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Multisystem inflammatory syndrome (MIS) in children and adolescents temporally related to COVID-19 - MODULE 1: PRESENTATION/ADMISSION CASE REPORT FORM

- 03-08-21 - 1 Formulier, 10 Itemgroepen, 188 Data-elementen, 1 Taal
Itemgroepen: Participant Identification, Demographics, Onset of current illness and vital signs, Possible signs and symptoms of multisystem inflammatory syndrome, Other signs and symptoms of multisystem inflammatory syndrome, Recent history, Co-morbidities, past history, Pre-admission and chronic medication, Laboratory results, Imaging and pathogen testing
Based on CRF on https://isaric.org/research/covid-19-clinical-research-resources/multisystem-inflammatory-syndrome-mis-c/ This Case Report Form (CRF) has been developed by ISARIC in cooperation with WHO's working group (https://www.who.int/news-room/commentaries/detail/multisystem-inflammatory-syndrome-in-children-and-adolescents-with-covid-19) to use as a standalone CRF for children and adolescents presenting with syndrome of suspected Multisystem Inflammatory Syndrome (MIS-C). Preliminary case definition Children and adolescents 0–19 years of age with measured or self-reported fever ≥ 3 days AND two or more of the following: a) Rash or bilateral non-purulent conjunctivitis or muco-cutaneous inflammation signs (oral, hands or feet) b) Hypotension or shock c) Features of myocardial dysfunction, or pericarditis, or valvulitis, or coronary abnormalities (clinical features, ECHO findings, or laboratory markers such as elevated Troponin/NT-proBNP) d) Evidence of coagulopathy (such as abnormal PT, PTT, elevated d-Dimers) e) Acute gastrointestinal problems (such as diarrhoea, vomiting or abdominal pain) AND Elevated markers of inflammation such as ESR, C-reactive protein or procalcitonin AND No other obvious microbial cause of inflammation, including bacterial sepsis, staphylococcal or streptococcal shock syndromes AND Evidence of current or previous COVID-19 (RT-PCR, antigen test or serology positive) or likely contact with patients with COVID NB Consider this syndrome in children with features of typical or atypical Kawasaki disease or toxic shock syndrome. This Module is to be completed when multisystem inflammatory syndrome is suspected, on admission or in-patients.

Multisystem inflammatory syndrome (MIS) in children and adolescents temporally related to COVID-19 - MODULE 2: OUTCOME CASE REPORT FORM

- 11-08-21 - 1 Formulier, 7 Itemgroepen, 195 Data-elementen, 1 Taal
Itemgroepen: Participant Identification, Summary of clinical features of current illness, Laboratory results, Imaging and pathogen testing, Treatment, Supportive care, Outcome
Preliminary case definition Children and adolescents 0–19 years of age with measured or self-reported fever ≥ 3 days AND two or more of the following: a) Rash or bilateral non-purulent conjunctivitis or muco-cutaneous inflammation signs (oral, hands or feet) b) Hypotension or shock c) Features of myocardial dysfunction, or pericarditis, or valvulitis, or coronary abnormalities (clinical features, ECHO findings, or laboratory markers such as elevated Troponin/NT-proBNP) d) Evidence of coagulopathy (such as abnormal PT, PTT, elevated d-Dimers) e) Acute gastrointestinal problems (such as diarrhoea, vomiting or abdominal pain) AND Elevated markers of inflammation such as ESR, C-reactive protein or procalcitonin AND No other obvious microbial cause of inflammation, including bacterial sepsis, staphylococcal or streptococcal shock syndromes AND Evidence of current or previous COVID-19 (RT-PCR, antigen test or serology positive) or likely contact with patients with COVID NB Consider this syndrome in children with features of typical or atypical Kawasaki disease or toxic shock syndrome. Based on CRF on https://isaric.org/research/covid-19-clinical-research-resources/multisystem-inflammatory-syndrome-mis-c/ This Case Report Form (CRF) has been developed by ISARIC in cooperation with WHO's working group (https://www.who.int/news-room/commentaries/detail/multisystem-inflammatory-syndrome-in-children-and-adolescents-with-covid-19) to use as a standalone CRF for children and adolescents presenting with syndrome of suspected Multisystem Inflammatory Syndrome (MIS-C). This Module is to be completed at time of discharge or death.

LEOSS: Lean European Open Survey on SARS-CoV-2 Infected Patients - Ethics and palliative care details

- 29-06-21 - 1 Formulier, 8 Itemgroepen, 41 Data-elementen, 1 Taal
Itemgroepen: Reasons for change of therapeutic goals from life-prolonging to palliative, Ethics consultation, Patient declined life-prolonging measures in case of life threatening diseases, Specialist palliative care setting, Specialist palliative care type, Specialist palliative care professionals involved, Drugs prescribed for symptom control (e.g. breathlessness, pain, death rattle), Is data entry for this section finished?
Study Title: LEOSS: Lean European Open Survey on SARS-CoV-2 Infected Patients https://leoss.net Study Indication: COVID-19 Date: 21.03.2021 Published with permission by Prof. Dr. med. J.-J. Vehreschild. LEOSS, a multi-center cohort study, has been created to get more in-depth knowledge about the epidemiology and clinical course of patients infected with SARS-CoV-2. Initiated by the ESCMID Emerging Infections Task Force (EITaF) and the German Infectious Disease Society, and supported by all German Centers for Health Research (DZG), LEOSS has developed into an international network of contributors. Via an integrative research approach with anonymous recruitment and collection of routine data in an open science context, LEOSS is building a uniform clinical dataset and providing real-time analyses. For more information feel free to explore https://leoss.net/. This document is for ethics and palliative care details. If a text field can't be filled out, note 'ND'.

LEOSS: Lean European Open Survey on SARS-CoV-2 Infected Patients - Ethics and palliative care details

- 16-07-21 - 23 Formulieren, 8 Itemgroepen, 41 Data-elementen, 1 Taal
Itemgroepen: Reasons for change of therapeutic goals from life-prolonging to palliative, Ethics consultation, Patient declined life-prolonging measures in case of life threatening diseases, Specialist palliative care setting, Specialist palliative care type, Specialist palliative care professionals involved, Drugs prescribed for symptom control (e.g. breathlessness, pain, death rattle), Is data entry for this section finished?
Study Title: LEOSS: Lean European Open Survey on SARS-CoV-2 Infected Patients https://leoss.net Study Indication: COVID-19 Date: 19.03.2021 Published with permission by Prof. Dr. med. J.-J. Vehreschild. LEOSS, a multi-center cohort study, has been created to get more in-depth knowledge about the epidemiology and clinical course of patients infected with SARS-CoV-2. Initiated by the ESCMID Emerging Infections Task Force (EITaF) and the German Infectious Disease Society, and supported by all German Centers for Health Research (DZG), LEOSS has developed into an international network of contributors. Via an integrative research approach with anonymous recruitment and collection of routine data in an open science context, LEOSS is building a uniform clinical dataset and providing real-time analyses. For more information feel free to explore https://leoss.net/. Please note that only cases with known outcome are collected! Baseline / diagnosis is defined as the day the sample of the first positive SARS-CoV-2 result was taken. Criteria of the Uncomplicated Phase: Asymptomatic OR Symptoms of upper respiratory tract infection and/or Nausea, emesis, diarrhea and/or Fever Remember: The Uncomplicated Phase ends, if a previously febrile patient has no fever anymore and has completed 14 days of follow-up without entering Complicated or Critical Phase; then move to Recovery Phase. Also, as soon as one of the criteria of the Complicated or Critical Phase are fulfilled, Uncomplicated Phase ends; move over to there. If the patient has died, the phase ends with the death of the patient. If the patient has died, do not report terminal values, e.g. those recorded after switching off life-support or heart rate "0" after death of the patient. Criteria of the Complicated Phase: * Need for oxygen supplementation (In patients with prior oxygen home therapy, clinically meaningful increase in need for oxygenation.) * paO2 at room air < 70 mmHg * SO2 at room air < 90 % * GOT or GPT > 5x ULN * New cardiac arrhythmia * New pericardial effusion >1cm * New heart failure with pulmonary edema, congestive hepatopathy or peripheral edema Remember: The Complicated Phase ends, if none of the criteria for the Complicated Phase is fulfilled anymore AND the patient is free of fever; then move to Recovery Phase. Also, as soon as one of the criteria of the Critical Phase are fulfilled, Complicated Phase ends; move over to Critical Phase. If the patient has died, the phase ends with the death of the patient. If the patient has died, do not report terminal values, e.g. those recorded after switching off life-support or heart rate "0" after death of the patient. Criteria of the Critical Phase: * Need for catecholamines * Life-threatening cardiac arrhythmia * Mechanical ventilation (invasive or non-invasive) * Liver failure with Quick< 50% * qSOFA >= 2 * Renal failure in need of dialysis Remember: The Critical Phase ends as soon as none of the criteria for the Critical Phase is fulfilled anymore AND the patient is free of fever. If the patient has died, it ends with the death of the patient. If the patient has died, do not report terminal values, i.e. those recorded after turning off life-support or heart rate "0" after death of the patient. Criteria of the Recovery Phase: *Improvement by at least one phase, i.e. Critical to Complicated or Complicated to Uncomplicated * Defervescence Remember: Uncomplicated asymptomatic patients enter recovery phase after 14 days of observation without disease progression No further progression or re-hospitalization If a text field can't be filled out, note 'ND' (for not determined).

Cardiac MRI (CMR) details

17 Itemgroepen 89 Data-elementen

Neurological sub-cohort

24 Itemgroepen 156 Data-elementen

Recovery Phase

15 Itemgroepen 80 Data-elementen

Complicated Phase

28 Itemgroepen 155 Data-elementen

Critical Phase

32 Itemgroepen 188 Data-elementen

Baseline I

39 Itemgroepen 280 Data-elementen

LEOSS: Lean European Open Survey on SARS-CoV-2 Infected Patients - Cardiac MRI (CMR) details

- 07-05-21 - 1 Formulier, 17 Itemgroepen, 89 Data-elementen, 1 Taal
Itemgroepen: Clinical phase of CMR diagnostic, CMR Indication, CMR context, Patient's characteristics, Heart Rhythm, CMR procedure completed, MRI: Delayed contrast enhancement, CMR measurements, Mapping results, Edema T2 on T2-weighted imaging, Wall motion abnormalities, Perfusion deficit during stress testing, Pericardium, Myocardial strain, Assessment, CMR: Additional information, CMR_completed
Study Title: LEOSS: Lean European Open Survey on SARS-CoV-2 Infected Patients https://leoss.net Study Indication: COVID-19 Date: 19.03.2021 Published with permission by Prof. Dr. med. J.-J. Vehreschild. LEOSS, a multi-center cohort study, has been created to get more in-depth knowledge about the epidemiology and clinical course of patients infected with SARS-CoV-2. Initiated by the ESCMID Emerging Infections Task Force (EITaF) and the German Infectious Disease Society, and supported by all German Centers for Health Research (DZG), LEOSS has developed into an international network of contributors. Via an integrative research approach with anonymous recruitment and collection of routine data in an open science context, LEOSS is building a uniform clinical dataset and providing real-time analyses. For more information feel free to explore https://leoss.net/. This document is for cardiac MRI (CMR) details. If a text field can't be filled out, note 'ND'.

LEOSS: Lean European Open Survey on SARS-CoV-2 Infected Patients - Neurological sub-cohort

- 27-05-21 - 1 Formulier, 24 Itemgroepen, 156 Data-elementen, 1 Taal
Itemgroepen: Duration of neurological comorbidity, Neurological medication before SARS-CoV-2 infection, Neurological status, Specification of neurological comorbidities, Cerebrovascular disease, Cerebrovascular disease: Medication, Multiple Sclerosis subtype & severity, Multiple Sclerosis: Immunomodulatory medication at Baseline, MS: Immunosuppression discontinuation in context of COVID-19, Recent MS relapse treatment, Neurodegeneration, Cognitive / neuropsychiatric impairment during COVID-19 infection, Visual impairment during COVID-19, Oculomotoric impairment during COVID-19 infection, Paresis during COVID-19 infection, Abnormal muscle reflexes during COVID-19 infection, Sensory deficit during COVID-19 infection, Other neurological findings during COVID-19 infection, Neurological diagnostics; Imaging, Neurological diagnostics: EEG, Neurological diagnostics: Electrophysiology, Neurological diagnostics: Spinal tap, Neurological diagnostics: Spinal tap - pathogens, Is data entry for this section finished?
Study Title: LEOSS: Lean European Open Survey on SARS-CoV-2 Infected Patients https://leoss.net Study Indication: COVID-19 Date: 19.03.2021 Published with permission by Prof. Dr. med. J.-J. Vehreschild. LEOSS, a multi-center cohort study, has been created to get more in-depth knowledge about the epidemiology and clinical course of patients infected with SARS-CoV-2. Initiated by the ESCMID Emerging Infections Task Force (EITaF) and the German Infectious Disease Society, and supported by all German Centers for Health Research (DZG), LEOSS has developed into an international network of contributors. Via an integrative research approach with anonymous recruitment and collection of routine data in an open science context, LEOSS is building a uniform clinical dataset and providing real-time analyses. For more information feel free to explore https://leoss.net/. This document is for the neurological sub-cohort. If a text field can't be filled out, note 'ND'.

LEOSS: Lean European Open Survey on SARS-CoV-2 Infected Patients - Recovery Phase

- 28-06-21 - 1 Formulier, 15 Itemgroepen, 80 Data-elementen, 1 Taal
Itemgroepen: RC: Respiratory findings, RC: Cardiovascular findings, RC: Neurological findings, RC: Further findings, RC: Vitals, RC: Lung ultrasound, RC: worst chest CT result, RC: Co/Superinfections, RC: Antibacterial treatment: Betalactams, RC: Antibacterial treatment: Macrolides, RC: Antibacterial treatment: Other antibacterial treatment, RC: Multiple sclerosis, severity after COVID-19 infection, RC: Pulmonary function test (Spirometry), RC: Deterioration of prior chronic pulmonary disease, RC: Is data entry for this section finished?
Study Title: LEOSS: Lean European Open Survey on SARS-CoV-2 Infected Patients https://leoss.net Study Indication: COVID-19 Date: 19.03.2021 Published with permission by Prof. Dr. med. J.-J. Vehreschild. LEOSS, a multi-center cohort study, has been created to get more in-depth knowledge about the epidemiology and clinical course of patients infected with SARS-CoV-2. Initiated by the ESCMID Emerging Infections Task Force (EITaF) and the German Infectious Disease Society, and supported by all German Centers for Health Research (DZG), LEOSS has developed into an international network of contributors. Via an integrative research approach with anonymous recruitment and collection of routine data in an open science context, LEOSS is building a uniform clinical dataset and providing real-time analyses. For more information feel free to explore https://leoss.net/. This document is for data aggregated in the recovery phase. If a text field can't be filled out, note 'ND'. Criteria of the Recovery Phase: Improvement by at least one phase, i.e. Critical to Complicated or Complicated to Uncomplicated Defervescence Remember: Uncomplicated asymptomatic patients enter recovery phase after 14 days of observation without disease progression No further progression or re-hospitalization

Risk perception and optimism during the early stages of the COVID-19 pandemic - Questionnaire risk perception and optimism about COVID-19

- 05-01-22 - 1 Formulier, 7 Itemgroepen, 151 Data-elementen, 1 Taal
Itemgroepen: Risk perception for COVID-19, Control questions for optimism, Adherence to protective measures, Mental health, General control questions, Other, Demographics
In this study, we assessed risk perception and optimism about COVID-19 in a multinational (UK, USA and Germany), longitudinal design during the early stages of the pandemic (16 March 2020; 1 April 2020; 20 May 2020). Our main findings are that (i) people showed a comparative optimism bias about getting infected and infecting others, but not for getting severe symptoms, (ii) this optimism bias did not change over time, (iii) optimism bias seemed to relate to perceived level of control over the action, (iv) risk perception was linked to publicly available information about the disorder, (v) people reported adhering closely to protective measures but these measures did not seem to be related to risk perception, and (vi) risk perception was related to questions about stress and anxiety. Kuper-Smith BJ, Doppelhofer LM, Oganian Y, Rosenblau G, Korn CW. 2021 Risk perception and optimism during the early stages of the COVID-19 pandemic. R. Soc. Open Sci. 8: 210904. https://doi.org/10.1098/rsos.210904

GECCO - German Corona Consensus - Covid-19 Research-Dataset - Symptome

- 05-01-23 - 13 Formulieren, 7 Itemgroepen, 80 Data-elementen, 1 Taal
Itemgroepen: Symptome, Atemwegssymptome, Systemische Symptome, Neurologische/Psychiatrische Symptome, Schmerzen, Magendarmsymptome, Andere Symptome
Disclaimer: Der „GECCO - German Corona Consensus - Covid-19 Research-Dataset“ Inhalt, der auf dem Portal für medizinische Datenmodelle (MDM Portal) zu finden ist, ersetzt nicht den GECCO Datensatz auf simplifier.net. Für die Nutzung von GECCO-FHIR-Profilen verwenden Sie bitte die auf https://simplifier.net/ForschungsnetzCovid-19/ verfügbaren Profile. Der FHIR-Download auf MDM erzeugt lediglich eine FHIR-Fragebogenresource. Ziel Überarbeitung August 2021: höhere Kompatibilität mit der NUM-COMPASS-App bzw. der Schnittstelle zur zentralen Datenbank; Zwischenstand, gewisse Module sind noch nicht kompatibel mit der Schnittstelle (u.a. Medikation und Laborwerte; Beatmungstherapie ist aktuell doppelt hinterlegt) This version of the GECCO logical model is based on https://art-decor.org/art-decor/decor-datasets--covid19f-, and the implementation for REDCap by the University of Tübingen (3.3.2021), partially updated with https://simplifier.net/guide/GermanCoronaConsensusDataSet-ImplementationGuide/Home information. For actual use of FHIR profiles, please use the actual profiles available on https://simplifier.net/ForschungsnetzCovid-19/ResearchDatasetGECCO/~overview (FHIR download on MDM is only a FHIR questionnaire resource). This version is not compatible with the REDCap to FHIR GECCO converter of the University of Tübingen. It aims at a higher compatibility with the app generated for the NUM-COMPASS project (conversion to COMPASS-compatible FHIR questionnaire necessary) and from there with the central platform of the NUM-CODEX project. A few modules are not yet compatible (e.g. Medication and lab values; ventilation is currently double). Official German text from http://cocos.team/datasets.html: Zur Bewältigung der aktuellen Pandemie und der damit einhergehenden Behandlung von Patienten fördert das Bundesministerium für Bildung und Forschung (BMBF) ein nationales Netzwerk der Universitätsmedizin im Kampf gegen COVID-19. Unter anderem soll das Netzwerk die Daten der behandelten COVID-19 Patienten systematisch erfassen und bündeln. Die Forschenden sollen die Behandlung der COVID-19-Patienten standardisiert erheben, verfolgen und analysieren. Die hohe Bedrohungslage hat zu intensiver wissenschaftlicher Aktivität zu COVID-19 geführt, wozu zahlreiche regionale, nationale und internationale epidemiologische Erhebungen und Registerstudien zählen. Der Konsensusdatensatz gibt der Wissenschaft um COVID-19 eine gemeinsame Sprache und Arbeitsgrundlage. Inofficial translation: In order to cope with the current pandemic and the associated treatment of patients, the Federal Ministry of Education and Research (BMBF) is funding a national network of university medicine in the fight against COVID-19. Among other things, the network will systematically collect and bundle the data of the treated COVID-19 patients. The researchers are to collect, track and analyze the treatment of COVID-19 patients in a standardized way. The high threat level has led to intensive scientific activity on COVID-19, including numerous regional, national and international epidemiological surveys and register studies. The consensus data set provides a common language and working basis for the science around COVID-19.

Anamnese/Risikofaktoren

16 Itemgroepen 101 Data-elementen

LEOSS: Lean European Open Survey on SARS-CoV-2 Infected Patients - Complicated Phase

- 22-06-21 - 1 Formulier, 28 Itemgroepen, 155 Data-elementen, 1 Taal
Itemgroepen: CO: Symptoms / Findings, CO: Feeling of breathlessness, CO: Fever, CO: Vitals, CO: Lung ultrasound, CO: worst chest CT result, CO: Antivirals, CO: Antibiotics, CO: Antifungals, CO: Immunomodulators, CO: Cardiovascular medication, CO: Non-oral anticoagulants, CO: Oral anticoagulants, CO: Platelet aggregation inhibition, CO: Further anticoagulation / platelet aggregation inhibition, CO: Other COVID-19 related therapy, CO: Co/Superinfections, CO: Antibacterial treatment, Betalactams, CO: Antibacterial treatment: Macrolides, CO: Antibacterial treatment: Other antibacterial treatment, CO: Complications, Thrombotic and thromboembolic manifestations, CO: Complications, Neurological, CO, Ischemic stroke: TOAST classification, CO, Ischemic stroke: NIHSS score in acute phase, CO: Complications, Other, CO, Acute kidney injury (KDIGO criteria), CO: SOFA score, CO: Is data entry for this section finished?
Study Title: LEOSS: Lean European Open Survey on SARS-CoV-2 Infected Patients https://leoss.net Study Indication: COVID-19 Date: 19.03.2021 Published with permission by Prof. Dr. med. J.-J. Vehreschild. LEOSS, a multi-center cohort study, has been created to get more in-depth knowledge about the epidemiology and clinical course of patients infected with SARS-CoV-2. Initiated by the ESCMID Emerging Infections Task Force (EITaF) and the German Infectious Disease Society, and supported by all German Centers for Health Research (DZG), LEOSS has developed into an international network of contributors. Via an integrative research approach with anonymous recruitment and collection of routine data in an open science context, LEOSS is building a uniform clinical dataset and providing real-time analyses. For more information feel free to explore https://leoss.net/. This document is for data aggregated in the complicated phase. If a text field can't be filled out, note 'ND'. Criteria of the Complicated Phase: Need for oxygen supplementation (In patients with prior oxygen home therapy, clinically meaningful increase in need for oxygenation.) paO2 at room air < 70 mmHg SO2 at room air < 90 % GOT or GPT > 5x ULN New cardiac arrhythmia New pericardial effusion >1cm New heart failure with pulmonary edema, congestive hepatopathy or peripheral edema Remember: The Complicated Phase ends, if none of the criteria for the Complicated Phase is fulfilled anymore AND the patient is free of fever; then move to Recovery Phase. Also, as soon as one of the criteria of the Critical Phase are fulfilled, Complicated Phase ends; move over to Critical Phase. If the patient has died, the phase ends with the death of the patient. If the patient has died, do not report terminal values, e.g. those recorded after switching off life-support or heart rate "0" after death of the patient.

LEOSS: Lean European Open Survey on SARS-CoV-2 Infected Patients - Critical Phase

- 23-06-21 - 1 Formulier, 32 Itemgroepen, 188 Data-elementen, 1 Taal
Itemgroepen: CR: Cardiovascular findings, CR: Respiratory findings, CR: Other severe organ damage, CR: Fever, CR: Vitals, CR: Lung ultrasound, CR: worst chest CT result, CR: Antivirals, CR: Antibiotics, CR: Antifungals, CR: Immunomodulators, CR: Cardiovascular medication, CR: Non-oral anticoagulants, CR: Oral anticoagulants, CR: Platelet aggregation inhibition, CR: Further anticoagulation / platelet aggregation inhibition, CR: Other COVID-19 related therapy, CR: ICU treatment, CR: Mechanical ventilation, CR: Other extracorporeal support, CR: Co/Superinfections, CR: Antibacterial treatment: Betalactams, CR: Antibacterial treatment: Macrolides, CR: Other antibacterial treatment, CR: Complications, Thrombotic and thromboembolic manifestations, CR: Complications, Neurological, Ischemic stroke: TOAST classification, Ischemic stroke: NIHSS score in acute phase, CR: Complications, Other, Acute kidney injury (KDIGO criteria), CR: SOFA score, CR: Is data entry for this section finished?
Study Title: LEOSS: Lean European Open Survey on SARS-CoV-2 Infected Patients https://leoss.net Study Indication: COVID-19 Date: 19.03.2021 Published with permission by Prof. Dr. med. J.-J. Vehreschild. LEOSS, a multi-center cohort study, has been created to get more in-depth knowledge about the epidemiology and clinical course of patients infected with SARS-CoV-2. Initiated by the ESCMID Emerging Infections Task Force (EITaF) and the German Infectious Disease Society, and supported by all German Centers for Health Research (DZG), LEOSS has developed into an international network of contributors. Via an integrative research approach with anonymous recruitment and collection of routine data in an open science context, LEOSS is building a uniform clinical dataset and providing real-time analyses. For more information feel free to explore https://leoss.net/. This document is for data aggregated in the critical phase. If a text field can't be filled out, note 'ND'. Criteria of the Critical Phase: Need for catecholamines Life-threatening cardiac arrhythmia Mechanical ventilation (invasive or non-invasive) Liver failure with Quick< 50% qSOFA >= 2 Renal failure in need of dialysis Remember: The Critical Phase ends as soon as none of the criteria for the Critical Phase is fulfilled anymore AND the patient is free of fever. If the patient has died, it ends with the death of the patient. If the patient has died, do not report terminal, i.e. those recorded after turning off life-support or heart rate "0" after death of the patient.

ISARIC/WHO Novel Coronavirus (nCoV) / COVID-19 Case Report Form - MODULE 1: PRESENTATION/ADMISSION CASE REPORT FORM

- 18-01-21 - 1 Formulier, 10 Itemgroepen, 112 Data-elementen, 1 Taal
Itemgroepen: Participant Identification, Clinical Inclusion Criteria, Demographics, Post Partum, Infant, Onset and admission, Signs and symptoms at hospital admission, Admission signs and symptoms, Pre-admission medication, Co-morbidities and risk factors
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/

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