crf1a1_version |
|
radio |
CRF1 Version Completed |
1, Unversioned; 2, 1.0; 3, 1.1; 4, 1.2; 5, 1.3; 6, 1.4; 7, 1.5; 8, 2.0 |
crf1a_date |
|
text |
Date of collection |
|
crf1a_sex |
|
radio |
1) Sex at birth |
M, Male; F, Female |
crf1a_pregnant_yn |
Pregnancy (females only) |
radio |
Pregnant? |
1, Yes; 0, No; NK, Not known |
crf1a_gestational_weeks |
|
text |
If pregnant, gestation weeks at admission |
|
crf1a_post_partum_yn |
|
radio |
Post-partum? |
1, Yes; 0, No; NK, Not known |
crf1a_pregnancy_outcome |
|
radio |
Pregnancy outcome: |
1, Live Birth; 2, Still Birth; NK, Not Known |
crf1a_delivery_date_yn |
|
yesno |
Delivery date known? |
1, Yes; 0, No |
crf1a_delivery_date |
|
text |
Delivery date: |
|
crf1a_infant_c19_tested_yn |
|
radio |
Has infant been tested for COVID? |
1, Yes; 0, No; NK, Not known |
crf1a_infant_c19_result_1 |
|
radio |
Infant COVID-19 test result: |
1, Positive; 0, Negative; 2, Indeterminate |
crf1a_date_first_sympt_yn |
Onset and Admission |
yesno |
Is the date of first/earliest symptoms known? |
1, Yes; 0, No |
crf1a_date_first_symptoms |
|
text |
Date of first/earliest symptoms |
|
crf1a_date_adm_yn |
|
yesno |
Is the date of admission to this hospital known? |
1, Yes; 0, No |
crf1a_date_adm |
|
text |
Date of admission to this hospital |
|
age_admission |
|
calc |
Age at Admission (Years) |
round(datediff([date_of_birth], [crf1a_date_adm], "y","dmy"),0) |
crf1a_re_adm_with_c19 |
|
radio |
Is this a re-admission with COVID-19? |
1, Yes; 0, No; NK, N/K |
crf1a_re_adm_rsn |
|
notes |
If yes, reason for re-admission: |
|
crf1a_xfer_in |
|
radio |
Was the patient transferred from another hospital? |
1, Yes; 0, No; NK, N/K |
crf1aprev_hosp_name_known |
|
yesno |
Is the name of the previous hospital known? |
1, Yes; 0, No |
crf1a_name_xfer_in_hosp |
|
text |
What was the name of the previous hospital? |
|
crf1a_prev_adm_date_known |
|
yesno |
Is the date of the previous hospital admission known? |
1, Yes; 0, No |
crf1a_xfer_in_adm_date |
|
text |
If yes: What was the admission date? |
|
crf1a_date_dis_yn |
|
yesno |
Is the date of discharge from hospital known? |
1, Yes; 0, No |
crf1a_date_dis |
|
text |
Date of discharge from hospital |
|
duration_adm |
|
calc |
Duration of Admission (Days) |
datediff([crf1a_date_adm], [crf1a_date_dis], "d","dmy") |
crf1a_temperature |
Vital Signs at Hospital Admission |
text |
Temperature |
|
crf1a_hr |
|
text |
Heart Rate |
|
crf1a_respiratory_rate |
|
text |
Respiratory Rate |
|
crf1a_bp_sys |
|
text |
Blood pressure (Sys) |
|
crf1a_bp_dia |
|
text |
Blood pressure (Dia) |
|
crf1a_sev_dehydr |
|
radio |
Severe Dehydration |
1, Yes; 0, No; NK, N/K |
crf1a_stcap_refill_2s |
|
radio |
Sternal capillary refill time > 2 seconds |
1, Yes; 0, No; NK, N/K |
crf1a_o2_sat |
|
text |
Oxygen saturation |
|
crf1a_supp_o2 |
|
radio |
Supplemental oxygen |
1, Air; 2, Any Oxygen therapy; NK, N/K |
crf1a_fever_history |
Admission signs and symptoms |
radio |
a) History of fever |
1, Yes; 0, No; 2, N/K |
crf1a_cough |
|
radio |
b) Cough |
1, Yes; 0, No; 2, N/K |
crf1a_cough_sputum |
|
radio |
bi) Cough With sputum |
1, Yes; 0, No; 2, N/K |
crf1a_cough_blood |
|
radio |
bii) Cough Blood/ haemoptysis |
1, Yes; 0, No; 2, N/K |
crf1a_sore_throat |
|
radio |
c) Sore throat |
1, Yes; 0, No; 2, N/K |
crf1a_runny_nose |
|
radio |
d) Runny nose (rhinorrhoea) |
1, Yes; 0, No; 2, N/K |
crf1a_ear_pain |
|
radio |
e) Ear pain |
1, Yes; 0, No; 2, N/K |
crf1a_wheezing |
|
radio |
f) Wheezing |
1, Yes; 0, No; 2, N/K |
crf1a_chest_pain |
|
radio |
g) Chest pain |
1, Yes; 0, No; 2, N/K |
crf1a_muscle_aches |
|
radio |
h) Muscle aches (Myalgia) |
1, Yes; 0, No; 2, N/K |
crf1a_join_pain |
|
radio |
i) Joint pain (Arthralgia) |
1, Yes; 0, No; 2, N/K |
crf1a_fatigue |
|
radio |
j) Fatigue/ Malaise |
1, Yes; 0, No; 2, N/K |
crf1a_shortness_breath |
|
radio |
k) Shortness of breath (dyspnoea) |
1, Yes; 0, No; 2, N/K |
crf1a_loss_taste |
|
radio |
l) Disturbance or loss of taste (Ageusia) |
1, Yes; 0, No; 2, N/K |
crf1a_loss_smell |
|
radio |
m) Disturbance or loss of smell (Anosmia) |
1, Yes; 0, No; 2, N/K |
crf1a_chest_indrawing |
|
radio |
n) Lower chest wall indrawing |
1, Yes; 0, No; 2, N/K |
crf1a_headache |
|
radio |
o) Headache |
1, Yes; 0, No; 2, N/K |
crf1a_confusion |
|
radio |
p) Altered consciousness/confusion |
1, Yes; 0, No; 2, N/K |
crf1a_seizures |
|
radio |
q) Seizures |
1, Yes; 0, No; 2, N/K |
crf1a_pain |
|
radio |
r) Abdominal Pain |
1, Yes; 0, No; 2, N/K |
crf1a_nausea |
|
radio |
s) Vomiting / Nausea |
1, Yes; 0, No; 2, N/K |
crf1a_diarrhoea |
|
radio |
t) Diarrhoea |
1, Yes; 0, No; 2, N/K |
crf1a_conjunctivitis |
|
radio |
u) Conjunctivitis |
1, Yes; 0, No; 2, N/K |
crf1a_skin_rash |
|
radio |
v) Skin rash |
1, Yes; 0, No; 2, N/K |
crf1a_skin_ulcers |
|
radio |
w) Skin ulcers |
1, Yes; 0, No; 2, N/K |
crf1a_lymphadenopathy |
|
radio |
x) Lymphadenopathy |
1, Yes; 0, No; 2, N/K |
crf1a_bleeding |
|
radio |
y) Bleeding (Haemorrhage) |
1, Yes; 0, No; 2, N/K |
crf1a_bleeding_site_known |
|
yesno |
Bleeding site known? |
1, Yes; 0, No |
crf1a_bleed_site |
|
notes |
If bleeding: specify site(s): |
|
crf1a_immunosuppressant |
Pre-admission medication (Were any of the following taken within 14 days of admission?) |
radio |
a) Immunosuppressant e.g. oral (not inhaled) corticosteroids (not low dose hydrocortisone) |
1, Yes; 0, No; 2, N/K |
crf1a_anti_infectives |
|
radio |
b) Anti-infectives for this illness episode prior to admission? |
1, Yes; 0, No; 2, N/K |
crf1a_acei |
|
radio |
c) Angiotensin converting enzyme inhibitors (ACEI)? |
1, Yes; 0, No; 2, N/K |
crf1a_abbs |
|
radio |
d) Angiotensin II receptor blockers (ARBs)? |
1, Yes; 0, No; 2, N/K |
crf1a_nsaid |
|
radio |
e) Non-steroidal anti-inflammatory (NSAID)? |
1, Yes; 0, No; 2, N/K |
crf1a_con_meds_comp_yn |
Medication Log |
yesno |
Medication log complete? |
1, Yes; 0, No |