Stage at diagnosis


Parameter Case Report Form and Response Options

Stage at diagnosis Uncomplicated phase Complicated phase Critical phase Recovery phase Dead Unknown
Stage of illness at the time of COVID-19 diagnosis

Control the different response options via the Condition.stage element:

RESPONSE OPTIONS Condition.stage.summary Definition
Uncomplicated phase Mild (qualifier value)
Mild to moderate (qualifier value)
Asymptomatic OR Symptoms of upper respiratory tract infection / Nausea, emesis, diarrhea / Fever
Complicated phase Moderate (severity modifier) (qualifier value)
Moderate to severe (qualifier value)
Need for oxygen supplementation / paO2 at room air < 70 mmHg / SO2 at room air < 90 mmHg / GOT or GPT > 5x ULN / New cardiac arrhythmia / New pericardial effusion > 1 cm / New heart failure with pulmonary edema, congestive hepatopathy or peripheral edema
Critical phase Severe (severity modifier) (qualifier value)
Life threatening severity (qualifier value)
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
Recovery phase Remission phase (qualifier value) Improvement by one degree of severity according to this scheme AND Defervescence
Dead Fatal (qualifier value)
Unknown Unknown (qualifier value)

Profile - Diagnosis Covid-19

Canonical: https://www.netzwerk-universitaetsmedizin.de/fhir/StructureDefinition/diagnosis-covid-19

Snapshot

idS Σ0..1string
id0..1string
extensionC0..*Extension
versionIdΣ0..1id
lastUpdatedΣ0..1instant
sourceS Σ0..1uri
profileS Σ0..*canonical(StructureDefinition)
securityΣ0..*CodingBinding
tagΣ0..*Coding
implicitRulesΣ ?!0..1uri
language0..1codeBinding
text0..1Narrative
contained0..*Resource
ReferenzPrimaerdiagnoseS C0..1Extension(Reference(Condition))
modifierExtension?! C0..*Extension
identifierΣ0..*Identifier
clinicalStatusS Σ ?! C0..1CodeableConceptBinding
id0..1string
extensionC0..*Extension
id0..1string
extensionC0..*Extension
systemΣ1..1uriPattern
versionΣ0..1string
codeΣ1..1code
displayΣ0..1string
userSelectedΣ0..1boolean
snomedΣ1..1CodingBindingPattern
textΣ0..1string
id0..1string
extensionC0..*Extension
id0..1string
extensionC0..*Extension
systemΣ1..1uriPattern
versionΣ0..1string
codeΣ1..1codePattern
displayΣ0..1string
userSelectedΣ0..1boolean
textΣ0..1string
severity0..1CodeableConceptBinding
id0..1string
extensionC0..*Extension
id0..1string
Mehrfachcodierungs-KennzeichenS C0..1Extension(Coding)
SeitenlokalisationS C0..1Extension(Coding)
DiagnosesicherheitS C0..1Extension(Coding)
systemS Σ1..1uriFixed ValuePattern
versionS Σ1..1string
codeS Σ C1..1code
displayΣ0..1string
userSelectedΣ0..1boolean
id0..1string
extensionC0..*Extension
systemS Σ1..1uriFixed ValuePattern
versionΣ1..1string
codeS Σ1..1code
displayΣ0..1string
userSelectedΣ0..1boolean
id0..1string
extensionC0..*Extension
systemS Σ1..1uriPattern
versionΣ0..1string
codeS Σ1..1codePattern
displayΣ0..1string
userSelectedΣ0..1boolean
id0..1string
extensionC0..*Extension
systemS Σ1..1uriPattern
versionΣ0..1string
codeS Σ1..1code
displayΣ0..1string
userSelectedΣ0..1boolean
textΣ0..1string
id0..1string
extensionC0..*Extension
id0..1string
extensionC0..*Extension
systemS Σ1..1uriPattern
versionΣ0..1string
codeΣ1..1code
displayΣ0..1string
userSelectedΣ0..1boolean
textΣ0..1string
subjectS Σ C1..1MII-Reference(Group | Patient)
encounterS Σ C0..1MII-Reference(Encounter)
id0..1string
extensionC0..*Extension
id0..1string
lebensphase-vonS C0..1Extension(CodeableConcept)
value0..1System.DateTime
id0..1string
lebensphase-bisS C0..1Extension(CodeableConcept)
value0..1System.DateTime
onsetDateTimeS Σ0..1dateTime
abatementAgeAge
abatementDateTimedateTime
abatementPeriodPeriod
abatementRangeRange
abatementStringstring
recordedDateS Σ1..1dateTime
recorderΣ C0..1Reference(Patient | Practitioner | PractitionerRole | RelatedPerson)
asserterΣ C0..1Reference(Patient | Practitioner | PractitionerRole | RelatedPerson)
id0..1string
extensionC0..*Extension
modifierExtensionΣ ?! C0..*Extension
id0..1string
extensionC0..*Extension
id0..1string
extensionC0..*Extension
systemS Σ1..1uriPattern
versionΣ0..1string
codeS Σ1..1code
displayΣ0..1string
userSelectedΣ0..1boolean
textΣ0..1string
assessmentC0..*Reference(ClinicalImpression | DiagnosticReport | Observation)
id0..1string
extensionC0..*Extension
id0..1string
extensionC0..*Extension
systemS Σ1..1uriPattern
versionΣ0..1string
codeS Σ1..1codePattern
displayΣ0..1string
userSelectedΣ0..1boolean
textΣ0..1string
id0..1string
extensionC0..*Extension
modifierExtensionΣ ?! C0..*Extension
codeΣ C0..*CodeableConcept
detailΣ C0..*Reference(Resource)
noteS0..*Annotation


ValueSets

Valuesets are provided with both SNOMED-CT codes.


Canonical: https://www.netzwerk-universitaetsmedizin.de/fhir/ValueSet/stage-at-diagnosis

This value set includes codes from the following code systems:

  • The following codes from system: SNOMED_CT

    CodeDisplay
    255604002Mild (qualifier value)
    371923003Mild to moderate (qualifier value)
    6736007Moderate (severity modifier) (qualifier value)
    371924009Moderate to severe (qualifier value)
    24484000Severe (severity modifier) (qualifier value)
    442452003Life threatening severity (qualifier value)
    277022003Remission phase (qualifier value)
    399166001Fatal (qualifier value)
    261665006Unknown (qualifier value)


Examples

Critical phase at Covid-19 Diagnosis

{
"resourceType": "Condition",
"id": "diagnosis-covid-19-present",
"meta": {
"profile": [
"https://www.netzwerk-universitaetsmedizin.de/fhir/StructureDefinition/diagnosis-covid-19"
]
},
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/condition-clinical",
"code": "active",
"display": "Active"
}
]
},
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/condition-ver-status",
"code": "confirmed",
"display": "Confirmed"
},
{
"system": "http://snomed.info/sct",
"code": "410605003",
"display": "Confirmed present (qualifier value)"
}
]
},
{
"coding": [
{
"system": "http://snomed.info/sct",
"code": "394807007",
"display": "Infectious diseases (specialty) (qualifier value)"
}
]
}
],
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "840539006",
"display": "Disease caused by Severe acute respiratory syndrome coronavirus 2 (disorder)"
}
]
},
"subject": {
"reference": "Patient/gecco-patient"
},
"recordedDate": "2020-10-23T12:48:23+02:00",
"stage": [
{
"summary": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "24484000",
"display": "Severe (severity modifier) (qualifier value)"
}
],
"text": "Critical phase"
},
"type": {
"coding": [
{
"system": "http://loinc.org",
"code": "88859-4",
"display": "Disease stage score for risk calculation"
}
]
}
}
]
}