Protocol - Long COVID - Symptoms Due to COVID-19 - Psychiatric (Short Form)
Description
A self-administered questionnaire to better describe and understand the patient experience and recovery of those with confirmed or suspected COVID-19, with a specific emphasis on Long COVID experience especially with sleep issues and hallucinations.
Specific Instructions
The Steering Committee recommends using insomnia in the context as described by NHLBI - https://www.nhlbi.nih.gov/health/insomnia.
Availability
This protocol is freely available; permission not required for use.
Protocol
Sleeping Issues
1. Have you experienced any SLEEPING ISSUES since the start of your COVID-19 illness?
[ ] Yes[ ] No
1a. Which of the following sleeping issues have you experienced since the start of your COVID-19 illness?
[ ] Lucid dreams (dreams where you are aware you are dreaming or have some control over what you dream about)[ ] Vivid dreams
[ ] Nightmares
[ ] Insomnia
[ ] Night sweats
[ ] Restless leg syndrome
[ ] Awakened by feeling like you couldn’t breathe
[ ] Sleep apnea
[ ] Other ________
1b. When did you experience these symptoms?
Please mark symptoms for the first 4 weeks, then months (if applicable). Even if you have only experienced these symptoms for part of a week or month, please select it.
| Week 1 | Week 2 | Week 3 | Week 4 | Month 2 | Month 3 | Month 4 | Month 5 | Month 6 | Month 7 | |
| Insomnia | ||||||||||
| Sleep | ||||||||||
| All the other sleeping symptoms |
2. If you have/had insomnia, which best describes the type of insomnia?
[ ] Difficulty falling asleep[ ] Waking up early in the morning
[ ] Waking up several times during the night
[ ] None of the above
3. What is causing/caused your insomnia?
[ ] Pain[ ] Sensitivity to outside light/noise
[ ] Other physical discomfort
[ ] Anxiety/depression/racing thoughts
[ ] Difficulty breathing
[ ] A sensation of adrenaline/energy
[ ] A sensation like the virus was keeping me awake
[ ] Other ___________
Hallucinations
4. Have you experienced any HALLUCINATIONS (visual, hearing, or touch) since the start of your COVID-19 illness?
[ ] Yes[ ] No
4a. Which of the following hallucinations have you experienced since the start of your COVID-19 illness?
[ ] Visual (seeing) Hallucinations[ ] Auditory (hearing) Hallucinations
[ ] Tactile (touch) Hallucinations
[ ] Hallucinations, other ___________
4b. When did you experience these symptoms?
Please mark symptoms for the first 4 weeks, then months (if applicable). Even if you have only experienced these symptoms for part of a week or month, please select it.
| Week 1 | Week 2 | Week 3 | Week 4 | Month 2 | Month 3 | Month 4 | Month 5 | Month 6 | Month 7 | |
| Hallucinations |
Personnel and Training Required
None
Equipment Needs
None
Requirements
| Requirement Category | Required |
|---|---|
| Major equipment | No |
| Specialized training | No |
| Specialized requirements for biospecimen collection | No |
| Average time of greater than 15 minutes in an unaffected individual | No |
Mode of Administration
Self-administered questionnaire
Lifestage
Adult
Participants
Adults aged 18 years or older
Selection Rationale
PhenX used input from the PhenX Steering Committee to enable rapid response and release of COVID-19 related protocols in the Toolkit.
Language
English, Other languages available at source
Standards
| Standard | Name | ID | Source |
|---|---|---|---|
| caDSR Form | PX992006 Long Covid Symptoms Psychiatric Short | 14397085 | caDSR Form |
Derived Variables
None
Process and Review
Not applicable
Protocol Name from Source
Online Survey on Recovery from COVID-19
Source
University College London (2022). Online Survey on Recovery from COVID-19, Section “Sleep Issues and Hallucinations Sections”
General References
None
Protocol ID
992006
Variables
Export Variables| Variable Name | Variable ID | Variable Description | dbGaP Mapping | |
|---|---|---|---|---|
| PX992006_Long_Covid_Symptoms_Psychiatric_Short_Experience_Symptoms_Hallucinations | ||||
| PX992006040300 | When did you experience these symptoms? more | N/A | ||
| PX992006_Long_Covid_Symptoms_Psychiatric_Short_Experience_Symptoms_Sleep_Apnea | ||||
| PX992006010302 | When did you experience these symptoms? more | N/A | ||
| PX992006_Long_Covid_Symptoms_Psychiatric_Short_Hallucinations_Type | ||||
| PX992006040201 | Which of the following hallucinations have more | N/A | ||
| PX992006_Long_Covid_Symptoms_Psychiatric_Short_Insomnia_Cause_Other | ||||
| PX992006030200 | What is causing/caused your insomnia? Other | N/A | ||
| PX992006_Long_Covid_Symptoms_Psychiatric_Short_Insomnia_Type | ||||
| PX992006020000 | If you have/had insomnia, which best more | N/A | ||
| PX992006_Long_Covid_Symptoms_Psychiatric_Short_Sleeping_Issues | ||||
| PX992006010100 | Have you experienced any SLEEPING ISSUES more | N/A | ||
| PX992006_Long_Covid_Symptoms_Psychiatric_Short_Sleeping_Issues_Symptoms_Other | ||||
| PX992006010202 | Which of the following sleeping issues have more | N/A | ||
Measure Name
Long COVID - Symptoms Due to COVID-19
Release Date
March 17, 2023
Definition
This is a measure of an individual’s new or continuing COVID-19 symptoms.
Purpose
Presence of lingering COVID-19 symptoms is a sign of Long COVID, and use of this measure helps with understanding people’s experience with COVID-19 and implications of Long COVID.
Keywords
coronavirus, COVID-19, Sleep Issues, hallucinations, University College London, UCL, insomnia, sleep apnea, Restless leg syndrome
Measure Protocols
Publications
There are no publications listed for this protocol.
FHIR
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