MODULE 1: PRESENTATION/ADMISSION 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])
Facility name
Item
Facility name
text
C1552416 (UMLS CUI [1,1])
C0027365 (UMLS CUI [1,2])
Country
Item
Country
text
C0454664 (UMLS CUI [1])
Date of patient assessment
Item
Date of patient assessment
date
C2985720 (UMLS CUI [1])
Date of admission to hospital
Item
Date of admission to hospital
date
C0806429 (UMLS CUI [1])
Item Group
Demographics, complete when MIS is first suspected
C1704791 (UMLS CUI-1)
Item
Sex at Birth
integer
C4019317 (UMLS CUI [1])
Employed as healthcare worker
Code List
Sex at Birth
CL Item
Male (1)
CL Item
Female (2)
CL Item
Not specified/Unknown (3)
Date of birth
Item
Date of birth
date
C0421451 (UMLS CUI [1])
Estimated age in years
Item
Estimated age in years
integer
C0750572 (UMLS CUI [1,1])
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])
Ethnicity
Item
Ethnicity (as reported by family) (please pre-specify main groups in the population and choose from the list)
text
C0015031 (UMLS CUI [1])
Item Group
Onset of current illness and vital signs, complete when MIS is first suspected
C0277793 (UMLS CUI-1)
C0518766 (UMLS CUI-2)
Date of onset of first symptom or sign
Item
Date of onset of first symptom or sign
date
C0574845 (UMLS CUI [1,1])
C0205435 (UMLS CUI [1,2])
C3540840 (UMLS CUI [1,3])
Fever onset date
Item
Date of onset of fever
date
C0574845 (UMLS CUI [1,1])
C0015967 (UMLS CUI [1,2])
Temperature
Item
Temperature
text
C0005903 (UMLS CUI [1])
Heart rate
Item
Heart rate
integer
C0018810 (UMLS CUI [1])
Respiratory rate
Item
Respiratory rate
integer
C0231832 (UMLS CUI [1])
Systolic blood pressure
Item
Systolic BP
integer
C0871470 (UMLS CUI [1])
Diastolic blood pressure
Item
Diastolic BP
integer
C0428883 (UMLS CUI [1])
Item
Dehydration
text
C0011175 (UMLS CUI [1])
Dehydration
Code List
Dehydration
CL Item
severe (1)
CL Item
some  (2)
CL Item
none (3)
Item
Capillary refill time >2 seconds
text
C0425716 (UMLS CUI [1])
Capillary refill time
Code List
Capillary refill time >2 seconds
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Oxygen saturation
text
C0523807 (UMLS CUI [1])
Oxygen saturation
Code List
Oxygen saturation
CL Item
on (1)
CL Item
room air (2)
CL Item
oxygen therapy  (3)
CL Item
unknown (4)
Oxygen saturation, if on, please specify
Item
Oxygen saturation, if on, please specify
text
C0523807 (UMLS CUI [1,1])
C1521902 (UMLS CUI [1,2])
Item
Conscious state
text
C0517960 (UMLS CUI [1])
Conscious state
Code List
Conscious state
CL Item
alert (1)
CL Item
response to verbal stimuli (2)
CL Item
response to painful stimuli (3)
CL Item
unresponsive (4)
Mid-upper arm circumference
Item
Mid-upper arm circumference
integer
C0562351 (UMLS CUI [1])
Length / Height
Item
Length / Height
integer
C0005890 (UMLS CUI [1])
C1444754 (UMLS CUI [2])
Weight
Item
Weight
integer
C0005910 (UMLS CUI [1])
Item Group
Possible signs and symptoms of multisystem inflammatory syndrome, complete when MIS is first suspected
C0332149 (UMLS CUI-1)
C0037088 (UMLS CUI-2)
C5389369 (UMLS CUI-3)
Item
Fever
text
C0005903 (UMLS CUI [1])
Fever
Code List
Fever
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Duration of fever
Item
Duration of fever
integer
C0015967 (UMLS CUI [1,1])
C0449238 (UMLS CUI [1,2])
Item
Rash
text
C0015230 (UMLS CUI [1])
Rash
Code List
Rash
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Rash type
Item
If yes, please specify type of rash
text
C0015230 (UMLS CUI [1,1])
C0332307 (UMLS CUI [1,2])
Item
Bilateral conjunctivitis
text
C0238767 (UMLS CUI [1,1])
C0009763 (UMLS CUI [1,2])
Bilateral conjunctivitis
Code List
Bilateral conjunctivitis
CL Item
Yes, purulent (1)
CL Item
Yes, non-purulent (2)
CL Item
No (3)
CL Item
Unknown (4)
Item
Oral mucosal inflammation signs
text
C0026639 (UMLS CUI [1,1])
C0021368 (UMLS CUI [1,2])
C0037088 (UMLS CUI [1,3])
Oral mucosal inflammation signs
Code List
Oral mucosal inflammation signs
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Peripheral cutaneous inflammation signs (hands or feet)
text
C0205100 (UMLS CUI [1,1])
C0221912 (UMLS CUI [1,2])
C0021368 (UMLS CUI [1,3])
C0037088 (UMLS CUI [1,4])
C0018563 (UMLS CUI [1,5])
C0205100 (UMLS CUI [2,1])
C0221912 (UMLS CUI [2,2])
C0021368 (UMLS CUI [2,3])
C0037088 (UMLS CUI [2,4])
C0016504 (UMLS CUI [2,5])
Peripheral cutaneous inflammation signs (hands or feet)
Code List
Peripheral cutaneous inflammation signs (hands or feet)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Hypotension (age-appropriate)
text
C0020649 (UMLS CUI [1])
Hypotension
Code List
Hypotension (age-appropriate)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Tachycardia (age appropriate)
text
C0039231 (UMLS CUI [1])
Tachycardia
Code List
Tachycardia (age appropriate)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Prolonged capillary refill time
text
C0425716 (UMLS CUI [1,1])
C0439590 (UMLS CUI [1,2])
Prolonged capillary refill time
Code List
Prolonged capillary refill time
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Pale/motted skin
text
C0151907 (UMLS CUI [1])
C0302133 (UMLS CUI [2,1])
C1123023 (UMLS CUI [2,2])
Pale/motted skin
Code List
Pale/motted skin
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Cold hands/feet
text
C0857073 (UMLS CUI [1])
Cold hands/feet
Code List
Cold hands/feet
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Urinary output <2mL/kg/hr
text
C1287298 (UMLS CUI [1,1])
C1532580 (UMLS CUI [1,2])
Urinary output
Code List
Urinary output <2mL/kg/hr
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Chest pain
text
C0008031 (UMLS CUI [1])
Chest pain
Code List
Chest pain
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Tachypnoea (age appropriate)
text
C0231835 (UMLS CUI [1])
Tachypnoea
Code List
Tachypnoea (age appropriate)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Respiratory distress
text
C0476273 (UMLS CUI [1])
Respiratory distress
Code List
Respiratory distress
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Abdominal pain
text
C0000737 (UMLS CUI [1])
Respiratory distress
Code List
Abdominal pain
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Diarrhoea
text
C0011991 (UMLS CUI [1])
Respiratory distress
Code List
Diarrhoea
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Vomiting
text
C0042963 (UMLS CUI [1])
Respiratory distress
Code List
Vomiting
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item Group
Other signs and symptoms
C0037088 (UMLS CUI-1)
C5389369 (UMLS CUI-2)
C0205394 (UMLS CUI-3)
Item
Cough
integer
C0010200 (UMLS CUI [1])
History of fever
Code List
Cough
CL Item
Yes (1)
CL Item
No (4)
CL Item
Unknown (5)
Item
Sore throat
integer
C0242429 (UMLS CUI [1])
History of fever
Code List
Sore throat
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Runny nose
integer
C1260880 (UMLS CUI [1])
History of fever
Code List
Runny nose
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Wheezing
integer
C0043144 (UMLS CUI [1])
History of fever
Code List
Wheezing
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Swollen joints
integer
C0152031 (UMLS CUI [1])
Travel to an area with documentet nCoV infection cases
Code List
Swollen joints
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Cervical lymphadenopathy
integer
C0235592 (UMLS CUI [1])
History of fever
Code List
Cervical lymphadenopathy
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Joint pain (Arthralgia)
integer
C0003862 (UMLS CUI [1])
History of fever
Code List
Joint pain (Arthralgia)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Muscle aches (Myalgia)
integer
C0231528 (UMLS CUI [1])
History of fever
Code List
Muscle aches (Myalgia)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Skin ulcers
integer
C1123023 (UMLS CUI [1,1])
C0041582 (UMLS CUI [1,2])
Travel to an area with documentet nCoV infection cases
Code List
Skin ulcers
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Stiff neck
Item
Stiff-neck
text
C0221170 (UMLS CUI [1,1])
C0027530 (UMLS CUI [1,2])
Item
Fatigue / Malaise
integer
C0024528 (UMLS CUI [1])
History of fever
Code List
Fatigue / Malaise
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Seizures
integer
C0036572 (UMLS CUI [1])
History of fever
Code List
Seizures
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Headache
integer
C0018681 (UMLS CUI [1])
History of fever
Code List
Headache
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Hypotonia/floppiness
integer
C0026827 (UMLS CUI [1])
Travel to an area with documentet nCoV infection cases
Code List
Hypotonia/floppiness
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Paralysis
integer
C3842981 (UMLS CUI [1])
Travel to an area with documentet nCoV infection cases
Code List
Paralysis
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Irritability
integer
C0022107 (UMLS CUI [1])
Travel to an area with documentet nCoV infection cases
Code List
Irritability
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Photophobia
integer
C0085636 (UMLS CUI [1])
Travel to an area with documentet nCoV infection cases
Code List
Photophobia
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Hyposmia/Anosmia (loss of smell)
integer
C0003126 (UMLS CUI [1])
C2364082 (UMLS CUI [2])
Travel to an area with documentet nCoV infection cases
Code List
Hyposmia/Anosmia (loss of smell)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Hypogeusia (loss of taste)
integer
C1868003 (UMLS CUI [1])
Travel to an area with documentet nCoV infection cases
Code List
Hypogeusia (loss of taste)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Not able to drink
integer
C0684271 (UMLS CUI [1,1])
C1299582 (UMLS CUI [1,2])
Travel to an area with documentet nCoV infection cases
Code List
Not able to drink
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Bleeding (Haemorrhage)
integer
C0019080 (UMLS CUI [1])
History of fever
Code List
Bleeding (Haemorrhage)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Haemorrhage Site specification
Item
If bleeding: specify site(s):
text
C0019080 (UMLS CUI [1,1])
C1515974 (UMLS CUI [1,2])
C1521902 (UMLS CUI [1,3])
Other symptom(s) specification
Item
Other symptom(s) specification
text
C1457887 (UMLS CUI [1,1])
C0205394 (UMLS CUI [1,2])
C1521902 (UMLS CUI [1,3])
Item Group
Recent history
C0332185 (UMLS CUI-1)
C0262926 (UMLS CUI-2)
Item
Has the child been admitted to hospital in the last 3 months?
integer
C0332185 (UMLS CUI [1,1])
C0205156 (UMLS CUI [1,2])
C0184666 (UMLS CUI [1,3])
Travel to an area with documentet nCoV infection cases
Code List
Has the child been admitted to hospital in the last 3 months?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Previous hospital discharge date
Item
If yes, date of discharge from hospital
date
C0205156 (UMLS CUI [1,1])
C0184666 (UMLS CUI [1,2])
C2361123 (UMLS CUI [1,3])
Item
If yes, was it related to this illness episode or for the same or similar problems?
integer
C0184666 (UMLS CUI [1,1])
C0205156 (UMLS CUI [1,2])
C5389369 (UMLS CUI [1,3])
C0184666 (UMLS CUI [2,1])
C0205156 (UMLS CUI [2,2])
C5203670 (UMLS CUI [2,3])
Travel to an area with documentet nCoV infection cases
Code List
If yes, was it related to this illness episode or for the same or similar problems?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
History of COVID-19 infection in the previous 4 weeks prior to current illness?
text
C0332185 (UMLS CUI [1,1])
C0262926 (UMLS CUI [1,2])
C5203670 (UMLS CUI [1,3])
Recent history of COVID-19 infection
Code List
History of COVID-19 infection in the previous 4 weeks prior to current illness?
CL Item
Yes - Lab confirmed (1)
CL Item
Yes - Clinically diagnosed (2)
CL Item
No (3)
CL Item
Unknown (4)
Item
History of any respiratory infection in the previous 4 weeks prior to current illness?
integer
C0332185 (UMLS CUI [1,1])
C0262926 (UMLS CUI [1,2])
C0035243 (UMLS CUI [1,3])
Travel to an area with documentet nCoV infection cases
Code List
History of any respiratory infection in the previous 4 weeks prior to current illness?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Any household member (or other contact) with comfirmed COVID-19 in previous 4 weeks?
integer
C4330269 (UMLS CUI [1,1])
C0332185 (UMLS CUI [1,2])
C5203670 (UMLS CUI [1,3])
C0750484 (UMLS CUI [1,4])
C0337611 (UMLS CUI [2,1])
C0332185 (UMLS CUI [2,2])
C5203670 (UMLS CUI [2,3])
C0750484 (UMLS CUI [2,4])
Travel to an area with documentet nCoV infection cases
Code List
Any household member (or other contact) with comfirmed COVID-19 in previous 4 weeks?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Past history of Kawasaki disease?
integer
C0262926 (UMLS CUI [1,1])
C0026691 (UMLS CUI [1,2])
Travel to an area with documentet nCoV infection cases
Code List
Past history of Kawasaki disease?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Family history of Kawasaki disease?
integer
C0241889 (UMLS CUI [1,1])
C0026691 (UMLS CUI [1,2])
Travel to an area with documentet nCoV infection cases
Code List
Family history of Kawasaki disease?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item Group
Co-morbidities, past history (complete when MIS is first suspected)
C0262926 (UMLS CUI-1)
C0009488 (UMLS CUI-2)
Item
Inflammatory or rheumatological disorder
integer
C1290884 (UMLS CUI [1])
C3495832 (UMLS CUI [2])
Travel to an area with documentet nCoV infection cases
Code List
Inflammatory or rheumatological disorder
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Inflammatory or rheumatological disorder specification
Item
If yes, specify:
text
C1290884 (UMLS CUI [1,1])
C1521902 (UMLS CUI [1,2])
C3495832 (UMLS CUI [2,1])
C1521902 (UMLS CUI [2,2])
Item
Hypertension (age appropriate)
integer
C0020538 (UMLS CUI [1])
Travel to an area with documentet nCoV infection cases
Code List
Hypertension (age appropriate)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Other chronic cardiac disease
integer
C1290386 (UMLS CUI [1,1])
C0205394 (UMLS CUI [1,2])
Travel to an area with documentet nCoV infection cases
Code List
Other chronic cardiac disease
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Other chronic cardiac disease specification
Item
If yes, please specify
text
C1290386 (UMLS CUI [1,1])
C0205394 (UMLS CUI [1,2])
C1521902 (UMLS CUI [1,3])
Item
Asthma
integer
C0004096 (UMLS CUI [1])
Travel to an area with documentet nCoV infection cases
Code List
Asthma
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Tuberculosis
integer
C0041296 (UMLS CUI [1])
Travel to an area with documentet nCoV infection cases
Code List
Tuberculosis
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Other chronic pulmonary disease
integer
C0746102 (UMLS CUI [1,1])
C0205394 (UMLS CUI [1,2])
Travel to an area with documentet nCoV infection cases
Code List
Other chronic pulmonary disease
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Other chronic pulmonary disease specification
Item
If yes, specify:
text
C0746102 (UMLS CUI [1,1])
C0205394 (UMLS CUI [1,2])
C1521902 (UMLS CUI [1,3])
Item
Diabetes
integer
C0011849 (UMLS CUI [1])
Chronic cardiac disease
Code List
Diabetes
CL Item
Yes type 1  (1)
CL Item
Yes type 2  (2)
CL Item
No (3)
CL Item
Unknown (4)
Item
Malignant neoplasm
integer
C0006826 (UMLS CUI [1])
Travel to an area with documentet nCoV infection cases
Code List
Malignant neoplasm
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Asplenia
integer
C0600031 (UMLS CUI [1])
C4523973 (UMLS CUI [2])
Travel to an area with documentet nCoV infection cases
Code List
Asplenia
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Congenital or acquired immunesuppression
integer
C0000768 (UMLS CUI [1,1])
C4048329 (UMLS CUI [1,2])
C0439661 (UMLS CUI [2,1])
C4048329 (UMLS CUI [2,2])
Travel to an area with documentet nCoV infection cases
Code List
Congenital or acquired immunesuppression
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Congenital or acquired immunesuppression specification
Item
If yes, specify:
text
C0000768 (UMLS CUI [1,1])
C4048329 (UMLS CUI [1,2])
C1521902 (UMLS CUI [1,3])
C0439661 (UMLS CUI [2,1])
C4048329 (UMLS CUI [2,2])
C1521902 (UMLS CUI [2,3])
Item
Chronic kidney disease
integer
C1561643 (UMLS CUI [1])
Travel to an area with documentet nCoV infection cases
Code List
Chronic kidney disease
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Chronic liver disease
integer
C0341439 (UMLS CUI [1])
Travel to an area with documentet nCoV infection cases
Code List
Chronic liver disease
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])
Travel to an area with documentet nCoV infection cases
Code List
Chronic neurological disorder
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Hematologic disorder
integer
C1275398 (UMLS CUI [1])
Travel to an area with documentet nCoV infection cases
Code List
Hematologic disorder
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
HIV
integer
C0019693 (UMLS CUI [1])
AIDS / HIV
Code List
HIV
CL Item
Yes (on ART) (1)
CL Item
Yes (not on ART) (2)
CL Item
No (3)
CL Item
Unknown (4)
Item
Other comorbidity
integer
C0205394 (UMLS CUI [1,1])
C0009488 (UMLS CUI [1,2])
Travel to an area with documentet nCoV infection cases
Code List
Other comorbidity
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Other comorbidity specification
Item
Other comorbidity
text
C0205394 (UMLS CUI [1,1])
C0009488 (UMLS CUI [1,2])
C1521902 (UMLS CUI [1,3])
Item Group
Pre-admission and chronic medication: Were any of the following taken within 14days of admission (complete when MIS is first suspected)?
C0559269 (UMLS CUI-1)
C0205355 (UMLS CUI-2)
C0013227 (UMLS CUI-3)
Item
Non-steroidalanti-inflammatory (NSAIDs)
integer
C0003211 (UMLS CUI [1])
Travel to an area with documentet nCoV infection cases
Code List
Non-steroidalanti-inflammatory (NSAIDs)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Non-steroidalanti-inflammatory (NSAIDs) specification
Item
If yes, specify name:
text
C0003211 (UMLS CUI [1,1])
C1521902 (UMLS CUI [1,2])
Item
If yes, specify route:
integer
C0003211 (UMLS CUI [1,1])
C1521902 (UMLS CUI [1,2])
C0013153 (UMLS CUI [1,3])
Travel to an area with documentet nCoV infection cases
Code List
If yes, specify route:
CL Item
Oral/rectal (1)
CL Item
Parenteral (IM/IV) (2)
CL Item
Unknown (3)
Item
Steroids
integer
C0038317 (UMLS CUI [1])
Travel to an area with documentet nCoV infection cases
Code List
Steroids
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Steroids specification
Item
If yes, specify name:
text
C0038317 (UMLS CUI [1,1])
C1521902 (UMLS CUI [1,2])
Item
If yes, specify route:
integer
C0038317 (UMLS CUI [1,1])
C1521902 (UMLS CUI [1,2])
C0013153 (UMLS CUI [1,3])
Steroids route specification
Code List
If yes, specify route:
CL Item
Oral/rectal  (1)
CL Item
Parenteral (IM/IV) (2)
CL Item
Inhaled  (3)
CL Item
Topical (4)
CL Item
Unknown (5)
Item
Antibiotics
integer
C0003232 (UMLS CUI [1])
Travel to an area with documentet nCoV infection cases
Code List
Antibiotics
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Antibiotics specification
Item
If yes, specify name:
text
C0003232 (UMLS CUI [1,1])
C1521902 (UMLS CUI [1,2])
Item
If yes, specify route:
integer
C0003232 (UMLS CUI [1,1])
C0013153 (UMLS CUI [1,2])
C1521902 (UMLS CUI [1,3])
Antibiotics route specification
Code List
If yes, specify route:
CL Item
Oral/rectal (1)
CL Item
Parenteral (IM/IV) (2)
CL Item
Unknown (3)
Item
Any other medication
integer
C0205394 (UMLS CUI [1,1])
C0013227 (UMLS CUI [1,2])
Travel to an area with documentet nCoV infection cases
Code List
Any other medication
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Other medication specification
Item
If yes, specify name:
text
C0205394 (UMLS CUI [1,1])
C0013227 (UMLS CUI [1,2])
C1521902 (UMLS CUI [1,3])
Item
If yes, specify route:
integer
C0205394 (UMLS CUI [1,1])
C0013227 (UMLS CUI [1,2])
C1521902 (UMLS CUI [1,3])
C0013153 (UMLS CUI [1,4])
Other medication route specification
Code List
If yes, specify route:
CL Item
Oral/rectal (1)
CL Item
Parenteral (IM/IV) (2)
CL Item
Inhaled (3)
CL Item
Topical (4)
CL Item
Unknown (5)
Other medication specification
Item
If yes, specify name:
text
C0205394 (UMLS CUI [1,1])
C0013227 (UMLS CUI [1,2])
C1521902 (UMLS CUI [1,3])
Item
If yes, specify route:
integer
C0205394 (UMLS CUI [1,1])
C0013227 (UMLS CUI [1,2])
C1521902 (UMLS CUI [1,3])
C0013153 (UMLS CUI [1,4])
Other medication route specification
Code List
If yes, specify route:
CL Item
Oral/rectal (1)
CL Item
Parenteral (IM/IV) (2)
CL Item
Inhaled (3)
CL Item
Topical (4)
CL Item
Unknown (5)
Other medication specification
Item
If yes, specify name:
text
C0205394 (UMLS CUI [1,1])
C0013227 (UMLS CUI [1,2])
C1521902 (UMLS CUI [1,3])
Item
If yes, specify route:
integer
C0205394 (UMLS CUI [1,1])
C0013227 (UMLS CUI [1,2])
C1521902 (UMLS CUI [1,3])
C0013153 (UMLS CUI [1,4])
Other medication route specification
Code List
If yes, specify route:
CL Item
Oral/rectal (1)
CL Item
Parenteral (IM/IV) (2)
CL Item
Inhaled (3)
CL Item
Topical (4)
CL Item
Unknown (5)
Item Group
Laboratory results (complete with results of tests ordered at the time MIS is first suspected) (* record units if different from those listed) Record the worst value between 00:00 to 24:00 on day of assessment (if Not Available write ‘N/A’):
C1254595 (UMLS CUI-1)
Worst Haemoglobin
Item
Haemoglobin (g/L)
float
C1522166 (UMLS CUI [1,1])
C0518015 (UMLS CUI [1,2])
Haemoglobin not done
Item
Haemoglobin (g/L) measurement not done?
boolean
C0518015 (UMLS CUI [1,1])
C1272696 (UMLS CUI [1,2])
Worst total WBC count
Item
Total WBC count (x10^9/L)
float
C1522166 (UMLS CUI [1,1])
C0023508 (UMLS CUI [1,2])
Total WBC count not done
Item
Total WBC count (x10^9/L) not done?
boolean
C0023508 (UMLS CUI [1,1])
C1272696 (UMLS CUI [1,2])
Worst neutrophils
Item
Neutrophils (x10^9/L)
float
C1522166 (UMLS CUI [1,1])
C0948762 (UMLS CUI [1,2])
Neutrophils not done
Item
Neutrophils (x10^9/L) measurement not done?
boolean
C0948762 (UMLS CUI [1,1])
C1272696 (UMLS CUI [1,2])
Worst lymphocytes
Item
Lymphocytes (x10^9/L)
float
C1522166 (UMLS CUI [1,1])
C0200635 (UMLS CUI [1,2])
Lymphocytes not done
Item
Lymphocytes (x10^9/L) measurement not done?
boolean
C0200635 (UMLS CUI [1,1])
C1272696 (UMLS CUI [1,2])
Worst haematocrit
Item
Haematocrit (%)
float
C1522166 (UMLS CUI [1,1])
C0018935 (UMLS CUI [1,2])
Haematocrit not done
Item
Haematocrit (%) measurement not done?
boolean
C0018935 (UMLS CUI [1,1])
C1272696 (UMLS CUI [1,2])
Worst platelets
Item
Platelets (x10^9/L)
float
C1522166 (UMLS CUI [1,1])
C0032181 (UMLS CUI [1,2])
Platelets not done
Item
Platelets (x10^9/L) measurement not done?
boolean
C0032181 (UMLS CUI [1,1])
C1272696 (UMLS CUI [1,2])
Highest APTT/APTR
Item
APTT/APTR
float
C1522410 (UMLS CUI [1,1])
C0030605 (UMLS CUI [1,2])
C1522410 (UMLS CUI [2,1])
C1272061 (UMLS CUI [2,2])
APTT/APTR not done
Item
APTT/APTR measurement not done?
boolean
C0030605 (UMLS CUI [1,1])
C1272696 (UMLS CUI [1,2])
C1272061 (UMLS CUI [2,1])
C1272696 (UMLS CUI [2,2])
Highest prothrombin time
Item
PT (seconds)
float
C1522410 (UMLS CUI [1,1])
C0033707 (UMLS CUI [1,2])
Prothrombin time not done
Item
PT (seconds) measurement not done?
boolean
C0033707 (UMLS CUI [1,1])
C1272696 (UMLS CUI [1,2])
Highest INR
Item
INR
float
C1522410 (UMLS CUI [1,1])
C0525032 (UMLS CUI [1,2])
INR not done
Item
INR measurement not done?
boolean
C0525032 (UMLS CUI [1,1])
C1272696 (UMLS CUI [1,2])
Worst fibrinogen
Item
Fibrinogen (g/L)
float
C1522166 (UMLS CUI [1,1])
C0016006 (UMLS CUI [1,2])
Fibrinogen not done
Item
Fibrinogen (g/L) measurement not done?
boolean
C0016006 (UMLS CUI [1,1])
C1272696 (UMLS CUI [1,2])
Highest procalcitonin
Item
Procalcitonin (ng/mL)
float
C1535922 (UMLS CUI [1,1])
C1522410 (UMLS CUI [1,2])
Procalcitonin not done
Item
Procalcitonin (ng/mL) measurement not done?
boolean
C1535922 (UMLS CUI [1,1])
C1272696 (UMLS CUI [1,2])
Highest CRP
Item
CRP (mg/L)
float
C0201657 (UMLS CUI [1,1])
C1522410 (UMLS CUI [1,2])
CRP not done
Item
CRP (mg/L) measurement not done?
boolean
C0201657 (UMLS CUI [1,1])
C1272696 (UMLS CUI [1,2])
Highest creatinine
Item
Creatinine (umol/L)
float
C0201975 (UMLS CUI [1,1])
C1522410 (UMLS CUI [1,2])
Creatinine not done
Item
Creatinine (umol/L) measurement not done?
boolean
C0201975 (UMLS CUI [1,1])
C1272696 (UMLS CUI [1,2])
Worst sodium
Item
Sodium (mmol/L)
float
C1522166 (UMLS CUI [1,1])
C0337443 (UMLS CUI [1,2])
Sodium not done
Item
Sodium (mmol/L) measurement not done?
boolean
C0337443 (UMLS CUI [1,1])
C1272696 (UMLS CUI [1,2])
Worst potassium
Item
Potassium (mmol/L)
float
C1522166 (UMLS CUI [1,1])
C0202194 (UMLS CUI [1,2])
Potassium not done
Item
Potassium (mmol/L) measurement not done?
boolean
C0202194 (UMLS CUI [1,1])
C1272696 (UMLS CUI [1,2])
Highest urea (BUN)
Item
Urea (BUN) (mmol/L)
float
C1522410 (UMLS CUI [1,1])
C0005845 (UMLS CUI [1,2])
C1522410 (UMLS CUI [2,1])
C0523961 (UMLS CUI [2,2])
Urea (BUN) not done
Item
Urea (BUN) (mmol/L) measurement not done?
boolean
C0005845 (UMLS CUI [1,1])
C1272696 (UMLS CUI [1,2])
C0523961 (UMLS CUI [2,1])
C1272696 (UMLS CUI [2,2])
Worst glucose
Item
Glucose (mmol/L)
float
C1522166 (UMLS CUI [1,1])
C0337438 (UMLS CUI [1,2])
Glucose not done
Item
Glucose (mmol/L) measurement not done?
boolean
C0337438 (UMLS CUI [1,1])
C1272696 (UMLS CUI [1,2])
Highest pro-BNP
Item
Pro-BNP (pg/mL)
float
C3272900 (UMLS CUI [1,1])
C1522410 (UMLS CUI [1,2])
Pro-BNP not done
Item
Pro-BNP (pg/mL) measurement not done?
boolean
C3272900 (UMLS CUI [1,1])
C1272696 (UMLS CUI [1,2])
Highest Troponin
Item
Troponin (ng/mL)
float
C0523952 (UMLS CUI [1,1])
C1522410 (UMLS CUI [1,2])
Troponin not done
Item
Troponin (ng/mL) measurement not done?
boolean
C0523952 (UMLS CUI [1,1])
C1272696 (UMLS CUI [1,2])
Highest creatine kinase
Item
Creatine kinase (U/L)
float
C0201973 (UMLS CUI [1,1])
C1522410 (UMLS CUI [1,2])
Creatine kinase not done
Item
Creatine kinase (U/L) measurement not done?
boolean
C0201973 (UMLS CUI [1,1])
C1272696 (UMLS CUI [1,2])
Highest LDH
Item
LDH (U/L)
float
C0202113 (UMLS CUI [1,1])
C1522410 (UMLS CUI [1,2])
LDH not done
Item
LDH (U/L) measurement not done?
boolean
C0202113 (UMLS CUI [1,1])
C1272696 (UMLS CUI [1,2])
Worst triglyceride
Item
Triglyceride
float
C1522166 (UMLS CUI [1,1])
C0202236 (UMLS CUI [1,2])
Triglyceride not done
Item
Triglyceride measurement not done?
boolean
C0202236 (UMLS CUI [1,1])
C1272696 (UMLS CUI [1,2])
Highest ALT/SGPT
Item
ALT/SGPT (U/L)
float
C0201836 (UMLS CUI [1,1])
C1522410 (UMLS CUI [1,2])
ALT/SGPT not done
Item
ALT/SGPT (U/L) measurement not done?
boolean
C0201836 (UMLS CUI [1,1])
C1272696 (UMLS CUI [1,2])
Highest total bilirubin
Item
Total bilirubin (umol/L)
float
C0201913 (UMLS CUI [1,1])
C1522410 (UMLS CUI [1,2])
Total bilirubin not done
Item
Total bilirubin (umol/L) measurement not done?
boolean
C0201913 (UMLS CUI [1,1])
C1272696 (UMLS CUI [1,2])
Highest ESR
Item
ESR (mm/hr)
float
C1176468 (UMLS CUI [1,1])
C1522410 (UMLS CUI [1,2])
ESR not done
Item
ESR (mm/hr) measurement not done?
boolean
C1176468 (UMLS CUI [1,1])
C1272696 (UMLS CUI [1,2])
Highest D-Dimer
Item
D-Dimer (mg/L)
float
C2826333 (UMLS CUI [1,1])
C1522410 (UMLS CUI [1,2])
D-Dimer not done
Item
D-Dimer (mg/L) measurement not done?
boolean
C2826333 (UMLS CUI [1,1])
C1272696 (UMLS CUI [1,2])
Highest IL-6
Item
IL-6 (pg/mL)
float
C0919829 (UMLS CUI [1,1])
C1522410 (UMLS CUI [1,2])
IL-6 not done
Item
IL-6 (pg/mL) measurement not done?
boolean
C0919829 (UMLS CUI [1,1])
C1272696 (UMLS CUI [1,2])
Highest IL-10
Item
IL-10 (pg/mL)
float
C0085295 (UMLS CUI [1,1])
C1522410 (UMLS CUI [1,2])
IL-10 not done
Item
IL-10 (pg/mL) measurement not done?
boolean
C0085295 (UMLS CUI [1,1])
C1272696 (UMLS CUI [1,2])
Highest AST/GOT
Item
AST/GOT (U/L)
float
C0201899 (UMLS CUI [1,1])
C1522410 (UMLS CUI [1,2])
AST/GOT not done
Item
AST/GOT (U/L) measurement not done?
boolean
C0201899 (UMLS CUI [1,1])
C1272696 (UMLS CUI [1,2])
Worst albumin
Item
Albumin (g/dL)
float
C1522166 (UMLS CUI [1,1])
C0201838 (UMLS CUI [1,2])
Albumin not done
Item
Albumin (g/dL) measurement not done?
boolean
C0201838 (UMLS CUI [1,1])
C1272696 (UMLS CUI [1,2])
Highest lactate
Item
Lactate (mmol/L)
float
C0202113 (UMLS CUI [1,1])
C1522410 (UMLS CUI [1,2])
Lactate not done
Item
Lactate (mmol/L) measurement not done?
boolean
C0202113 (UMLS CUI [1,1])
C1272696 (UMLS CUI [1,2])
Highest ferritin
Item
Ferritin (ng/mL)
float
C1522410 (UMLS CUI [1,1])
C0373607 (UMLS CUI [1,2])
Ferritin not done
Item
Ferritin (ng/mL) measurement not done?
boolean
C0373607 (UMLS CUI [1,1])
C1272696 (UMLS CUI [1,2])
Item Group
Imaging and pathogen testing (complete when results of tests ordered at the time MIS is first suspected are available)
C0011923 (UMLS CUI-1)
C0450254 (UMLS CUI-2)
C0039593 (UMLS CUI-3)
Item
Chest X-ray/CT performed
integer
C0039985 (UMLS CUI [1])
C0202823 (UMLS CUI [2])
Travel to an area with documentet nCoV infection cases
Code List
Chest X-ray/CT performed
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Chest X-ray/CT findings
Item
If yes, findings:
text
C0039985 (UMLS CUI [1,1])
C0243095 (UMLS CUI [1,2])
C0202823 (UMLS CUI [2,1])
C0243095 (UMLS CUI [2,2])
Item
ECG performed?
integer
C0013798 (UMLS CUI [1])
Travel to an area with documentet nCoV infection cases
Code List
ECG performed?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
ECG finding
Item
On that ECG what were the findings?
text
C0013798 (UMLS CUI [1,1])
C0243095 (UMLS CUI [1,2])
Item
Echocardiography performed
integer
C0013516 (UMLS CUI [1])
Travel to an area with documentet nCoV infection cases
Code List
Echocardiography performed
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
If yes, features of myocardial dysfunction?
integer
C0013516 (UMLS CUI [1,1])
C0340515 (UMLS CUI [1,2])
Travel to an area with documentet nCoV infection cases
Code List
If yes, features of myocardial dysfunction?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
If yes, features of pericarditis?
integer
C0013516 (UMLS CUI [1,1])
C0031046 (UMLS CUI [1,2])
Travel to an area with documentet nCoV infection cases
Code List
If yes, features of pericarditis?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
If yes, features of valvulitis?
integer
C0013516 (UMLS CUI [1,1])
C0018826 (UMLS CUI [1,2])
C0021368 (UMLS CUI [1,3])
Travel to an area with documentet nCoV infection cases
Code List
If yes, features of valvulitis?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
If yes, features of coronary abnormalities?
integer
C0013516 (UMLS CUI [1,1])
C1704258 (UMLS CUI [1,2])
C1522318 (UMLS CUI [1,3])
Travel to an area with documentet nCoV infection cases
Code List
If yes, features of coronary abnormalities?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Other cardiac imaging performed?
integer
C2936236 (UMLS CUI [1,1])
C0205394 (UMLS CUI [1,2])
Travel to an area with documentet nCoV infection cases
Code List
Other cardiac imaging performed?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Other cardiac imaging type specification
Item
If yes, specify name of imaging
text
C2936236 (UMLS CUI [1,1])
C0205394 (UMLS CUI [1,2])
C0332307 (UMLS CUI [1,3])
C1521902 (UMLS CUI [1,4])
Other cardiac imaging results specification
Item
If yes, specify results of imaging
text
C2936236 (UMLS CUI [1,1])
C0205394 (UMLS CUI [1,2])
C1274040 (UMLS CUI [1,3])
C1521902 (UMLS CUI [1,4])
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