TX Section Short Label EN: Variable Name

Tx section Variable name Short label EN
Reporting report_date Date (DD/MM/YYYY)*: _____/____/______

Reporting report_country reporting country
Reporting report_test_reason Why the case was tested for COVID-19
Reporting report_test_reason_other Other reason the case was tested for COVID-19
Patient informatiopatinfo_ID country case ID*:
Patient informatiopatinfo_ageonset or Age:_______
Patient informatiopatinfo_ageonsetunit unit of age
Patient informatiopatinfo_sex Sex at birth: Male Female
Patient informatiopatinfo_idadmin0 where the case was diagnosed, admin level 0 (country)
Patient informatiopatinfo_idadmin1 identified Admin Level 1 (province):
Patient informatiopatinfo_resadmin0 place of residence admin level 0
Clinical status Lab_date1 Date of first laboratory confirmation
Clinical status patcourse_dateonset Date of onset of first symptoms:____/___
Clinical status patcourse_asymp Patient asymptomatic at time of speciment
Clinical status Comcond_present Does the patient have any underlying conditions?
Clinical status Comcond_preg Pregnancy
Clinical status Comcond_pregt Trimester of pregancy
Clinical status Comcond_partum Post-partum (<6 weeks)
Clinical status Comcond_immuno Immunodeficiency including HIV
Clinical status Comcond_cardi Cardiovacsular disease including hypertension
Clinical status Comcond_diabetes Diabetes
Clinical status Comcond_liver Liver disease
Clinical status Comcond_renal Renal disease
Clinical status Comcond_neuro Chronic neurological or neuromuscular disease
Clinical status Comcond_malig Malignancy
Clinical status Comcond_lung Chronic lung disease
Clinical status Comcond_other Other, specify
Clinical status patcourse_admit admission to hospital?:
Clinical status patcourse_presHCF For this episode, date first admitted in hosp
Clinical status patcourse_icu Did the patient receive care in an ICU?
Clinical status patcourse_vent Was the patient ventilated?
Clinical status patcourse_ecmo Did the patient receive ECMO?
Clinical status patcourse_iso Was the case isolated?
Clinical status patcourse_dateiso date of isolation
Exposure and travepatinfo_occuhcw Health care worker
Exposure and travepatinfo_occuhcw_country Healthcare worker country
Exposure and travepatinfo_occuhcw_city Healthcare worker city
Exposure and travepatinfo_occuhcw_name Healthcare worker facility name
Exposure and traveexpo_travel Has the patient travelled in the 14 days pr
Exposure and traveexpo_travel_country1 Specify country travelled to 1
Exposure and traveexpo_travel_city1 Specify city travelled to 1
Exposure and traveexpo_travel_date1 Specify date departed from 1
Exposure and traveexpo_visit_healthcare Has the patient visited any health care faci
Exposure and traveexpo_contact_case Has the patient had contact with a confir
Exposure and traveexpo_case_setting_detail Explain contact setting
Exposure and traveexpo_ID1 ID number of confirmed case 1
Exposure and traveexpo_case_date_first1 Date of first exposure to confirmed case 1
Exposure and traveexpo_case_date_last1 Date of last exposure to confirmed case 1
Exposure and traveexpo_case_location Likely country for exposure to case?
Outcome outcome_submitted Outcome section submitted
Outcome outcome_submitted_date Date of outcome submission
Outcome outcome_asymp Case developed symptoms
Outcome outcome_asymp_date Date case developed symptoms
Outcome outcome_patcourse_admitPatient admitted to hospital
Outcome outcome_patcourse_presHDate patient admitted to hospital
Outcome outcome_patcourse_icu Did the patient receive care in an ICU?
Outcome outcome_patcourse_vent Was the patient ventilated?
Outcome outcome_patcourse_ecmo Did the patient receive ECMO?
Outcome outcome_patcourse_statusPatient status (outcome)
Outcome outcome_patcourse_statusOther patient status (outcome)
Outcome outcome_date_of_outcom Date of patient release or date of death
Outcome outcome_lab_date If released, date of last laboratory test
Outcome outcome_lab_result laboratory result from last test
Outcome outcome_contacts_followeHigh risk contacts followed from case
Outcome outcome_contacts_follow Number of high risk contacts followed unknown
Short label FR Description Data type
Date*: _____/____/______ Date of reporting
Country/territory/national boundary within which the case Date
currently/usually resides.
Pays*: If transborders or international spread of outbreak String
Why the case was tested for COVID-19 Coded
ed for COVID-19 Any other reason the case was tested for COVID-19 String
Numéro d'identification unique*: Unique case identification number (used in country) String
ou Age *: ______ Age in units on the date of illness onset. Numeric
Unité de l'âge Years or months or days Coded
Sexe a la naissance*: Homme Fe Biological sex. That is the biological differential character Coded
admin level 0 (country) Administrative level 0: Country where the case was diagnosString
Niveau admin 1*(préfecture): Administrative level 1: First sub-national boundary (e.g. proString
Administrative level 0: Country within which the case's currString
Date prélèvement1 Date of first laboratory confirmation Date
Date de début des premiers sympDate of first appearance of the signs or symptoms of the ill Date
Patient asymptomatique Is the case asymptomatic? Coded
erlying conditions? Does the patient have any underlying conditions? Coded
Grossesse Is the patient pregnant? Coded
Trimestre de grossesse Coded
Post-partum (<6 semaines) Is the patient in the post partum period defined as less tha Coded
Immunodéficience, y compris le Vhas the patient an adquired immunodeficiency (HIV) or is t Coded
g hypertension any cardiovacsular disease Coded
Coded
any liver diseases Coded
any renal diseases Coded
muscular disease Coded
Malignité Coded
Maladie aiguë ou chronique associée: Coded
Autre spécifier Describe other underlying conditions and comorbidity String
Hospitalisation* ?: Was the case hospitalized, admitted to a hospital or other he Coded
Pour cet épisode, quelle est la da Date the case was first admitted to any health facility. Date
Did the patient receive care in an intensive care unit (ICU)?Coded
Est ce que le patient a été venti Was the patient ever ventilated for this episode at time of Coded
Est ce que le patient a été venti Did the patient receive extracorporeal membrane oxygena Coded
Was the case isolated with proper IPC controls implementeCoded
date d'isolement What date was the case isolated? Date
Is the patient working in a health care setting? Coded
If case is a healthcare worker, in which country do they wo String
If case is a healthcare worker, in which city do they work? String
If case is a healthcare worker, what is the name of the facil String
Le patient a-t-il voyagé au cours Has the patient travelled in the 14 days prior to symptom Coded
Précisez le pays visité jusqu'à 1 List the country from location 1 that the case has travelled String
Précisez la ville parcourue au 1 List the city from location 1 that the case has travelled to String
Précisez la ville parcourue au 1 List the date departed from location 1 that the case has tr Date
Le patient a-t-il visité un établiHas the patient visited any health care facilities in the 14 Coded
Le patient a-t-il eu un contact avHas the patient had contact with a confirmed case in the 14Coded
If the patient has had contact with a confirmed case in the String
Numero identification du cas contList the unique case identifier 1 with whom the patient hadString
Numero identification du cas contDate of first exposure to confirmed case 1 Date
Numero identification du cas contDate of last exposure to confirmed case 1 Date
Quel est l'endroit le plus probableSpecify the location of possible exposure to a case String
Has the outcome section been submitted? Coded
Date of outcome submission Date
If case was asymptomatic at time of specimen collection resCoded
If case was asymptomatic and developed symptoms, what isDate
Patient was first admitted to hospital (outcome) Coded
Date patient was first admitted to hospital (outcome) Date
Did the patient receive care in an intensive care unit (ICU) Coded
Est ce que le patient a été venti Was the patient ever ventilated for this episode? (outcomeCoded
Est ce que le patient a été venti Did the patient receive extracorporeal membrane oxygena Coded
Patient status (outcome) Coded
Other patient status (outcome) String
Date of Release from isolation/hospital or Date of Death Date
If released from hospital /isolation, date of last laboratory tDate
laboratory result from last test Coded
Total number of high-risk contacts followed for this case Numeric
llowed unknown Number of high risk contacts followed unknown Coded
Permissible values EN Permissible values FR
Format (response options) (response options)
DD/MM/YYYY
Free text
Coded variables CASE_CONTACT, SEEKING_HC, POE_DETECTION, REPATRIATION, SURVEILLANCE, UNKNOWN, OTHER
Free text
Free text
### 0-110 0-110
Coded variables YEARS, MONTHS, DAYS 1 = année 2 = mois 3=jours
Coded variables MALE, FEMALE 1 = Homme; 2 = Femme;
Free text
Free text
Free text
DD/MM/YYYY
DD/MM/YYYY
Coded variables YES, NO, UNKNOWN 1 = Oui; 2 = Non
Coded variables YES, NO, UNKNOWN
Coded variables YES, NO 1 = Oui; 2 = Non
Coded variables FIRST, SECOND, THIRD
Free text
Coded variables YES, NO, UNKNOWN 1 = Oui; 2 = Non, 3 = Inconnue
DD/MM/YYYY
DD/MM/YYYY
Free text
Free text
Free text
Free text
Free text
DD/MM/YYYY
Free text
Free text
DD/MM/YYYY
Free text
Free text
DD/MM/YYYY
Free text
Free text
Free text
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Free text
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DD/MM/YYYY
DD/MM/YYYY
DD/MM/YYYY
DD/MM/YYYY
DD/MM/YYYY
DD/MM/YYYY
DD/MM/YYYY
DD/MM/YYYY
DD/MM/YYYY
DD/MM/YYYY
Free text
Coded variables YES, NO, PARTIAL
DD/MM/YYYY
DD/MM/YYYY
DD/MM/YYYY YES, NO, UNKNOWN
Coded variables RECOVERED, NOTRECOVERED, DEATH, UNKNOWN, OTHER
Free text
DD/MM/YYYY
DD/MM/YYYY
Coded variables POSITIVE, NEGATIVE,INCONCLUSIVE, UNKNOWN
###
NCE, UNKNOWN, OTHER
Tx section Variable name
Reporting report_whoID
Reporting report_date
Reporting report_orginst
Reporting report_country
Reporting report_test_reason
Reporting report_test_reason_other
Reporting report_diag_class
Reporting report_pointofentry
Reporting report_pointofentry_date
Patient information patinfo_ID
Patient information patinfo_DoB
Patient information patinfo_ageonset
Patient information patinfo_ageonsetunit
Patient information patinfo_sex
Patient information patinfo_idadmin0
Patient information patinfo_resadmin0
Clinical status Lab_date1
Clinical status patcourse_dateonset
Clinical status patcourse_asymp
Clinical status patcourse_dateonset_unk
Clinical status Comcond_present
Clinical status Comcond_preg
Clinical status Comcond_pregt
Clinical status Comcond_partum
Clinical status Comcond_immuno
Clinical status Comcond_cardi
Clinical status Comcond_diabetes
Clinical status Comcond_liver
Clinical status Comcond_renal
Clinical status Comcond_neuro
Clinical status Comcond_malig
Clinical status Comcond_lung
Clinical status Comcond_other
Clinical status patcourse_admit
Clinical status patcourse_presHCF
Clinical status patcourse_admitname
Clinical status patcourse_icu
Clinical status patcourse_vent
Clinical status patcourse_ecmo
Clinical status patcourse_iso
Clinical status patcourse_dateiso
Clinical status patcourse_status
Clinical status patcourse_datedeath
Patient symptoms patsympt_fever
Patient symptoms patsympt_weak
Patient symptoms patsympt_irritability
Patient symptoms patsympt_sorethroat
Patient symptoms patsympt_produ
Patient symptoms patsympt_runnynose
Patient symptoms patsympt_short
Patient symptoms patsympt_diarr
Patient symptoms patsympt_vomit
Patient symptoms patsympt_headache
Patient symptoms patsympt_pain
Patient symptoms patsympt_muscupain
Patient symptoms patsympt_chestpain
Patient symptoms patsympt_abdopain
Patient symptoms patsympt_jointpain
Patient symptoms patsympt_other
Patient signs pat_sign_temp
Patient signs pat_sign_temp_unit
Patient signs pat_sign_pharyn
Patient signs pat_sign_conjunc
Patient signs pat_sign_dysp
Patient signs pat_sign_ausc
Patient signs pat_sign_xray
Patient signs pat_sign_seize
Patient signs pat_sign_coma
Patient signs pat_sign_other
Exposure and travel informatio patinfo_occus
Exposure and travel informatio patinfo_occuhcw
Exposure and travel informatio patinfo_occulab
Exposure and travel informatio patinfo_occuani
Exposure and travel informatio patinfo_occuother
Exposure and travel informatio patinfo_occuhcw_country
Exposure and travel informatio patinfo_occuhcw_city
Exposure and travel informatio patinfo_occuhcw_name
Exposure and travel informatio expo_travel
Exposure and travel informatio expo_travel_country1
Exposure and travel informatio expo_travel_city1
Exposure and travel informatio expo_travel_date1
Exposure and travel informatio expo_visit_healthcare
Exposure and travel informatio expo_ari
Exposure and travel informatio expo_ari_healthcare
Exposure and travel informatio expo_ari_family
Exposure and travel informatio expo_ari_workplace
Exposure and travel informatio expo_ari_settingother
Exposure and travel informatio expo_ari_settingunknown
Exposure and travel informatio expo_contact_case
Exposure and travel informatio expo_case_setting_detail
Exposure and travel informatio expo_ID1
Exposure and travel informatio expo_date_first1
Exposure and travel informatio expo_date_last1
Exposure and travel informatio expo_case_healthcare
Exposure and travel informatio expo_case_family
Exposure and travel informatio expo_case_workplace
Exposure and travel informatio expo_case_settingother
Exposure and travel informatio expo_case_settingunknown
Exposure and travel informatio expo_case_location
Exposure and travel informatio expo_animal
Exposure and travel informatio expo_animal_location
Laboratory information Lab_name
Laboratory information Lab_assay
Laboratory information Lab_sequencing
Outcome outcome_submitted
Outcome outcome_submitted_date
Outcome outcome_asymp
Outcome outcome_asymp_date
Outcome outcome_patcourse_admit
Outcome outcome_patcourse_presHCF
Outcome outcome_patcourse_icu
Outcome outcome_patcourse_vent
Outcome outcome_patcourse_ecmo
Outcome outcome_patcourse_status
Outcome outcome_patcourse_status_other
Outcome outcome_date_of_outcome
Outcome outcome_lab_date
Outcome outcome_lab_result
Outcome outcome_contacts_followed
Outcome outcome_contacts_followed_unk
Short label EN
WHO case ID
Date (DD/MM/YYYY)*: _____/____/______
reporting institution
reporting country
Why the case was tested for COVID-19
Other reason the case was tested for COVID-19
case classification
detected at point of entry
date detected at point of entry
country case ID*:
Date of birth*:_____/______/________
or Age:_______
unit of age
Sex at birth: Male Female
where the case was diagnosed, admin level 0 (country)
identified Admin Level 1 (province):
identified Admin Level 2(district):
place of residence admin level 0
Date of first laboratory confirmation
Date of onset of first symptoms:____/____/______
Patient asymptomatic at time of speciment collection
Patient date of onset unknown
Does the patient have any underlying conditions?
Pregnancy
Trimester of pregancy
Post-partum (<6 weeks)
Immunodeficiency including HIV
Cardiovacsular disease including hypertension
Diabetes
Liver disease
Renal disease
Chronic neurological or neuromuscular disease
Malignancy
Chronic lung disease
Other, specify
admission to hospital?:
For this episode, date first admitted in hospital
name of hospital
Did the patient receive care in an ICU?
Was the patient ventilated?
Did the patient receive ECMO?
Was the case isolated?
date of isolation
Outcome of illness (circle):
Date of death
History of fever/chills
General weakness
Irritability/confusion
Sore throat
Cough
Runny nose
Shortness of breath
Diarrhoea
Nausea/vomiting
Headache
Pain
Muscular pain
Chest pain
Abdominal pain
Joint pain
Other, specify
Temperature:
Celsius or Farenheight
Pharyngeal exsudate
Conjunctival injection
Dyspnea, tachypnea
Abnormal lung auscultation
Abnormal lung x-ray findings
Seizures
Coma
Other signs, specify
Student
Health care worker
Health laboratory worker
Working with animals
Other, specify
Healthcare worker country
Healthcare worker city
Healthcare worker facility name
Has the patient travelled in the 14 days prior to symptom
Specify country travelled to 1
Specify city travelled to 1
Specify date departed from 1
Has the patient visited any health care facilities in the 14
Has the patient had close contact with a person with acute
ARI close contact in Health care setting
ARI close contact in Family setting
ARI close contact in Work place
ARI close contact in other location (specify)
ARI close contact unkown
Has the patient had contact with a confirmed case?
Explain contact setting
ID number of confirmed case 1
Date of first exposure to confirmed case 1
Date of last exposure to confirmed case 1
Case contact health care setting
Case contact family setting
Case contact in work place
Case contact in other location (specify)
Case contact unknown
Likely country for exposure to case?
Did the patient visit any live animals markets?
Likely location/city/country for exposure to live animals
Name of confirming laboratory:
Assay used by confirming laboratory
Sequencing performed by confirming laboratory
Outcome section submitted
Date of outcome submission
Case developed symptoms
Date case developed symptoms
Patient admitted to hospital
Date patient admitted to hospital
Did the patient receive care in an ICU?
Was the patient ventilated?
Did the patient receive ECMO?
Patient status (outcome)
Other patient status (outcome)
Date of patient release or date of death
If released, date of last laboratory test
laboratory result from last test
High risk contacts followed from case
Number of high risk contacts followed unknown
Short label FR
Date*: _____/____/______
Organisation/institution*:
Pays*:
classification des cas

détecté au point d'entrée
date détectée au point d'entrée
Numéro d'identification unique*:
Date de naissance*: ____/____/______
ou Age *: ______
Unité de l'âge
Sexe a la naissance*: Homme Femme
Niveau admin 1*(préfecture):

Niveau admin 2*(département):
Date prélèvement1
Date de début des premiers symptomes*:
Patient asymptomatique
Date d'apparition des symptomes inconnue
Grossesse
Trimestre de grossesse
Post-partum (<6 semaines)
Immunodéficience, y compris le VIH
Malignité
Maladie aiguë ou chronique associée:
Autre spécifier
Hospitalisation* ?:
Pour cet épisode, quelle est la date de première présenta
veuillez préciser où:
Est ce que le patient a été ventilé mécaniquement?

date d'isolement
Evolution* (entourer):
Date* du décès:
Fièvre / frissons
Asthénie
confusion/irritabilité
Maux de gorge
Toux
Nez qui coule
Difficulté à respirer
Diarrhée
Nausée/vomissements
Maux de tete
Douleur
Douleurs musculaires
Douleurs thoraciques
Douleurs abdominales
Douleurs articulaires
Autre symptômes, spécifier
Température : ___________________
Celsius ou Farenheight
Exsudat pharyngé
Injection conjonctivale
Dyspnée, tachypnée
Auscultation pulmonaire anormale
Anomalies radiographies pulmonaires
Convulsions
Coma
Autre signes observés, spécifier:_______________
Etudiant
Le patient a-t-il voyagé au cours des 14 jours précédant

Précisez le pays visité jusqu'à 1
Précisez la ville parcourue au 1
Le patient a-t-il visité un établissement de santé au cou
Le patient a-t-il été en contact étroit avec une personne
Le patient a-t-il eu un contact ave cun cas probable ou co
Numero identification du cas contact probable ou confir

Milieu hospitalier
Dans la famillle
Milieu professionel
Autre contexte
Ne sait pas dans quel contexte
Quel est l'endroit le plus probable d'exposition à la mala
Le patient a-t-il eu des contacts, direct ou indeirect ave
Quel est l'endroit le plus probable d'exposition à les ani
Nom du laboratoire
Dosage utilisé par le laboratoire de confirmation
Séquençage effectué par le laboratoire de confirmation

Description
WHO assigned sequential number
Date of reporting
Unit/Department/Organization
Country/territory/national that interviewer
boundary within which is representing. Note, label should
the case currently/usually be adapted to suite local context.
resides.
If transborders or international spread of outbreak
Why the case was tested for COVID-19
Any other reason the case was tested for COVID-19
Is the case confirmed, probable, or suspected, as per case definition
Was the case detected at a point of entry?
What date was the case detected at a point of entry
Unique case identification number (used in country)
Date that the case was born on.
Age in units on the date of illness onset.
Years or months or days
Biological sex. That is the biological differential characteristics (chromosomes, hormonal profiles, internal and external sex
Administrative level 0: Country where the case was diagnosed.
Administrative level 1: First sub-national boundary (e.g. province, state, territory prefecture, region, etc.) where the case w
Administrative level 2: Second sub-national level boundary (e.g. district, county, local government area, department, provi
Administrative level 0: Country within which the case's currently/usually resides.
Administrative level 1: First sub-national boundary (e.g. province, state, territory prefecture, region, etc.) within which the
Administrative level 2: Second sub-national level boundary (e.g. district, county, local government area, department, provi
Date of first laboratory confirmation
Date of first appearance of the signs or symptoms of the illness/disease.
Is the case asymptomatic?
Is the date of the case's symptom onset unknown?
Does the patient have any underlying conditions?
Is the patient pregnant?
Is the patient in the post partum period defined as less than 6 weeks after delivery date
has the patient an adquired immunodeficiency (HIV) or is the patient treated with drugs that decreased immune response
any cardiovacsular disease
any liver diseases

any renal diseases
Describe other underlying conditions and comorbidity

Was the case hospitalized, admitted to a hospital or other health facility as an inpatient?
Date the case was first admitted to any health facility.
Name of health facility where the case was admitted.
Did the patient receive care in an intensive care unit (ICU)?
Was the patient ever ventilated for this episode at time of reporting?
Did the patient receive extracorporeal membrane oxygenation (ECMO)?
Was the case isolated with proper IPC controls implemented?
What date was the case isolated?
Health Status at time of reporting.
Date of death
Fever associated with chills or not
Intense fatigue, an abnormal state of drowsiness (lethargy or feeling lethargic), cannot conduct daily activity, lack of streng
Presence of any conscious disorder
Increase volume of the neck due to swollen glands
When coughing the patient produces or not phlegm or mucus/sputum or bloody sputum
Runny nose
Patient has difficulty breathing with short respiratory cycles
Diarrhoea, three or more loose or liquid stools (bowel movements) in a 24 hour period (or more frequent passage than is n
Include nausea, vomiting, abdominal pain, loss of appetite, diarrhea, dysentery, increased liver and/or spleen volume, ano
Headache
Patient complains of pain, at any site
Muscular pain
Chest pain
Abdominal pain
Joint pain
Describe other symptoms
Body temperature measured at time of interview or upon admission to the medical facility
Expressed in degree celcius
Temperature recorded in degrees Celsius or Farenheight
Pharyngitis or laryngitis
Bleeding/haemorrhage into the eyes (conjunctival injections).
Rapid respiration
Any sign resulting from pulmonary auscultation
Pulmonary Xrays showing abnormal patterns
Myoclonies, tremors, epilepsy, seizures/convulsions
Absence of reaction to orders
Describe other signs
is the patient a student?
Is the patient working in a health care setting?
Is the patient working in a health laboratory setting?
Is the patient working in contact with animals?
Please specify any other occupation not listed
If case is a healthcare worker, in which country do they work?
If case is a healthcare worker, in which city do they work?
If case is a healthcare worker, what is the name of the facility in which they work?
Has the patient travelled in the 14 days prior to symptom onset?
List the country from location 1 that the case has travelled to in the 14 days prior to symptom onset
List the city from location 1 that the case has travelled to in the 14 days prior to symptom onset
List the date departed from location 1 that the case has travelled to in the 14 days prior to symptom onset
Has the patient visited any health care facilities in the 14 days prior to symptom onset
Has the patient had close contact with a person with acute respiratory infection in the 14 days prior to symptom onset
Has the patient had close contact with a person with acute respiratory infection in the 14 days prior to symptom onset in
Please specify any close contact setting with a person with acute respiratory infection not listed.
Please select unkown if there was no known close contact with a person with acute respiratory infection
Has the patient had contact with a confirmed case in the 14 days prior to disease onset?
If the patient has had contact with a confirmed case in the 14 days prior to symptom onset, explain contact setting
List the unique case identifier 1 with whom the patient had contact with
Was the patient most likely exposed to another case in a health care setting?
Was the patient most likely exposed to another case in family settings?
Was the patient most likely exposed to another case at work?
Please specify any contact setting not listed.
Please select unkown if there were no known contact setting
Specify the location of possible exposure to a case
Did the patient visit any live animal marker 14 days prior to symptom onset?
Specify the location of possible exposure to live animals
Name of testing laboratory
Please specify which assay was used by the confirming laboratory
Please specify is sequencing was used by the confirming laboratory
Has the outcome section been submitted?
Date of outcome submission
If case was asymptomatic at time of specimen collection resulting in first laboratory confirmation, did the case develop any
If case was asymptomatic and developed symptoms, what is the date of onset for symptoms/signs of illness
Patient was first admitted to hospital (outcome)
Date patient was first admitted to hospital (outcome)
Did the patient receive care in an intensive care unit (ICU)? (outcome)
Was the patient ever ventilated for this episode? (outcome)
Did the patient receive extracorporeal membrane oxygenation (ECMO)? (outcome)
Patient status (outcome)
Other patient status (outcome)
Date of Release from isolation/hospital or Date of Death
If released from hospital /isolation, date of last laboratory test
laboratory result from last test
Total number of high-risk contacts followed for this case
Number of high risk contacts followed unknown
Permissible values EN Permissible values FR (response
Data type Format (response options) options)
String Free text
Date DD/MM/YYYY
String Free text
String Free text
Coded Coded variables CASE_CONTACT, SEEKING_HC, POE_DETECTION, REPATRIATION, SURVEILLANC
String Free text
Numeric # CONFIRMED, PROBABLE
Numeric # YES, NO, UNKNOWN 1 = Oui; 2 = Non, 3 = Inconnue
Date DD/MM/YYYY
String Free text
Date DD/MM/YYYY
Numeric ### 0-110 0-110
Coded Coded variables YEARS, MONTHS, DAYS 1 = année 2 = mois 3=jours
Coded Coded variables MALE, FEMALE 1 = Homme; 2 = Femme;
String Free text
String Free text
String Free text
String Free text
String Free text
String Free text
Date DD/MM/YYYY
Date DD/MM/YYYY
Coded Coded variables YES, NO, UNKNOWN 1 = Oui; 2 = Non
Numeric # YES, NO 1 = Oui; 2 = Non
Coded Coded variables YES, NO, UNKNOWN
Coded Coded variables YES, NO 1 = Oui; 2 = Non
Coded Coded variables FIRST, SECOND, THIRD
String Free text
Coded Coded variables YES, NO, UNKNOWN 1 = Oui; 2 = Non, 3 = Inconnue
Date DD/MM/YYYY
String Free text
Date DD/MM/YYYY
Numeric # 1 = recovered ; 2 = not recovered; 3 = death; 4 = unknown
Date DD/MM/YYYY
Numeric # 1 = Yes; 2 = No 1 = Oui; 2 = Non
Number # 1 = Yes; 2 = No 1 = Oui; 2 = Non
Number # 1 = Yes; 2 = No 1 = Oui; 2 = Non
String Free text
Numeric ## between 35 and 43 or 95 and entre 35 and 43 ou 95 and 110
Numeric # 1 = Celsius 2 = Farenheight 1 = Celsius 2 = Farenheight
String Free text
String Free text
String Free text
String Free text
String Free text
String Free text
String Free text
Date DD/MM/YYYY
String Free text
String Free text
Date DD/MM/YYYY
String Free text
String Free text
Date DD/MM/YYYY
Numeric # 1 = Yes; 2 = No; 3 = Unknown 1 = Oui; 2 = Non; 3 = Inconnue
String Free text
String Free text
String Free text
String Free text
String Free text
String Free text
String Free text
Date DD/MM/YYYY
Date DD/MM/YYYY
Date DD/MM/YYYY
Date DD/MM/YYYY
Date DD/MM/YYYY
Date DD/MM/YYYY
Date DD/MM/YYYY
Date DD/MM/YYYY
Date DD/MM/YYYY
Date DD/MM/YYYY
String Free text
String Free text
String Free text
String Free text
String Free text
Coded Coded variables YES, NO
Date DD/MM/YYYY
Date DD/MM/YYYY
Date DD/MM/YYYY YES, NO, UNKNOWN
Coded Coded variables RECOVERED, NOTRECOVERED, DEATH, UNKNOWN, OTHER
String Free text
Date DD/MM/YYYY
Date DD/MM/YYYY
Coded Coded variables POSITIVE, NEGATIVE, INCONCLUSIVE, UNKNOWN
Numeric ###
Coded Coded variables YES, NO
TRIATION, SURVEILLANCE, UNKNOWN, OTHER
Retained variable
Removed variable
New variable
Removed variable that can be populated by new variables

TX Section Short Label EN: Variable Name

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Reporting report_date Date (DD/MM/YYYY)*: _//__

classification des cas

Niveau admin 1*(préfecture):

Est ce que le patient a été ventilé mécaniquement?

Le patient a-t-il voyagé au cours des 14 jours précédant

Numero identification du cas contact probable ou confir

Est ce que le patient a été ventilé mécaniquement?

any liver diseases

Describe other underlying conditions and comorbidity

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