLS CUI [1,2])
C2348235 (UMLS CUI [1,3])
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Antivirals - Specification
Item
Antivirals - If Yes, agent(s):
text
C0003451 (UMLS CUI [1,1])
C2348235 (UMLS CUI [1,2])
C2348235 (UMLS CUI [1,2])
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Antibiotics - Specification
Item
Antibiotics - If Yes, agent(s):
text
C0003232 (UMLS CUI [1,1])
C2348235 (UMLS CUI [1,2])
C2348235 (UMLS CUI [1,2])
Item
Other targeted COVID-19 Medications
integer
C0205394 (UMLS CUI [1,1])
C5203670 (UMLS CUI [1,2])
C0013227 (UMLS CUI [1,3])
C5203670 (UMLS CUI [1,2])
C0013227 (UMLS CUI [1,3])
Code List
Other targeted COVID-19 Medications
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Other targeted COVID-19 Medications - Specification
Item
Other targeted COVID-19 Medications - If Yes, agent(s):
text
C0205394 (UMLS CUI [1,1])
C5203670 (UMLS CUI [1,2])
C0013227 (UMLS CUI [1,3])
C2348235 (UMLS CUI [1,4])
C5203670 (UMLS CUI [1,2])
C0013227 (UMLS CUI [1,3])
C2348235 (UMLS CUI [1,4])
Item Group
Co-morbidities and risk factors
C0009488 (UMLS CUI-1)
C0035648 (UMLS CUI-2)
C0035648 (UMLS CUI-2)
Item
Chronic cardiac disease, including congenital heart disease (not hypertension)
integer
C1290386 (UMLS CUI [1])
Code List
Chronic cardiac disease, including congenital heart disease (not hypertension)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Chronic pulmonary disease (not asthma)
integer
C0746102 (UMLS CUI [1,1])
C0332300 (UMLS CUI [1,2])
C0004096 (UMLS CUI [1,3])
C0332300 (UMLS CUI [1,2])
C0004096 (UMLS CUI [1,3])
Code List
Chronic pulmonary disease (not asthma)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Moderate or severe liver disease
integer
C0023895 (UMLS CUI [1,1])
C0205081 (UMLS CUI [1,2])
C0205082 (UMLS CUI [2,1])
C0023895 (UMLS CUI [2,2])
C0205081 (UMLS CUI [1,2])
C0205082 (UMLS CUI [2,1])
C0023895 (UMLS CUI [2,2])
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Mild liver disease
integer
C2945599 (UMLS CUI [1,1])
C0023895 (UMLS CUI [1,2])
C0023895 (UMLS CUI [1,2])
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Chronic neurological disorder
integer
C0027765 (UMLS CUI [1,1])
C0008679 (UMLS CUI [1,2])
C0008679 (UMLS CUI [1,2])
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
CL Item
Yes - on ART (1)
CL Item
Yes - not on ART (2)
CL Item
No (3)
CL Item
Unknown (4)
Code List
Obesity (as defined by clinical staff)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
CL Item
Yes - Type 1 (1)
CL Item
Yes - Type 2 (2)
CL Item
No (3)
CL Item
Unknown (4)
Item
Rheumatologic disorder
integer
C0035452 (UMLS CUI [1,1])
C0012634 (UMLS CUI [1,2])
C0012634 (UMLS CUI [1,2])
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
CL Item
Yes (1)
CL Item
Never smoked (2)
CL Item
Former smoker (3)
CL Item
Unknown (4)
Item
Other relevant risk factor
integer
C0035648 (UMLS CUI [1,1])
C0205394 (UMLS CUI [1,2])
C0205394 (UMLS CUI [1,2])
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Specification of relevant risk factor
Item
If other relevant risk factors are known, please specify:
text
C0035648 (UMLS CUI [1,1])
C0205394 (UMLS CUI [1,2])
C2348235 (UMLS CUI [1,3])
C0205394 (UMLS CUI [1,2])
C2348235 (UMLS CUI [1,3])