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COVID-19 Data Coding

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COVID-19 Data Coding

using SNOMED CT
v1.2

Web version link: http://snomed.org/cv19

SNOMED CT document library: http://snomed.org/doc

This PDF document was generated from the web version on the publication date shown
above. Any changes made to the web pages since that date will not appear in the PDF.

© Copyright 2021 International Health Terminology Standards Development Organisation

© Copyright 2021 International Health Terminology Standards Development Organisation
Table of Contents
1. Introduction................................................................................................................................................ 2
Background ..................................................................................................................................................................2
Purpose.........................................................................................................................................................................2
Scope ............................................................................................................................................................................2
Audience .......................................................................................................................................................................3
Acknowledgments .......................................................................................................................................................3
References ....................................................................................................................................................................3
1.1 How to Use this Guide ............................................................................................................................................4
2. Coding COVID-19 Related Data.................................................................................................................. 8
2.1 Provider and Facility Details ..................................................................................................................................9
2.2 Patient Demographics .........................................................................................................................................10
2.3 Clinical Assessment..............................................................................................................................................13
2.4 Tests and Investigations ......................................................................................................................................22
2.5 Prevention, Treatment and Education................................................................................................................27
3. Mapping to ICD-10.................................................................................................................................... 34
Footnotes ...................................................................................................................................................................34
Appendix A - Example Subsets .................................................................................................................... 35
Appendix B - Example Extension Content .................................................................................................. 37
B.1 Extension Concepts - Provider and Facility Details............................................................................................37
B.2 Extension Concepts - Patient Demographics .....................................................................................................37
B.3 Extension Concepts - Clinical Assessment .........................................................................................................38
B.4 Extension Concepts - Tests and Investigations ..................................................................................................41
B.5 Extension Concepts - Prevention, Treatment and Education ...........................................................................43

i
As part of the global effort to manage and contain the COVID-19 public health emergency, SNOMED
International is doing their part to support care teams and researchers in their efforts to address its
containment. SNOMED International took swift action by publishing a set of coronavirus related concepts in its
January 2020 SNOMED CT International Edition, with updated descriptions and SNOMED CT to ICD-10 maps in
the interim March 2020 International Edition release. Since then, SNOMED International has published
additional COVID-19 related content requested by the international community. SNOMED CT Coronavirus
Content has been made available as part of the Global Patient Set (GPS) Creative Commons
Attribution 4.0 International License.
This guide provides practical examples of SNOMED CT subsets that can be used to code a variety of COVID-19
related data elements, such as symptoms, risk factors and test results. These SNOMED CT subsets can be used
to record, communicate and integrate clinical data related to COVID-19, for the purposes of healthcare service
delivery, pandemic surveillance, international collaboration and retrospective data analysis. A set of
computable SNOMED CT subset artefacts also accompanies this guide.

http://snomed.org/cv19
SNOMED CT Document Library: http://snomed.org/doc
© Copyright 2021 International Health Terminology Standards Development Organisation, all rights reserved.

SNOMED International owns and maintains SNOMED CT®.

Any modification of this document (including without limitation the removal or modification of this notice) is prohibited without the express
written permission of SNOMED International. This document may be subject to updates. Always use the latest version of this document
published by SNOMED International. This can be viewed online and downloaded by following the links on the front page or cover of this
document.

SNOMED®, SNOMED CT® and IHTSDO® are registered trademarks of International Health Terminology Standards Development Organisation.
http://snomed.org/licensing. For more information about SNOMED International and
http://www.snomed.org [email protected].

1
1. Introduction

Background
global
pandemic Coronavirus disease
COVID-19 is an infectious disease caused by a newly discovered coronavirus.
SNOMED International is
doing their part to support care teams and researchers in their efforts to address its containment. SNOMED
a set of coronavirus related concepts in the January 31st 2020
International Edition of SNOMED CT, with updated descriptions and SNOMED CT to ICD-10 maps in the
March 2020 International Edition release. Since then, SNOMED International has published additional
SNOMED CT Coronavirus Content will be
made available as part of the Global Patient Set (GPS) in the September 2020 GPS release. In the meantime, this
content is available and can be used under the same open license as the GPS, Creative Commons Attribution 4.0
International License.

Purpose
As the global terminology for health, SNOMED CT can serve as a common language for recording, sharing,
integrating and analyzing COVID-19 This guide provides practical examples of SNOMED CT subsets
that can be used to code a variety of COVID-19 related data elements, such as symptoms, risk factors and test
results. These SNOMED CT subsets can be adapted to meet local requirements for healthcare service delivery,
A set of computable SNOMED
CT subset artefacts also accompanies this guide.
Data Analytics with SNOMED
CT SNOMED CT Document Library.

Scope
The scope of this document has been guided by the collective needs and experiences of our SNOMED International
Members.
covering the following
key areas:
Provider and facility details - e.g. healthcare profession, site of care, personal protective equipment

2
Patient demographics - e.g. biological sex, foreign travel history, living arrangements
Clinical assessment - e.g. symptoms, diagnosis, complications
Tests and procedures - e.g. specimen, laboratory test results
Treatment and education - e.g. vaccination, therapy
These subsets provide examples of SNOMED CT concepts that may be used to code data elements in
reporting requirements, as part of a healthcare data standard (e.g. a HL7 FHIR profile or openEHR archetype), or a
newly developed information model (data set). Before they can be used in a production system, these subsets
should be carefully reviewed and updated to ensure that they fully meet the requirements of the intended use case.
The example subsets included in this guide use concepts that are in (or are planned to be added to) the SNOMED CT
International Edition. This provides a foundation for international collaboration and research on COVID-19. Some
examples of SNOMED CT extension concepts, added in National Editions of SNOMED CT, are also provided for a
number of data elements. Please note that all concepts referenced in this guide should be used only in
implementations where the relevant Edition is deployed.

Audience
The primary audience of this guide is the SNOMED National Release Centers (NRCs), who themselves may be
required to provide national or regional guidance to their local implementations during or after the COVID-19
pandemic.

Acknowledgments
This guide has been developed in collaboration with our SNOMED National Release Centers (NRCs) and other
Member representatives. We would like to thank you all for sharing your knowledge and experience to collectively
help in the development of this COVID-19 guide.

References
The following references were used in the development of this guide.
Audits in Infection Prevention and Control, IFIC Basic Concepts of Infection Control (Chapter 6), 3rd edition,
2016, International Federation of Infection Control
Caution on Kidney Dysfunctions of COVID-19 Patients
Coronavirus Disease 2019 (COVID-19), Centers for Disease Control and Prevention, U.S.
Coronavirus Disease (COVID-19) Pandemic
Coronavirus: what are asymptomatic and mild COVID-19?, Patient.info
Coronavirus: what are moderate, severe and critical COVID-19?, Patient.info
COVID-19 and the Cardiovascular System
COVID-19 Dataset Specification, Feidhmeannacht na Seirbhise Slainte, Health Service Executive, Ireland.
COVID-19: Gastrointestinal Manifestations and Potential Fecal-Oral Transmission
COVID-19 Hospitalisation in England Surveillance System (CHESS) Daily Reporting, NHS, UK
COVID-19 Penomics, UCL, Health Data Research UK.
COVID-19 Response Home, HL7 International
Dysregulation of Immune Response in Patients with COVID-19 in Wuhan, China
Emergency use ICD codes for COVID-19 disease outbreak
Global Research on Coronavirus Disease (COVID-19), World Health Organization
Guidance document on appropriate management of suspect/confirmed cases of COVID-19 - Types of
Covid-19 dedicated facilities, Ministry of Health and Family Welfare (MoHFW), Govt. of India
HISO 10082:2020 Community Based Assessment Data Standard
Zealand
Holistic care for patients with severe coronavirus disease 2019: An expert consensus, International Journal
of Nursing Sciences, Volume 7, Issue 2, 10 April 2020, Pages 128-134
Interoperability for COVID-19 Novel Coronavirus Pandemic
Information Technology, U.S.
Logica Implementation Guide: Covid-19 - Terminology Value Sets, U.S.

3
Neurological Manifestations of Hospitalized Patients with COVID-19 in Wuhan, China: A Retrospective Case
Series Study
Novel Coronavirus (COVID-19) Case Record Form, Global COVID-19 Clinical Platform, World Health
Organization
openEHR Clinical Knowledge Manager (COVID-19 incubator)
Revised National Clinical Management Guidelines for COVID-19, Ministry of Health and Family Welfare
(MoHFW), Govt. of India
Rhabdomyolysis as Potential Late Complication Associated with COVID-19
SARS Coronavirus 2, Regenstrief Institute
SNOMED CT Coronavirus Content SNOMED International
Solidarity Clinical Trials for COVID-19 Treatment, World Health Organization
Standard Operating Procedure (SOP) for transporting a suspect/confirmed case of COVID-19, Ministry of
Health and Family Welfare (MoHFW), Govt of India.

1.1 How to Use this Guide

Overview
Any SNOMED CT subset used to code COVID-19 data should be designed based on its purpose and the context in
which it will be used.
To make the process of planning and designing your SNOMED CT subsets more efficient and internationally
consistent, we recommend the following three steps.

These three steps are explained in more detail below.

Step 1 - Identify Data Elements

The first step is to identify the data elements that may require SNOMED CT coding. These data elements may
already be defined in national 1 2 3 , as part of a healthcare data standard you are using
4 5
(e.g. a HL7 FHIR profile or openEHR archetypes ), or you may be developing a new information model (or data
set) for this purpose. Your requirements for coded content will depend on your specific use case and the data items
In addition, different countries, regions, and hospitals may apply different clinical

to implement requires clarification of the scope of content needed, by answering questions such as:
What will your SNOMED CT subsets be used for?
Will they be used to capture new data in a clinical information system to support frontline service
delivery?
Will they be used for disease surveillance?

4
Will they be used to integrate data from various sources?
Will they be used for international collaboration?
Will they be used for retrospective analysis of data?
Which data elements are required for your use case?
What coded data needs to be collected to support clinical care?
What coded data needs to be collected to provide disease surveillance?
What coded data needs to be shared between or integrated from different sources?
What coded data is required for international collaboration?
What coded data may be needed for retrospective data analysis?
What existing subsets are available for the data elements of interest?
Where these subsets designed based on the same or compatible requirements?
Answering these questions will help in understanding which of the existing subsets are relevant for your context. It
may also help to identify potential content gaps in the subsets, or extraneous concepts which are not required for
your specific scenario. Please note that the questions above are provided for inspiration only. Additional questions
specific to your use case are likely to be needed.

Step 2 - Download Subsets

The second step is to download any available existing subsets that are associated with your required data
elements.
The example COVID-19 subsets in this guide can be downloaded from Appendix A - Example Subsets.

Subset Naming Convention

The example COVID-19 subsets provided by SNOMED International have been named using the following
convention.

Subset Naming Convention Templates

SNOMED CT COVID-19 subsets: <category>-<subset>
SNOMED CT COVID-19 subsets including subtypes of
members: CV19-<category>-<subset>-withSubtypes

Examples of Named Subset

Category Subset Name
Provider and Facility Site of care subset CV19-PFD-SiteOfCare
Details (PFD)
Patient Demographics (PAT) Marital status subset CV19-PAT-MaritalStatus

Marital status subset including subtypes CV19-PAT-MaritalStatus-withSubtypes

Clinical Assessment (ASS) Symptoms subset CV19-ASS-Symptoms

Symptoms subset including subtypes CV19-ASS-Symptoms-withSubtypes

Subset Categories
The international SNOMED CT subsets have been organized into a number of categories, based on groupings of
data elements that are likely to be recorded together. The five categories identified are:
Provider and Facility Details
Patient Demographics
Clinical Assessment
Tests and Investigations
Prevention, Treatment, and Education

5
Please follow the links above for information on the specific subsets within each category.

Subset Types
Some of the international subsets have been developed intensionally
extensionally 2.1.1. Subset Definitions

For each extensionally-defined subset, where the members have subtypes, we provide two versions:
1. One subset which includes only the listed members. This version supports use cases (e.g. reporting, data
integration) that require more abstract concepts.
2. One subset which includes the members listed and
supports use cases that may require more specific values (e.g. data collection where more clinical detail is
required).
Please note that this second type of subset is automatically generated from the corresponding
subset with listed members. No manual curation has been performed, and therefore these subsets
may contain concepts that are not relevant for the context of use.

Step 3 - Review and Adapt

The third step is to carefully review each international subset, and adapt it to meet your specific requirements. The
subsets provided represent a collection of concepts that have been contributed from a range of SNOMED
International Members. It is therefore important to review each subset member to:
1. Remove any concepts that are not required for your use case
2. Add any concepts missing from the subset that may be required for your specific use case
Please note, if the concept you require is not included in the SNOMED CT Edition you are using,
please follow the content request processes in each country. For more information, refer to the
relevant SNOMED International Member page
SNOMED International National Release Centers and other authorized users may request additions or
changes to the SNOMED CT International Edition via the SNOMED CT Content Request Service. For
more information, refer to the CRS User Guide or contact [email protected].
3. not
involve
Checking the effective time of each international concept to ensure that it is less than or equal to the
International Version used by your local SNOMED CT edition
Checking that any extension concepts are published in the SNOMED CT edition you are using
4.
For example, this may involve checking that all members of the subset belong to a single hierarchy
(in most cases), and that no two members subsumesubsume each other (in most cases).
For more information, please watch our e-learning presentation on this topic - Subset Creation
Principles.

Unpublished Content
Please note that the subsets in this guide may include some unpublished content that is planned for a future
SNOMED CT edition. This content should not be used until it has been officially published, as we cannot guarantee
that the identifiers or terms will not change. For this reason, these unpublished concepts are not included in the
downloadable versions of the subsets. Unpublished concepts are included in this guide to assist with planning (e.g.
planning of national extensions).
Unpublished content is shown in this guide using grey, italic font on a pink background, as shown in the example
below.

6
Extension Content
In response to an immediate need for COVID-19-specific concepts, various Member countries have developed
concepts within their national SNOMED CT Extensions. Some of these extension concepts are documented in this
guide, for the interest of other Members, see 4. Extension Content for COVID-19. Please note, however,
extension concepts should only be used when the module in which they are published is included in the
SNOMED CT extension concepts are not included in the subsets downloadable
from the Reference Set tool.

Feedback
SNOMED International welcomes comments on this guide and suggestions for new or updated content. Please use
Feedback button at the bottom of each page to send us your feedback.

Footnotes
1 https://www.cdc.gov/
coronavirus/2019-ncov/php/reporting-pui.html
2 https://
www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/03/phe-letter-to-trusts-re-daily-covid-19-
hospital-surveillance-11-march-2020.pdf
3 Community Based Assessment Data Standard
Zealand
4 Logica Implementation Guide: Covid-19 - Terminology Value Sets, U.S.
5 openEHR Clinical Knowledge Manager (COVID-19 incubator)

7
2. Coding COVID-19 Related Data
The collection of coded COVID-19 related data can be critical for frontline service delivery, pandemic surveillance,
and retrospective data analysis.
The following table lists a collection of data elements for which SNOMED CT can be used to capture COVID-19

Data Group Data Element

Provider and facility details Healthcare profession
Site of care
(section 2.1)
Health management finding
Personal protective equipment
Patient demographics Biological sex
Gender identity
(section 2.2)
Marital or partnership status
Nationality
Ethnic group
Racial group
Occupation
Travel history
Residential location type
Next of kin relationship
Living arrangements
Care and support circumstances
Clinical assessment Symptoms
Severity
(section 2.3)
Clinical measurements
Clinical examination findings
Diagnosis and certainty
Secondary conditions and complications
Potential risk factors
Comorbidities
Exposure event
Covid-19 and viral co-infections
Tests and Investigations Specimen
Laboratory tests
(section 2.4)
Radiology procedures
Substances and virus
Laboratory test results
Other investigations

8
Data Group Data Element
Prevention, treatment and education Prevention
Prevention findings
(section 2.5)
Education
Medication
Administrative procedures
Therapeutic procedures
Treatment findings
Treatment equipment

Note

The SNOMED CT subsets are provided as a guide only, and may need to be constrained or extended to meet
local requirements.

2.1 Provider and Facility Details

Information about the healthcare providers and facilities involved with the investigation, treatment, and care of
patients with suspected or confirmed COVID-19 are usually recorded in electronic health records. The monitoring of
medical equipment availability at healthcare facilities, such as Personal Protective Equipment (PPE) and respiratory

SNOMED CT include:

Site of care
Health management finding
Personal protective equipment
These data elements are described below, with example SNOMED CT subsets for each.

2.1.1 Healthcare Profession

The healthcare profession is the occupation or qualification of the healthcare provider who is involved in the
224547003 |Intensive therapy nurse
(occupation)| or 76899008 |Infectious disease specialist (occupation)| .

9
CV19-PFD-HealthcareProfession
Intensional Definition:
223366009 |Healthcare professional (occupation)|

2.1.2 Site of Care

2.1.3 Health Management Finding

Health management finding includes concepts that describe the circumstances which affect whether the planned
patient outcomes are attained, that different areas within a health organization are running appropriately, that
tasks are correctly defined and assessed and that resources are used efficiently. -for example 305456005 |Under
care of own general practitioner (finding)| 706877002 |Problem with high complexity of treatment regime (finding)|
or 129837009 |Ineffective protection (finding)| .
CV19-PFD-HealthManagementFinding
Intensional Definition:
129843006 |Health management finding (finding)|

2.1.4 Personal Protective Equipment

2.2 Patient Demographics

General demographic characteristics are important to record for each patient being investigated or treated for
COVID-19. Relevant patient demographics, which can be recorded using SNOMED CT includes:
Biological sex
Gender identity
Marital or partnership status
Nationality

10
Ethnic group
Racial group
Occupation
Travel history
Residential location type
Next of kin relationship
Living arrangements
Care and support circumstances
These data elements are described below, with example SNOMED CT subsets for each.

2.2.1 Sex and Gender

248152002 |Female (finding)| ) and gender identity

(e.g. 703118005 |Feminine gender (finding)| ), as shown in the two subset definitions below.

CV19-PAT-BiologicalSex
Intensional Definition:
429019009 |Finding related to biological sex (finding)|
302081005 |Finding of sex of baby (finding)|

CV19-PAT-GenderIdentity
Intensional Definition:
365873007 |Gender finding (finding)|

The marital or partnership status of a patient elationship with their

significant other, for example 87915002 |Married (finding)|
CV19-PAT-MaritalOrPartnershipStatus
Intensional Definition: 365581002 |Finding of marital or partnership status (finding)|

sovereign state
nationality of a patient may refer to the nation in which they were born, have citizenship, or have other legal ties -
for example 223610001 |Jordan (geographic location)| 223625001 |New Zealand (geographic location)|.
CV19-PAT-Nationality
Intensional Definition: 223369002 |Country (geographic location)|

11
The racial group (or race) of a patient is the group (or groups) with whom they share inherited physical
414408004 |Hispanic (racial group)| 413773004 |Caucasian (racial group)| .
CV19-PAT-RacialGroup
Intensional Definition:
415229000 |Racial group (racial group)|

158942005 |Residential child care worker (occupation)|

308223007 |Hairdresser (occupation)|.
CV19-PAT-Occupation
Intensional Definition:
14679004 |Occupation (occupation)|

The travel history of a patient is a record of their past visits to locations both inside and outside their country of
residence. This may include a list of the specific countries and/or regions
223498002 |Africa (geographic location)| 223585008 |South east Asian country (geographic location)|
161090005 |Travel abroad for business (finding)|).
CV19-PAT-TravelHistory
Intensional Definition:

223496003 |Geographical and/or political region of the world (geographic location)|

365457007 |Foreign travel history finding (finding)|
420008001 |Travel (event)|

The residential location type is the type of place in which the patient is currently living, or was living prior to
admission to hospital - for example, 257564005 |Apartment (environment)| 257670006 |Private house
(environment)|.
CV19-PAT-ResidentialLocationType
Intensional Definition:
272497004 |Residential environment (environment)|

The next of kin relationship is the relationship that the patient has with their closest living relative (as chosen by the
patient) - for example 444053001 |Husband of subject (person)| 444301002 |Mother of subject (person)|.
CV19-PAT-NextOfKinRelationship
Intensional Definition:
444148008 |Person in family of subject (person)|

12
The living arrangements of the patient describes the familial and non-familial relationships of a person to all the
105529008 |Lives alone (finding)| 224133007 |Lives
with family (finding)|.
CV19-PAT-LivingArrangements
Intensional Definition:
365481000 |Finding of household composition (finding)|

The care and support circumstances of the patient describe how and by whom they are looked after when living at
427454004 |Cared for by neighbors (finding)| 301887005 |Needs
assistance at home (finding)|.
CV19-PAT-CareAndSupportCircumstances
Intensional Definition:
365483002 |Finding related to care and support circumstances and networks (finding)|

Footnotes
1 https://confluence.hl7.org/display/VOC/The+Gender+Harmony+Project

2.3 Clinical Assessment

The first step in delivering comprehensive care is to undertake a clinical assessment. Clinical assessment

Symptoms
Severity
Clinical Measurements
Clinical Examination Findings
Diagnosis and Certainty
Clinical History
Secondary Conditions and Complications
Potential Risk Factors
Comorbidities

Covid-19 and Viral Co-Infections

These data elements are described below, with example SNOMED CT subsets for each.
Global
Patient Set (GPS) Creative Commons Attribution 4.0
International License http://snomed.org/covid-19

13
Symptoms represent physical or mental features which are regarded as an indication of a condition or disease,
particularly those features that are apparent to the patient This SNOMED CT subset of COVID-19 symptoms has
1 , research performed
2 3 ). Please note that this subset
84387000 |Asymptomatic (finding)|, which can be used to represent the absence of symptoms.
CV19-ASS-Symptoms
Concept id Fully Specified Name en-US Preferred Term Effective Time
21522001 Abdominal pain (finding) Abdominal pain 20050131
84387000 Asymptomatic (finding) Asymptomatic 20020131
131148009 Bleeding (finding) Bleeding 20050131
29857009 Chest pain (finding) Chest pain 20040731
43724002 Chill (finding) Chill 20020131
82272006 Common cold (disorder) Common cold 20030131
9826008 Conjunctivitis (disorder) Conjunctivitis 20040731
49727002 Cough (finding) Cough 20020131
3415004 Cyanosis (finding) Cyanosis 20020131
62315008 Diarrhea (finding) Diarrhea 20020131
3006004 Disturbance of consciousness (finding) Disturbance of consciousness 20020131
267036007 Dyspnea (finding) Dyspnea 20020131
271807003 Eruption of skin (disorder) Eruption 20020731
84229001 Fatigue (finding) Fatigue 20020131
103001002 Feeling feverish (finding) Feeling feverish 20020131
386661006 Fever (finding) Fever 20030131
25064002 Headache (finding) Headache 20100131
66857006 Hemoptysis (finding) Hemoptysis 20020131

14
248567008 Indrawing of ribs during respiration Indrawing of ribs during respiration 20020131
(finding)
57676002 Joint pain (finding) Joint pain 20020131
79890006 Loss of appetite (finding) Loss of appetite 20020131
44169009 Loss of sense of smell (finding) Loss of sense of smell 20200131
36955009 Loss of taste (finding) Loss of taste 20020131
30746006 Lymphadenopathy (disorder) Lymphadenopathy 20020131
367391008 Malaise (finding) Malaise 20020131
68962001 Muscle pain (finding) Muscle pain 20020131
26544005 Muscle weakness (finding) Muscle weakness 20020131
68235000 Nasal congestion (finding) Nasal congestion 20020131
64531003 Nasal discharge (finding) Nasal discharge 20020131
422587007 Nausea (finding) Nausea 20070131
44077006 Numbness (finding) Numbness 20170731
162397003 Pain in throat (finding) Pain in throat 20020131
38880002 Rigor (finding) Rigor 20020131
91175000 Seizure (finding) Seizure 20020131
46742003 Skin ulcer (disorder) Skin ulcer 20020131
23924001 Tight chest (finding) Tight chest 20020131
282145008 Unable to walk (finding) Unable to walk 20080731
422400008 Vomiting (disorder) Vomiting 20180731
56018004 Wheezing (finding) Wheezing 20020131

Severity represents the quality 24484000 |Severe (severity modifier) (qualifier value)|
. Severity may be recorded for each symptom, or as a general statement of their disease state 4

CV19-ASS-Severity
Concept id Fully Specified Name en-US Preferred Term Effective Time
84387000 Asymptomatic (finding) Asymptomatic 20020131
255604002 Mild (qualifier value) Mild 20020131
6736007 Moderate (severity modifier) (qualifier Moderate 20020131
value)
24484000 Severe (severity modifier) (qualifier Severe 20020131
value)
442452003 Life threatening severity (qualifier value) Life threatening severity 20090731

Clinical measurements involve the performance of physiological tests to diagnose and refine therapeutic
management of an already established disease. The following clinical measurements (and related observables) can
be used in the assessment of a COVID-19 patient.

CV19-ASS-ClinicalMeasurements
Concept id Fully Specified Name en-US Preferred Term Effective Time
413384008 Ability to perform cognitive activity 20050131
(observable entity)
442476006 Arterial oxygen saturation (observable Arterial oxygen saturation 20090731
entity)

15
CV19-ASS-ClinicalMeasurements
386725007 Body temperature (observable entity) Body temperature 20170131
75367002 Blood pressure (observable entity) Blood pressure 20170131
248592006 Character of cough (observable entity) Character of cough 20020131

364533002 Color of skin (observable entity) Color of skin 20020131

709017009 Compliance behavior to safety precaution Compliance behavior to safety 20150731
(observable entity) precaution
263731006 Coughing (observable entity) Coughing 20020131
271626009 Depth of respiration (observable entity) Depth of respiration 20020131
226379006 Food intake (observable entity) 20020131
364075005 Heart rate (observable entity) Heart rate 20170131
103228002 Hemoglobin saturation with oxygen Hemoglobin saturation with oxygen 20020131
(observable entity)
6942003 Level of consciousness (observable entity) Level of consciousness 20020131
440398005 Level of fatigue (observable entity) Level of fatigue 20090131
405161002 Pain level (observable entity) Pain level 20040131
248750004 Peripheral blood flow (observable entity) Peripheral blood flow 20020131
431314004 Peripheral oxygen saturation (observable Peripheral oxygen saturation 20080731
entity)
8499008 Pulse, function (observable entity) Pulse 20020131
248565000 Respiratory effort (observable entity) Respiratory effort 20020131
86290005 Respiratory rate (observable entity) Respiratory rate 20170131
248582003 Rhythm of respiration (observable entity) Rhythm of respiration 20020131
247433003 Skin elasticity (observable entity) Skin elasticity 20020131
248598005 Sputum volume (observable entity) Sputum volume 20020131
442349007 Venous oxygen saturation (observable Venous oxygen saturation 20090731
entity)

Clinical examination findings are the result of measuring, questioning, evaluating, or otherwise examining a patient
in healthcare. The following clinical findings are positive or negative indications that signs are present in a COVID-19
patient.

CV19-ASS-ClinicalExaminationFindings
Concept id Fully Specified Name en-US Preferred Term Effective Time
288848001 Able to breathe (finding) Able to breathe 20080731
77427003 Activity intolerance (finding) Activity intolerance 20020131
20262006 Ataxia (finding) Ataxia 20020131
371632003 Coma (disorder) Coma 20020731
193894004 Conjunctival hyperemia (finding) Conjunctival hyperemia 20100131
58840004 Decreased breath sounds (finding) Decreased breath sounds 20020131
443371007 Decreased level of consciousness Decreased level of consciousness 20100131
(finding)
9763007 Expiratory wheezing (finding) Expiratory wheezing 20020131
126664009 Exudative pharyngitis (disorder) Exudative pharyngitis 20020131
386661006 Fever (finding) Fever 20030131

16
CV19-ASS-ClinicalExaminationFindings
442646005 Imaging of lung abnormal (finding) Imaging of lung abnormal 20090731
67750007 Ineffective airway clearance (finding) Ineffective airway clearance 20020131
70944005 Impaired gas exchange (finding) Impaired gas exchange 20080731
75252003 Inspiratory crackles (finding) Inspiratory crackles 20020131
419045004 Loss of consciousness (finding) Loss of consciousness 20060131
274710003 Lung field abnormal (finding) Lung field abnormal 20020131
91175000 Seizure (finding) Seizure 20020131
3424008 Tachycardia (finding) Tachycardia 20080731
271823003 Tachypnea (finding) Tachypnea 20020131
288849009 Unable to breathe (finding) Unable to breathe 20080731

A diagnosis is the identification of the nature of the illness, based on an examination of the symptoms,
observations, measurements, test results and other investigation results. The following subset includes a range of
diagnoses directly related to COVID-19.

CV19-ASS-Diagnosis
Concept id Fully Specified Name en-US Preferred Term Effective Time
1119302008 Acute disease caused by Severe acute respiratory Acute COVID-19 20210131
syndrome coronavirus 2 (disorder)
18948624100011910 Asymptomatic severe acute respiratory syndrome Asymptomatic SARS-CoV-2 20200731
0 coronavirus 2 infection (finding)
840539006 Disease caused by Severe acute respiratory COVID-19 20200131
syndrome coronavirus 2 (disorder)
68823224100011910 Disease caused by Severe acute respiratory Disease caused by Severe acute respiratory 20200731
0 syndrome coronavirus 2 absent (situation) syndrome coronavirus 2 absent
840544004 Suspected disease caused by severe acute Suspected COVID-19 20200131
respiratory coronavirus 2 (situation)
To represent the certainty of a positive COVID-19 diagnosis, the following subset may be used in conjunction with a
840539006 |COVID-19|.

CV19-ASS-DiagnosisPresentCertainty
Concept id Fully Specified Name en-US Preferred Term Effective Time
410605003 Confirmed present 20040731
410592001 Probably present 20040731
415684004 Suspected 20050131
To represent the certainty of the absence of COVID-19, the following subset may be used in conjunction with a
688232241000119100 |Disease caused by severe acute respiratory syndrome coronavirus 2 absent
(situation)|.

CV19-ASS-DiagnosisAbsentCertainty
Concept id Fully Specified Name en-US Preferred Term Effective Time
410594000 Definitely NOT present (qualifier value) Definitely NOT present 20040731
410593006 Probably NOT present (qualifier value) Probably NOT present 20040731

The clinical history concepts are used to record information gained by a physician by asking specific
questions, either of the patient or of other people who know the person and can give suitable information,

17
with the aim of obtaining information useful in formulating a diagnosis and providing medical care to the
patient.

CV19-ASS-ClinicalHistory
Concept id Fully Specified Name en-US Preferred Term Effective In GPS
Time
2925084710001 History of disease caused by severe acute respiratory History of SARS-CoV-2 20200731 -
19105 syndrome coronavirus 2 (situation)

A secondary condition is any additional health condition that occurs as a result of the natural progression or
expected outcome of the primary condition. A complication is "a disorder caused by another disorder,
5.

The following subset includes SNOMED CT clinical findings that may be recorded as either secondary
conditions or complications 6 . Clinical judgement is required to determine whether these conditions are

CV19-ASS-SecondaryConditionsAndComplications
Concept id Fully Specified Name en-US Preferred Term Effective
Time
138389411000119 Acute bronchitis caused by severe acute respiratory Acute bronchitis caused by SARS-CoV-2 20200731
105 syndrome coronavirus 2 (disorder)

870590002 Acute hypoxemic respiratory failure due to disease Acute hypoxemic respiratory failure due 20200731
caused by Severe acute respiratory syndrome to disease caused by Severe acute
coronavirus 2 (disorder) respiratory syndrome coronavirus 2
870589006 Acute kidney injury due to disease caused by Acute kidney injury due to disease 20200731
Severe acute respiratory syndrome coronavirus 2 caused by Severe acute respiratory
(disorder) syndrome coronavirus 2
373895009 Acute respiratory distress (finding) Acute respiratory distress 20020731
67782005 Acute respiratory distress syndrome (disorder) Acute respiratory distress syndrome 20020131
674814021000119 Acute respiratory distress syndrome due to disease Acute respiratory distress syndrome due 20200731
106 caused by Severe acute respiratory syndrome to disease caused by Severe acute
coronavirus 2 (disorder) respiratory syndrome coronavirus 2

64779008 Blood coagulation disorder (disorder) Blood coagulation disorder 20020731

119731000146105 Cardiomyopathy due to disease caused by Severe Cardiomyopathy due to disease caused 20200731
acute respiratory syndrome virus 2 (disorder) by Severe acute respiratory syndrome
virus 2
62914000 Cerebrovascular disease (disorder) Cerebrovascular disease 20020131
1119304009 Chronic post-COVID-19 syndrome (disorder) Chronic post-COVID-19 syndrome 20210131
119741000146102 Conjunctivitis due to disease caused by Severe Conjunctivitis due to disease caused by 20200731
acute respiratory syndrome coronavirus 2 Severe acute respiratory syndrome
(disorder) coronavirus 2
710027002 Cytokine-associated toxicity (disorder) Cytokine release syndrome 20150731
419099009 Dead (finding) Dead 20060131
128053003 Deep venous thrombosis (disorder) Deep venous thrombosis 20020131
34095006 Dehydration (disorder) Dehydration 20020131
67406007 Disseminated intravascular coagulation (disorder) Disseminated intravascular coagulation 20020131
3006004 Disturbance of consciousness (finding) Disturbance of consciousness 20020131

18
CV19-ASS-SecondaryConditionsAndComplications
119981000146107 Dyspnea caused by Severe acute respiratory Dyspnea caused by Severe acute 20200731
syndrome coronavirus 2 (disorder) respiratory syndrome coronavirus 2
124056100000010 Encephalopathy due to disease caused by Severe Encephalopathy due to disease caused 20200731
8 acute respiratory syndrome virus 2 (disorder) by Severe acute respiratory syndrome
virus 2
119751000146104 Fever caused by Severe acute respiratory syndrome Fever caused by Severe acute 20200731
coronavirus 2 (disorder) respiratory syndrome coronavirus 2
25374005 Gastroenteritis (disorder) Gastroenteritis 20020131
56265001 Heart disease (disorder) Heart disease 20020131
80394007 Hyperglycemia (disorder) Hyperglycemia 20020131
389086002 Hypoxia (disorder) Hypoxia 20030131
70944005 Impaired gas exchange (finding) Impaired gas exchange 20080731
124054100000010 Infection of upper respiratory tract caused by Infection of upper respiratory tract 20200731
7 Severe acute respiratory syndrome coronavirus 2 caused by Severe acute respiratory
(disorder) syndrome coronavirus 2
90708001 Kidney disease (disorder) Kidney disease 20020731
880529761000119 Lower respiratory infection caused by Severe acute Lower respiratory infection caused by 20200731
102 respiratory syndrome coronavirus 2 (disorder) SARS-CoV-2

866151004 Lymphocytopenia due to Severe acute respiratory Lymphocytopenia due to Severe acute 20200731
syndrome coronavirus 2 (disorder) respiratory syndrome coronavirus 2
59455009 Metabolic acidosis (disorder) Metabolic acidosis 20020131
57653000 Multiple organ failure (disorder) Multiple organ failure 20020131
124053100000010 Myocarditis due to disease caused by Severe acute Myocarditis due to disease caused by 20200731
3 respiratory syndrome virus 2 (disorder) Severe acute respiratory syndrome virus
2
124052100000010 Otitis media due to disease caused by Severe acute Otitis media due to disease caused by 20200731
0 respiratory syndrome virus 2 (disorder) Severe acute respiratory syndrome virus
2
183676005 Died in hospital (finding) Died in hospital 20020131
882784691000119 Pneumonia caused by Severe acute respiratory Pneumonia caused by SARS-CoV-2 20200731
100 syndrome coronavirus 2 (disorder)

1119303003 Post-acute COVID-19 (disorder) Post-acute COVID-19 20210131

870591003 Rhabdomyolysis due to disease caused by Severe Rhabdomyolysis due to disease caused 20200731
acute respiratory syndrome coronavirus 2 by Severe acute respiratory syndrome
(disorder) coronavirus 2
302846007 Rhabdomyoma (disorder) Rhabdomyoma 20040731
308906005 Secondary bacterial pneumonia (disorder) Secondary bacterial pneumonia 20160131
91302008 Sepsis (disorder) Sepsis 20200131
870588003 Sepsis due to disease caused by Severe acute Sepsis due to disease caused by Severe 20200731
respiratory syndrome coronavirus 2 (disorder) acute respiratory syndrome coronavirus
2
76571007 Septic shock (disorder) Septic shock 20050131
415623008 Stress ulcer (disorder) Stress ulcer 20050131
238149007 Systemic inflammatory response syndrome Systemic inflammatory response 20020131
(disorder) syndrome
866152006 Thrombocytopenia due to Severe acute respiratory Thrombocytopenia due to Severe acute 20200731
syndrome coronavirus 2 (disorder) respiratory syndrome coronavirus 2

429340002 Traumatic injury of skeletal muscle (disorder) Traumatic injury of skeletal muscle 20080131

19
CV19-ASS-SecondaryConditionsAndComplications
75570004 Viral pneumonia (disorder) Viral pneumonia 20130731
1017214008 Viremia caused by Severe acute respiratory SARS-CoV-2 viremia 20210131
syndrome coronavirus 2 (disorder)

Potential risk factors are the patient conditions which may influence the course or outcomes of the COVID-19
disease. The following clinical findings may be recorded as potential risk factors 3 7 8 .

CV19-ASS-RiskFactors
Concept id Fully Specified Name en-US Preferred Term Effective
Time
78648007 At risk for infection (finding) At risk for infection 20020131

27624003 Chronic disease (disorder) Chronic disease 20020131

49601007 Disorder of cardiovascular system (disorder) Disorder of cardiovascular system 20020131
414029004 Disorder of immune function (disorder) Disorder of immune function 20190131
235856003 Disorder of liver (disorder) Disorder of liver 20020131
118940003 Disorder of nervous system (disorder) Disorder of nervous system 20020131
50043002 Disorder of respiratory system (disorder) Disorder of respiratory system 20020131
722499006 Electronic cigarette user (finding) Electronic cigarette user 20170131
8517006 Ex-smoker (finding) Ex-smoker 20020131
80141007 Hemoglobinopathy (disorder) Hemoglobinopathy 20020131
10792100011 History of immune disorder (situation) History of immune disorder 20150731
9107
90708001 Kidney disease (disorder) Kidney disease 20020731
363346000 Malignant neoplastic disease (disorder) Malignant neoplastic disease 20020131
75934005 Metabolic disease (disorder) Metabolic disease 20020131
414825006 Neoplasm of hematopoietic cell type (disorder) Neoplasm of hematopoietic cell type 20050131
414915002 Obese (finding) Obese 20050131
370388006 Patient immunocompromised (finding) Patient immunocompromised 20020731
370391006 Patient immunosuppressed (finding) Patient immunosuppressed 20020731
77386006 Pregnant (finding) Pregnant 20020131
77176002 Smoker (finding) Smoker 20020131
procedures performed on the patient within a clinically relevant timeframe may also influence the
course or outcomes of the COVID-19 disease. The following procedures may be recorded as potential risk
8.

CV19-ASS-ProcedureRiskFactors
Concept id Fully Specified Name en-US Preferred Term Effective
Time
367336001 Chemotherapy (procedure) Chemotherapy 20020131
788751009 Corticosteroid and corticosteroid derivative Corticosteroid and corticosteroid derivative 20200131
therapy (procedure) therapy
234336002 Hemopoietic stem cell transplant (procedure) Hemopoietic stem cell transplant 20050131
86553008 Immunosuppressive therapy (procedure) Immunosuppressive therapy 20020131

20
CV19-ASS-ProcedureRiskFactors
76334006 Immunotherapy (procedure) Immunological therapy 20020131
108290001 Radiation oncology AND/OR radiotherapy Radiation oncology AND/OR radiotherapy 20020131
(procedure)
312235007 Radiolabeled antibody therapy (procedure) Radiolabeled antibody therapy 20020131
265764009 Renal dialysis (procedure) Renal dialysis 20020131
313039003 Solid organ transplant (procedure) Solid organ transplant 20060731

Comorbidities are additional medical conditions of concern. The following SNOMED CT subset can be used to
record comorbidities.

CV19-ASS-Comorbidities
Intensional Definition:

Intensional Definition:
64572001 |Disease (disorder)|

An exposure event is when an individual comes into close contact with an infected person's contaminated
droplets, carried in the air or on contaminated hands, surfaces or other objects. The subset below includes
SNOMED CT events for recording exposure to COVID-19.

CV19-ASS-ExposureEvent
Concept id Fully Specified Name en-US Preferred Term Effective Time
840546002 Exposure to severe acute respiratory syndrome coronavirus 2 Exposure to SARS-CoV-2 20200131
(event)
897036007 Occupational exposure to Severe acute respiratory syndrome Occupational exposure to 20210131
coronavirus 2 (event) SARS-CoV-2
An exposure finding is the result of an observation or evaluation that relates to the patient's exposure to an
infection. The subset below includes SNOMED CT findings relating to COVID-19 exposure.

CV19-ASS-ExposureFinding
Concept id Fully Specified Name en-US Preferred Term Effective
Time
870577009 At increased risk of exposure to severe acute At increased risk of exposure to severe acute 20200731
respiratory syndrome coronavirus 2 (finding) respiratory syndrome coronavirus 2

The following organism should be used when recording the organism causing COVID-19 infections.

CV19-ASS-Organism
Concept id Fully Specified Name en-US Preferred Term Effective Time
840533007 Severe acute respiratory syndrome coronavirus 2 (organism) SARS-CoV-2 20200131
The following organisms can be used to record the cause of related viral co-infections.

21
CV19-ASS-ViralCoInfections
Definition:

Intensional Definition:
49872002 |Virus (organism)| 840533007 |Severe acute respiratory syndrome coronavirus 2 (organism)|

Footnotes
1 Articles found using the Pubmed query "https://pubmed.ncbi.nlm.nih.gov/?term=covid+19&filter=pubt.review"
2 COVID Symptom Tracker Research Updates
3 COVID-19 Case Reporting Forms, including:
COVID-19 Case Report Form, CDC, US
Novel Coronavirus (COVID-19) Case Record Form, Global COVID-19 Clinical Platform, World Health Organization
COVID-19 Hospitalisation in England Surveillance System (CHESS) Daily Reporting, NHS, UK
4 Coronavirus: what are asymptomatic and mild COVID-19?, Patient.info
Coronavirus: what are moderate, severe and critical COVID-19?, Patient.info
5 SNOMED CT Editorial Guide, SNOMED International
6 Clinical papers, including:
COVID-19: Gastrointestinal Manifestations and Potential Fecal-Oral Transmission
COVID-19 and the Cardiovascular System
Caution on Kidney Dysfunctions of COVID-19 Patients
Holistic care for patients with severe coronavirus disease 2019: An expert consensus
7 Rhabdomyolysis as Potential Late Complication Associated with COVID-19
Neurological Manifestations of Hospitalized Patients with COVID-19 in Wuhan, China: A Retrospective Case
Series Study
Dysregulation of Immune Response in Patients with COVID-19 in Wuhan, China
8 CHESS Daily Reporting, NHS, UK
9 COVID-19 - High Risk Shielded Patient List Identification Methodology - Clinical Inclusion Criteria, NHS, UK

2.4 Tests and Investigations

Laboratory testing for COVID-19 and the associated SARS-CoV-2 virus includes methods that detect the presence of
the virus and antibodies produced in response to infection, in specimen samples taken from potentially infected
individuals. Test and investigation data which can be recorded using SNOMED CT includes:
Specimen
Laboratory Tests
Radiology Procedures
Substances and Virus
Laboratory Test Results
Other Investigations
These data elements are described below, with example SNOMED CT subsets for each.

22
Specimens are samples of substances taken from an individual for testing - for example 258500001 |
Nasopharyngeal swab (specimen)| 119339001 |Stool specimen (specimen)|. The following specimens may be
1

CV19-INV-Specimen
Concept id Fully Specified Name en-US Preferred Term Effective Time
* 697989009 Anterior nares swab (specimen) Anterior nares swab 20140131

119297000 Blood specimen (specimen) Blood specimen 20040731

* 258607008 Bronchoalveolar lavage fluid sample Bronchoalveolar lavage fluid 20080731
(specimen) sample
* 122554006 Capillary blood specimen Capillary blood specimen 20080731
(specimen)
* 119294007 Dried blood specimen (specimen) Dried blood specimen 20020131
168137004 Gastric aspirate sample (specimen) Gastric aspirate sample 20060131
258606004 Lower respiratory sample Lower respiratory sample 20080731
(specimen)
258411007 Nasopharyngeal aspirate Nasopharyngeal aspirate 20080731
(specimen)
258500001 Nasopharyngeal swab (specimen) Nasopharyngeal swab 20080731
258412000 Oropharyngeal aspirate (specimen) Oropharyngeal aspirate 20080731
418564007 Pleural fluid specimen (specimen) Pleural fluid specimen 20080731
119342007 Saliva specimen (specimen) Saliva specimen 20040731
* 119364003 Serum specimen (specimen) Serum specimen 20050131
734427005 Specimen from duodenum obtained Specimen from duodenum 20180131
by aspiration (specimen) obtained by aspiration
122610009 Specimen from lung obtained by Specimen from lung obtained by 20080731
biopsy (specimen) biopsy
445447003 Specimen from trachea obtained by Specimen from trachea obtained 20100731
aspiration (specimen) by aspiration
119334006 Sputum specimen (specimen) Sputum specimen 20080731
119339001 Stool specimen (specimen) Stool specimen 20030731
* 472901003 Swab from nasal sinus (specimen) Swab from nasal sinus 20130131
445297001 Swab of internal nose (specimen) Swab of internal nose 20100731

23
CV19-INV-Specimen
* 871810001 Swab specimen from nasal mid- Mid-turbinate nasal swab 20200731
turbinate (specimen)
461911000124106 Swab specimen from oropharynx Oropharyngeal swab 20200731
(specimen)

258529004 Throat swab (specimen) Throat swab 20080731

122877000 Upper respiratory fluid specimen Upper respiratory fluid specimen 20040731
obtained by tracheal aspiration obtained by tracheal aspiration
(specimen)
309164002 Upper respiratory swab sample Upper respiratory swab sample 20080731
(specimen)
122575003 Urine specimen (specimen) Urine specimen 20080731
* 258580003 Whole blood sample (specimen) Whole blood sample 20080731
The specimens prefixed with a star '*' are a subtype of another member of this subset.

Laboratory tests can be performed to detect the presence of the COVID-19 virus and antibodies produced in
response to this virus. The following SNOMED CT concepts can be used to record laboratory tests that may be
2

CV19-INV-LaboratoryTests
Concept id Fully Specified Name en-US Preferred Term Effective Time
60170009 Analysis of arterial blood gases and pH Analysis of arterial blood gases and pH 20020131
(procedure)
444077007 Analysis using reverse transcriptase Analysis using reverse transcriptase PCR 20100131
polymerase chain reaction technique
(procedure)
61911006 Blood gases, venous measurement Blood gases, venous measurement 20020131
(procedure)
871555000 Detection of ribonucleic acid of Severe Detection of ribonucleic acid of Severe 20200731
acute respiratory syndrome coronavirus 2 acute respiratory syndrome coronavirus
(observable entity) 2
871559006 Detection of ribonucleic acid of Severe Detection of ribonucleic acid of Severe 20200731
acute respiratory syndrome coronavirus 2 acute respiratory syndrome coronavirus
in bronchoalveolar lavage fluid 2 in bronchoalveolar lavage fluid
(observable entity)
871556004 Detection of ribonucleic acid of Severe Detection of ribonucleic acid of Severe 20200731
acute respiratory syndrome coronavirus 2 acute respiratory syndrome coronavirus
in nasopharyngeal swab (observable 2 in nasopharyngeal swab
entity)
871557008 Detection of ribonucleic acid of Severe Detection of ribonucleic acid of Severe 20200731
acute respiratory syndrome coronavirus 2 acute respiratory syndrome coronavirus
in oropharyngeal swab (observable entity) 2 in oropharyngeal swab
871558003 Detection of ribonucleic acid of Severe Detection of ribonucleic acid of Severe 20200731
acute respiratory syndrome coronavirus 2 acute respiratory syndrome coronavirus
in sputum (observable entity) 2 in sputum
871560001 Detection of ribonucleic acid of Severe Detection of ribonucleic acid of Severe 20200731
acute respiratory syndrome coronavirus 2 acute respiratory syndrome coronavirus
using polymerase chain reaction 2 using polymerase chain reaction
(observable entity)
871562009 Detection of Severe acute respiratory Detection of Severe acute respiratory 20200731
syndrome coronavirus 2 (observable syndrome coronavirus 2
entity)

24
CV19-INV-LaboratoryTests
871553007 Detection of Severe acute respiratory Detection of Severe acute respiratory 20200731
syndrome coronavirus 2 antigen syndrome coronavirus 2 antigen
(observable entity)
76978006 Enzyme-linked immunosorbent assay Enzyme-linked immunosorbent assay 20080731
(procedure)
30662005 Fluorescent immunoassay (procedure) Fluorescent immunoassay 20020131
414464004 Immunoassay method (procedure) Immunoassay method 20050131
1240461000000109 Measurement of severe acute respiratory Measurement of severe acute respiratory 20200731
syndrome coronavirus 2 antibody syndrome coronavirus 2 antibody
(observable entity)
1240471000000102 Measurement of severe acute respiratory Measurement of severe acute respiratory 20200731
syndrome coronavirus 2 antigen syndrome coronavirus 2 antigen
(observable entity)
122435008 Measurement of viral antibody (procedure) Measurement of viral antibody 20100131
9718006 Polymerase chain reaction analysis Polymerase chain reaction analysis 20080731
(procedure)
122433001 Viral antigen assay (procedure) Viral antigen assay 20050131
118147004 Viral nucleic acid assay (procedure) Viral nucleic acid assay 20020131
88667002 Viral serologic study (procedure) Viral serologic study 20150131

2.4.3 Radiology Procedures

concepts may be used to record radiology procedures that may be performed during the investigation and
treatment of suspected or confirmed Covid-19 patients.

CV19-INV-RadiologyProcedures
Concept id Fully Specified Name en-US Preferred Term Effective Time
1633284100 Computed tomography angiography of pulmonary artery with CT angiography of pulmonary 20170131
0119106 contrast (procedure) artery with contrast
169069000 Computed tomography of chest (procedure) CT of chest 20040731
399208008 Plain chest X-ray (procedure) Plain chest X-ray 20050131
88628008 Ultrasonography of lung (procedure) Ultrasonography of lung 20020131

An antibody is a protective protein produced by the immune system in response to the presence of a foreign
The following antibody/antigen and virus organism concepts can be used to record
the focus of a COVID-19 investigation.

CV19-INV-SubstancesAndVirus
Concept id Fully Specified Name
840535000 Antibody to severe acute respiratory syndrome coronavirus 2 (substance)
840536004 Antigen of severe acute respiratory syndrome coronavirus 2 (substance)
870361009 Immunoglobulin G antibody to Severe acute respiratory syndrome coronavirus 2 (substance)
870362002 Immunoglobulin M antibody to Severe acute respiratory syndrome coronavirus 2 (substance)
1155866009 Messenger ribonucleic acid of Severe acute respiratory syndrome coronavirus 2 encoding spike protein (substance)
1119343008 Messenger ribonucleic acid of Severe acute respiratory syndrome coronavirus 2 (substance)
1240411000000107 Ribonucleic acid of Severe acute respiratory syndrome coronavirus 2 (substance)

25
CV19-INV-SubstancesAndVirus
840533007 Severe acute respiratory syndrome coronavirus 2 (organism)

Laboratory test results are used to specify whether the Laboratory test focus was detected or not detected
following the conducted laboratory test. The following qualifier values may be used for this purpose.

CV19-INV-LabTestResults
Concept id Fully Specified Name en-US Preferred Term Effective Time
260373001 Detected (qualifier value) Detected 20020131
419984006 Inconclusive (qualifier value) Inconclusive 20060131
260415000 Not detected (qualifier value) Not detected 20020131
895231008 Not detected in pooled specimen Not detected in pooled specimen 20200731
(qualifier value)
897035006 Severe acute respiratory syndrome SARS-CoV-2 antibody test negative 20210131
coronavirus 2 antibody test negative
(finding)
897034005 Severe acute respiratory syndrome SARS-CoV-2 antibody test positive 20210131
coronavirus 2 antibody test positive
(finding)
1240581000000104 Severe acute respiratory syndrome Severe acute respiratory syndrome 20200731
coronavirus 2 detected (finding) coronavirus 2 detected
1240591000000102 Severe acute respiratory syndrome Severe acute respiratory syndrome 20200731
coronavirus 2 not detected (finding) coronavirus 2 not detected
125154007 Specimen unsatisfactory for evaluation Specimen unsatisfactory for 20020131
(finding) evaluation

CV19-INV-InvestigationProcedures
Intensional Definition:

386053000 |Evaluation procedure (procedure)|

308335008 |Patient encounter procedure (procedure)|
17636008 |Specimen collection (procedure)|

The following subset represents a collection of findings with context that may be related to these investigations and
269944001 |Nasal swab taken (situation)| 168331006 |Blood sent for
virology (situation)|.

CV19-INV-InvestigationFindings
Intensional Definition:

313333008 |Sample obtained (situation)|

168123008 |Sample sent for examination (situation)|

26
Footnotes
1 LOINC In Vitro Diagnostic (LIVD) Test Code Mapping for SARS-CoV-2 Tests, Division of Laboratory Systems, CDC,
US
2 Why We Need Antigen and Antibody Tests for COVID-19, The Native Antigen Company, UK

2.5 Prevention, Treatment and Education

Preventing the potential spread of COVID-19 can involve a range of precautions, such as isolation and the wearing
of personal protective equipment, and education to patients, healthcare workers and the broader community.
Once COVID-19 is diagnosed, various treatments may be considered, together with education for the patient and
their families/caregivers
Prevention
Prevention Findings
Education
Medication
Administrative Procedures
Therapeutic Procedures
Treatment Findings
Treatment Equipment
These data elements are described below, with example SNOMED CT subsets where applicable.

840534001 |SARS-CoV-2 vaccination| 225368008 |Contact tracing|

170499009 |Isolation of infection contact (procedure)|
1

CV19-PTE-PreventionProcedures
Concept id Fully Specified Name en-US Preferred Term Effective
Time
115719600 Administration of vaccine product containing only inactivated whole Administration of inactivated 20210731
0 Severe acute respiratory syndrome coronavirus 2 antigen (procedure) whole SARS-CoV-2 antigen
vaccine
114499700 Administration of first dose of vaccine product containing only Severe Administration of first dose of 20210131
7 acute respiratory syndrome coronavirus 2 messenger ribonucleic acid SARS-CoV-2 mRNA vaccine
(procedure)

27
CV19-PTE-PreventionProcedures
115719700 Administration of second dose of vaccine product containing only Administration of second 20210731
9 inactivated whole Severe acute respiratory syndrome coronavirus 2 dose of inactivated whole
antigen (procedure) SARS-CoV-2 antigen vaccine
115710800 Administration of second dose vaccine product containing only Administration of second 20210731
8 recombinant non-replicating viral vector encoding Severe acute respiratory dose SARS-CoV-2 non-
syndrome coronavirus 2 spike protein (procedure) replicating viral vector
vaccine
114499800 Administration of second dose of vaccine product containing only Severe Administration of second 20210131
2 acute respiratory syndrome coronavirus 2 messenger ribonucleic acid dose of SARS-CoV-2 mRNA
(procedure) vaccine
116264600 Administration of second dose of vaccine product containing only Severe Administration of second 20210731
9 acute respiratory syndrome coronavirus 2 recombinant spike protein dose of SARS-CoV-2
antigen (procedure) recombinant spike protein
antigen vaccine
115625700 Administration of vaccine product against Severe acute respiratory Administration of SARS-CoV-2 20210731
7 syndrome coronavirus 2 (procedure) vaccine
115710700 Administration of vaccine product containing only recombinant non- Administration of SARS-CoV-2 20210731
3 replicating viral vector encoding Severe acute respiratory syndrome non-replicating viral vector
coronavirus 2 spike protein (procedure) vaccine
840534001 Administration of vaccine product containing only Severe acute respiratory Administration of SARS-CoV-2 20210131
syndrome coronavirus 2 antigen (procedure) antigen vaccine
111935000 Administration of vaccine product containing only Severe acute respiratory Administration of SARS-CoV-2 20210131
7 syndrome coronavirus 2 messenger ribonucleic acid (procedure) mRNA vaccine
116264500 Administration of vaccine product containing only Severe acute respiratory Administration of SARS-CoV-2 20210731
8 syndrome coronavirus 2 recombinant spike protein antigen (procedure) recombinant spike protein
antigen vaccine
409524006 Airborne precautions (procedure) Airborne precautions 20040731

422181004 Antibiotic prophylaxis (procedure) Antibiotic prophylaxis 20060731

449399005 Application of personal protective equipment (procedure) Application of personal 20110731
protective equipment
386242000 Communicable disease management (procedure) Communicable disease 20030131
management
225368008 Contact tracing (procedure) Contact tracing 20020131
409529001 Contact precautions (procedure) Contact precautions 20040731

409686004 Disinfecting of equipment (procedure) Disinfecting of equipment 20040731

449390009 Ensuring use of supplies and equipment within safe parameters Ensuring use of supplies and 20110731
(procedure) equipment within safe
parameters
122467006 Fitting procedure (procedure) Fitting procedure 20020131
77248004 Infection control procedure (procedure) Infection control procedure 20020131
370832005 Initiation of traffic control (procedure) Initiation of traffic control 20020731
361235007 Isolation of infected patient (procedure) Isolation of infected patient 20020131

170499009 Isolation of infection contact (procedure) Isolation of infection contact 20020131

170500000 Isolation of infection carrier (procedure) Isolation of infection carrier 20020131

40174006 Isolation procedure (procedure) 20020131

225995005 Maintaining a safe environment (procedure) Maintaining a safe 20020131
environment

28
CV19-PTE-PreventionProcedures
275827007 Maintaining asepsis (procedure) Maintaining asepsis 20020131
38883000 Preoperative disinfection of skin (procedure) Preoperative disinfection of 20020131
skin
29537000 Preoperative shaving of skin (procedure) Preoperative shaving of skin 20080131
736762004 Provision of personal protective equipment (procedure) Provision of personal 20180131
protective equipment
409525007 Respiratory secretion precautions (procedure) Respiratory secretion 20040731
precautions
410410006 Screening surveillance (regime/therapy) Screening surveillance 20040731
409522005 Standard precautions (procedure) Standard precautions 20040731
409684001 Sterilization of equipment (procedure) Sterilization of equipment 20040731
409583003 Transmission-based precautions (procedure) Transmission-based 20040731
precautions
243791004 Viral screening (procedure) Viral screening 20080131

Clinical findings (or situations) relating to the COVID-19 preventative measures performed may be captured in a
health record. The following prevention findings (or situations) may be recorded using SNOMED CT.

CV19-PTE-PreventionFindings
Concept id Fully Specified Name en-US Preferred Term Effective Time
1156256003 Adverse reaction to component of vaccine product Adverse reaction to COVID-19 vaccine 20210731
against Severe acute respiratory syndrome
coronavirus 2 (disorder)
1157195001 Adverse reaction to component of vaccine product Adverse reaction to inactivated whole 20210731
containing only inactivated whole Severe acute COVID-19 antigen vaccine
respiratory syndrome coronavirus 2 antigen
(disorder)
1157106007 Adverse reaction to component of vaccine product Adverse reaction to COVID-19 non-replicating 20210731
containing only recombinant non-replicating viral viral vector vaccine
vector encoding Severe acute respiratory syndrome
coronavirus 2 spike protein (disorder)
1142182006 Adverse reaction to component of vaccine product Adverse reaction to COVID-19 antigen vaccine 20210131
containing only Severe acute respiratory syndrome
coronavirus 2 antigen (disorder)
1142181004 Adverse reaction to component of vaccine product Adverse reaction to COVID-19 mRNA vaccine 20210131
containing only Severe acute respiratory syndrome
coronavirus 2 messenger ribonucleic acid (disorder)
1162644007 Adverse reaction to component of vaccine product 20210731
containing only Severe acute respiratory syndrome spike protein antigen vaccine
coronavirus 2 recombinant spike protein antigen
(disorder)
1145003007 Hypersensitivity to vaccine product containing only Hypersensitivity to SARS-CoV-2 mRNA 20210131
Severe acute respiratory syndrome coronavirus 2 vaccine
messenger ribonucleic acid (finding)
1157198004 Inactivated whole Severe acute respiratory syndrome Inactivated whole SARS-CoV-2 antigen 20210731
coronavirus 2 antigen vaccine contraindicated vaccine contraindicated
(situation)
1157200005 Inactivated whole Severe acute respiratory syndrome Inactivated whole SARS-CoV-2 antigen 20210731
coronavirus 2 antigen vaccine declined (situation) vaccine declined
1157199007 Second dose of inactivated whole Severe acute Second dose of inactivated whole SARS- 20210731
respiratory syndrome coronavirus 2 antigen vaccine CoV-2 antigen vaccine contraindicated
contraindicated (situation)

29
CV19-PTE-PreventionFindings
1157201009 Second dose of inactivated whole Severe acute Second dose of inactivated whole SARS- 20210731
respiratory syndrome coronavirus 2 antigen vaccine CoV-2 antigen vaccine declined
declined (situation)
1145035007 Second dose of Severe acute respiratory syndrome Second dose of SARS-CoV-2 mRNA vaccine 20210131
coronavirus 2 messenger ribonucleic acid vaccine contraindicated
contraindicated (situation)
1145034006 Second dose of Severe acute respiratory syndrome Second dose of SARS-CoV-2 mRNA vaccine 20210131
coronavirus 2 messenger ribonucleic acid vaccine declined
declined (situation)
1157113007 Second dose of Severe acute respiratory syndrome Second dose of SARS-CoV-2 non-replicating 20210731
coronavirus 2 non-replicating viral vector vaccine viral vector vaccine contraindicated
contraindicated (situation)
1157120000 Second dose of Severe acute respiratory syndrome Second dose of SARS-CoV-2 non-replicating 20210731
coronavirus 2 non-replicating viral vector vaccine viral vector vaccine declined
declined (situation)
1162648005 Second dose of Severe acute respiratory syndrome Second dose of recombinant spike protein 20210731
coronavirus 2 recombinant spike protein antigen SARS-CoV-2 antigen vaccine contraindicated
vaccine contraindicated (situation)
1162650002 Second dose of Severe acute respiratory syndrome Second dose of SARS-CoV-2 recombinant 20210731
coronavirus 2 recombinant spike protein antigen spike protein antigen vaccine declined
vaccine declined (situation)
1145031003 Severe acute respiratory syndrome coronavirus 2 SARS-CoV-2 vaccine declined 20210131
antigen or Severe acute respiratory syndrome
coronavirus 2 messenger ribonucleic acid vaccine
declined (situation)
1145023008 Severe acute respiratory syndrome coronavirus 2 SARS-CoV-2 antigen vaccine contraindicated 20210131
antigen vaccine contraindicated (situation)
1145033000 Severe acute respiratory syndrome coronavirus 2 SARS-CoV-2 antigen vaccine declined 20210131
antigen vaccine declined (situation)
1145030002 Severe acute respiratory syndrome coronavirus 2 SARS-CoV-2 antigen vaccination not 20210131
antigen vaccination not indicated (situation) indicated
1145022003 Severe acute respiratory syndrome coronavirus 2 SARS-CoV-2 mRNA vaccine contraindicated 20210131
messenger ribonucleic acid vaccine contraindicated
(situation)
1145032005 Severe acute respiratory syndrome coronavirus 2 SARS-CoV-2 mRNA vaccine declined 20210131
messenger ribonucleic acid vaccine declined
(situation)
1145029007 Severe acute respiratory syndrome coronavirus 2 SARS-CoV-2 mRNA vaccination not indicated 20210131
messenger ribonucleic acid vaccination not indicated
(situation)
1157110005 Severe acute respiratory syndrome coronavirus 2 SARS-CoV-2 non-replicating viral vector 20210731
non-replicating viral vector vaccine contraindicated vaccine contraindicated
(situation)
1157118003 Severe acute respiratory syndrome coronavirus 2 SARS-CoV-2 non-replicating viral vector 20210731
non-replicating viral vector vaccine declined vaccine declined
(situation)
1162647000 Severe acute respiratory syndrome coronavirus 2 SARS-CoV-2 recombinant spike protein 20210731
recombinant spike protein antigen vaccine antigen vaccine contraindicated
contraindicated (situation)
1162649002 Severe acute respiratory syndrome coronavirus 2 SARS-CoV-2 recombinant spike protein 20210731
recombinant spike protein antigen vaccine declined antigen vaccine declined
(situation)
1156270003 Severe acute respiratory syndrome coronavirus 2 SARS-CoV-2 vaccination declined 20210731
vaccination declined (situation)
1156267002 Severe acute respiratory syndrome coronavirus 2 SARS-CoV-2 vaccination not indicated 20210731

30
CV19-PTE-PreventionFindings
1156265005 Severe acute respiratory syndrome coronavirus 2 SARS-CoV-2 vaccine contraindicated 20210731
vaccine contraindicated (situation)
1156746003 Vaccine-induced prothrombotic immune Vaccine-induced prothrombotic immune 20210731
thrombocytopenia (disorder) thrombocytopenia

concepts may be used to record this data.

CV19-PTE-Education
Concept id Fully Specified Name en-US Preferred Term Effective Time
736017006 Education about hand hygiene Education about hand hygiene 20180131
(procedure)
868263005 Education about infectious disease Education about infectious disease 20200731
(procedure)
223426009 Equipment use education (procedure) Equipment use education 20020131
698608004 Hand washing education (procedure) Hand washing education 20140131
385820004 Infection control education (procedure) 20100731

A number of countries are trialling the use of medication to treat COVID-19. Many of these medications can be found
373873005 |Pharmaceutical / biologic product (product)|
sufficient evidence, the WHO is cautioning against associations recommending or administering these unproven
treatments to patients with COVID-19 or people self-medicating with them 2 . For this reason, we have not included
a medication treatment subset at this time.
COVID-19 vaccines, however, have been proven to be effective in clinical trials. The following generic vaccine
concepts may be recorded using SNOMED CT.

CV19-PTE-Vaccines
Concept id Fully Specified Name en-US Preferred Term Effective Time
2853100008 Vaccine product against Severe acute respiratory COVID-19 vaccine 20210731
7107 syndrome coronavirus 2 (medicinal product)
1157024006 Vaccine product containing only inactivated whole Severe Inactivated whole SARS-CoV-2 antigen vaccine 20210731
acute respiratory syndrome coronavirus 2 antigen
(medicinal product)
2906100008 Vaccine product containing only recombinant non- COVID-19 non-replicating viral vector vaccine 20210731
7103 replicating viral vector encoding Severe acute respiratory
syndrome coronavirus 2 spike protein (medicinal product)
1119305005 Vaccine product containing only Severe acute respiratory Severe acute respiratory syndrome 20210131
syndrome coronavirus 2 antigen (medicinal product) coronavirus 2 antigen only vaccine product
1119349007 Vaccine product containing only Severe acute respiratory Severe acute respiratory syndrome 20210131
syndrome coronavirus 2 messenger ribonucleic acid coronavirus 2 mRNA only vaccine product
(medicinal product)
1162643001 Vaccine product containing only Severe acute respiratory SARS-CoV-2 recombinant spike protein 20210731
syndrome coronavirus 2 recombinant spike protein antigen vaccine
antigen (medicinal product)

Patients with severe symptoms or complications may require admission to hospital, or other administrative
procedures. The following administrative procedures may be recorded using SNOMED CT.

31
CV19-PTE-AdministrativeProcedures
Concept id Fully Specified Name en-US Preferred Term Effective Time
183452005 Emergency hospital admission (procedure) Emergency hospital admission 20020131
305376003 Admission to infectious diseases department Admission to infectious diseases 20020131
(procedure) department
305351004 Admission to intensive care unit (procedure) Admission to intensive care unit 20020131
305360007 Admission to respiratory medicine department Admission to respiratory medicine 20020131
(procedure) department
32485007 Hospital admission (procedure) Hospital admission 20020131
417005 Hospital re-admission (procedure) Hospital re-admission 20020131
107724000 Patient transfer (procedure) Patient transfer 20020131
397821002 Patient transfer to intensive care unit (procedure) Patient transfer to intensive care unit 20030731
710112000 Transfer of care from hospital (procedure) Transfer of care from hospital 20150731
429202003 Transfer of care to hospital (procedure) Transfer of care to hospital 20080131

2.5.6 Therapeutic Procedures

symptoms or complications may require a range of therapeutic

may be recorded using SNOMED CT.

CV19-PTE-TherapeuticProcedures
Concept id Fully Specified Name en-US Preferred Term Effective Time
40617009 Artificial respiration (procedure) Artificial respiration 20020131
233573008 Extracorporeal membrane oxygenation Extracorporeal membrane oxygenation 20020131
(procedure)
697984004 Exteriorization of trachea (procedure) Exteriorization of trachea 20140131
229301009 Incentive spirometry (regime/therapy) Incentive spirometry 20020131
829831000000100 Insertion of fiducial marker into lung using Insertion of fiducial marker into lung 20200731
computed tomography guidance (procedure) using computed tomography guidance
447996002 Intubation of respiratory tract (procedure) Intubation of respiratory tract 20110731
243141005 Mechanically assisted spontaneous ventilation Mechanically assisted spontaneous 20020131
(procedure) ventilation
428311008 Noninvasive ventilation (procedure) Noninvasive ventilation 20080131

371908008 Oxygen administration by mask (procedure) Oxygen administration by mask 20020731

371907003 Oxygen administration by nasal cannula Oxygen administration by nasal 20020731
(procedure) cannula
431182000 Placing subject in prone position (procedure) Placing subject in prone position 20080731
11140008 Respiratory assist, manual (procedure) Respiratory assist, manual 20020131
1156748002 Transfusion of convalescent plasma into central Transfusion of convalescent plasma 20210731
vein (procedure) into central vein
1156747007 Transfusion of convalescent plasma into Transfusion of convalescent plasma 20210731
peripheral vein (procedure) into peripheral vein

Clinical findings relating to the treatment performed on a patient may be captured in a health record. The following
treatment findings may be recorded using SNOMED CT.

32
CV19-PTE-TreatmentPreventionFindings
Concept id Fully Specified Name en-US Preferred Term Effective Time
79031000119101 Dependence on respirator (finding) Dependence on respirator 20150731
931000119107 Dependence on supplemental oxygen (finding) Dependence on supplemental oxygen 20120731
444932008 Dependence on ventilator (finding) Dependence on ventilator 20100731
763326004 Difficult mask ventilation (finding) Difficult mask ventilation 20180731
718447001 Difficult tracheal intubation (finding) Difficult intubation 20160731
419991009 Endotracheal tube present (finding) Endotracheal tube present 20060131
405496006 Inability to ventilate patients lungs mechanically Inability to ventilate patients lungs 20040131
(finding) mechanically
22803001 Normal respiratory function (finding) Normal respiratory function 20020131
371825009 Patient on oxygen (finding) Patient on oxygen 20020731
371820004 Patient ventilated (finding) Patient ventilated 20020731
718085007 Unable to intubate and unable to ventilate Cannot intubate cannot ventilate 20160731
(finding)
128258000 Ventilation finding (finding) Ventilation finding 20020131

Footnotes
1 Audits in Infection Prevention and Control, IFIC Basic Concepts of Infection Control (Chapter 6), 3rd edition,
2016, International Federation of Infection Control
2 https://www.who.int/emergencies/diseases/novel-coronavirus-2019/global-research-on-novel-
coronavirus-2019-ncov/solidarity-clinical-trial-for-covid-19-treatments

33
3. Mapping to ICD-10
The following map members from SNOMED CT to the International Statistical Classification of Diseases and Related
Health Problems, Tenth Revision (© World Health organisation 1994) 2016 Version are published (or will be
published) in the SNOMED CT International Edition. These maps use ICD-10 codes identified in the WHO's
Emergency use ICD codes for COVID-19 disease outbreak 1

SNOMED CT ICD-10

SNOMED CT SNOMED CT Fully Specified ICD-10 ICD-10 Term Map Advice Effecti
Id Name Code ve
Time
840539006 Disease caused by Severe acute U07.1 COVID-19, virus identified POSSIBLE REQUIREMENT FOR 202101
respiratory syndrome ADDITIONAL CODE TO FULLY 31
coronavirus 2 (disorder) DESCRIBE DISEASE OR
CONDITION
840546002 Exposure to Severe acute Z20.8 Contact with and exposure to 202003
respiratory syndrome other communicable disease 09
coronavirus 2 (event)
124058100000 Severe acute respiratory U07.1 COVID-19, virus identified 202007
0104 syndrome coronavirus 2 31
detected (finding)

Footnotes
1 http://www9.who.int/classifications/icd/covid19/en/

34
Appendix A - Example Subsets
The example SNOMED CT subsets included in this guide are available to download below in two formats:
RF2 - This format uses the standard Simple Reference Set structure (except with the refsetId replaced with
an alphanumeric identifier). Please download this format if you plan to upload the subsets into a
terminology server. Please note that each refsetId should be replaced with a valid numeric identifier prior to
upload.
RF2+FSN - This format adds the US-english fully specified name to each member of the subset. Please
download this format if you plan to open the subsets directly (e.g. in a text editor or spreadsheet tool) for
review.
RF2+PT - This format adds the US-english preferred term to each member of the subset. Please download
this format if you plan to use the subsets directly in a simple value list.
These subsets have been created using the July 31st 2021 International Edition of SNOMED CT.
Please read the important note below before downloading these subset files.
SNOMED CT Example COVID-19 Subsets (RF2):

SNOMED CT Example COVID-19 Subsets (RF2+FSN):

SNOMED CT Example COVID-19 Subsets (RF2+PT):

35
Important Note
SNOMED International has created the SNOMED CT subsets in this guide to provide examples of SNOMED

These subsets have been guided by the collective needs and experiences of our SNOMED International
Members, and may therefore contain concepts that are not appropriate for use in all countries, regions
and use cases. Furthermore, they do not contain all SNOMED CT concepts required by every country,
1.1 How to Use this Guide, these subsets should not be used in a
production system without careful review and update to ensure that each subset fully meets the

guarantee that these subsets will be maintained moving forward after new releases of the SNOMED CT
International Edition are published.

36
Appendix B - Example Extension Content
The following pages include examples of COVID-19 extension content provided by a range of SNOMED International
Members.

B.1 Extension Concepts - Provider and Facility Details

2.1 Provider and Facility
Details.
Please note: This extension content should only be used in clinical systems that implement the relevant SNOMED
CT Edition.

B.1.1 Healthcare Profession

No known extension concepts for this data element have been published for the COVID-19 use case.

The following extensions concepts have been published for this COVID-19 data element.
CV19-PRF-SiteOfCare
Concept id Fully Specified Name National Preferred Term Edition
1454661000168105 COVID-19 Clinic and Testing Center (environment) COVID-19 Clinic and Testing Centre AU 20200331

B.1.3 Health Management Finding

No known extension concepts for this data element have been published for the COVID-19 use case.

B.1.4 Personal Protective Equipment

No known extension concepts for this data element have been published for the COVID-19 use case.

B.2 Extension Concepts - Patient Demographics

This page includes examples of SNOMED CT extension content for the subsets listed in 2.2 Patient Demographics.
Please note: This extension content should only be used in clinical systems that implement the relevant SNOMED
CT Edition.

37
B.2.1 Sex and Gender
No known extension concepts for this data element have been published for the COVID-19 use case.

No known extension concepts for this data element have been published for the COVID-19 use case.

B.2.4 Racial Group

No known extension concepts for this data element have been published for the COVID-19 use case.

The following extensions concepts for this data element have been created for the COVID-19 use case.
CV19-PAT-ForeignTravelHistory

Concept id Fully Specified Name National Preferred Term Edition

1454671000168104 History of recent travel to high risk COVID-19 region Recent travel to high risk COVID-19 AU 20200331
(finding) region

B.2.7 Residential Location Type

No known extension concepts for this data element have been published for the COVID-19 use case.

B.3 Extension Concepts - Clinical Assessment

2.3 Clinical Assessment.
Please note: This extension content should only be used in clinical systems that implement the relevant SNOMED
CT Edition.

The following extension concepts have been created for this COVID-19 data element.

38
CV19-ASS-Symptoms
Concept id Fully Specified Name National Preferred Term Edition
64751000052105 Loss of sense of smell and/or taste (finding) nedsatt smak- och/eller luktsinne SE 20200531

No known extension concepts have been published for this COVID-19 data element.
However, the following related extension concepts have been published.

Severity procedures and observable entities

Concept id Fully Specified Name National Preferred Term Edition
1300681000000102 Assessment using coronavirus disease 19 severity scale Assessment using COVID-19 severity UK 20200401
(procedure) scale
1300631000000101 Coronavirus disease 19 severity score (observable entity) COVID-19 severity score UK 20200401

The following extension concepts have been created for this COVID-19 data element.

CV19-ASS-ClinicalMeasurements
Concept id Fully Specified Name National Preferred Term Edition
251000220105 National adult early warning system parameter National adult early warning system key IE 20200421

In addition, the following extension concepts have been created for assessment scales.

Assessment Scale
Concept id Fully Specified Name National Preferred Term Edition
331000220106 Alert confusion voice pain unresponsive scale ACVPU scale IE 20200421
(assessment scale)

No known extension concepts have been published for this COVID-19 data element.

The following extension concepts have been created for this COVID-19 data element.

CV19-ASS-Diagnosis
Concept id Fully Specified Name National Edition
Preferred Term
1240751000000 Coronavirus disease 19 caused by severe acute respiratory syndrome coronavirus 2 COVID-19 UK 20200401
100 (disorder)
1240761000000 Suspected coronavirus disease 19 caused by severe acute respiratory syndrome Suspected UK 20200401
102 coronavirus 2 (situation) COVID-19

No known extension concepts have been published for this COVID-19 data element.

39
The following extensions concepts have been published for this COVID-19 data element.

CV19-ASS-SecondaryConditionsAndComplications
Concept id Fully Specified Name National Preferred Term Edition
11890100014610 Acute respiratory disease caused by severe acute Acute respiratory disease caused by severe acute NL 20200325
8 respiratory syndrome coronavirus 2 (disorder) respiratory syndrome coronavirus 2
11891100014610 Gastroenteritis caused by severe acute respiratory Gastroenteritis caused by severe acute respiratory NL 20200325
5 syndrome coronavirus 2 (disorder) syndrome coronavirus 2
11892100014610 Suspected acute respiratory disease caused by severe Suspected acute respiratory disease caused by NL 20200325
0 acute respiratory syndrome coronavirus 2 (situation) severe acute respiratory syndrome coronavirus 2
119731000146105 Cardiomyopathy due to infection by severe acute Cardiomyopathy due to infection by severe acute NL 20200925
respiratory syndrome coronavirus 2 (disorder) respiratory syndrome coronavirus 2
119741000146102 Conjunctivitis due to infection by severe acute respiratory Conjunctivitis due to infection by severe acute NL 20200925
syndrome coronavirus 2 (disorder) respiratory syndrome coronavirus 2
119971000146105 Disease due to infection by severe acute respiratory Disease due to infection by severe acute respiratory NL 20200925
syndrome coronavirus 2 (disorder)
119981000146107 Dyspnea due to infection by severe acute respiratory Dyspnea due to infection by severe acute respiratory NL 20200925
syndrome coronavirus 2 (finding) syndrome coronavirus 2
119751000146104 Fever due to infection by severe acute respiratory Fever due to infection by severe acute respiratory NL 20200925
syndrome coronavirus 2 (finding) syndrome coronavirus 2
119761000146101 NL 20200925
syndrome coronavirus 2 (disorder) respiratory syndrome coronavirus 2
12405710000001 Gastroenteritis caused by severe acute respiratory Gastroenteritis caused by SARS-CoV-2 (severe UK
01 syndrome coronavirus 2 (disorder) acute respiratory syndrome coronavirus 2) 20200401
12405410000001 Infection of upper respiratory tract caused by severe Upper respiratory tract infection caused by SARS- UK
07 acute respiratory syndrome coronavirus 2 (disorder) CoV-2 (severe acute respiratory syndrome 20200401
coronavirus 2)
12405310000001 Myocarditis caused by severe acute respiratory Myocarditis caused by SARS-CoV-2 (severe acute UK
03 syndrome coronavirus 2 (disorder) respiratory syndrome coronavirus 2) 20200401
12405210000001 Otitis media caused by severe acute respiratory Otitis media caused by SARS-CoV-2 (severe acute UK
00 syndrome coronavirus 2 (disorder) respiratory syndrome coronavirus 2) 20200401
12405510000001 Pneumonia caused by severe acute respiratory Pneumonia caused by SARS-CoV-2 (severe acute UK
05 syndrome coronavirus 2 (disorder) respiratory syndrome coronavirus 2) 20200401
12405610000001 Encephalopathy caused by severe acute respiratory Encephalopathy caused by SARS-CoV-2 (severe UK
08 syndrome coronavirus 2 (disorder) acute respiratory syndrome coronavirus 2) 20200401

No known extension concepts have been published for this COVID-19 data element.
However, the following related extension concepts have been published.

Risk Categories
Concept id Fully Specified Name National Preferred Term Edition
130059100000010 Low risk category for developing complication from coronavirus Low risk category for developing UK 20200401
1 disease 19 caused by severe acute respiratory syndrome coronavirus complication from COVID-19
2 infection (finding) infection
130057100000010 Moderate risk category for developing complication from Moderate risk category for UK 20200401
0 coronavirus disease 19 caused by severe acute respiratory syndrome developing complication from
coronavirus 2 infection (finding) COVID-19 infection
130056100000010 High risk category for developing complication from coronavirus High risk category for developing UK 20200401
7 disease 19 caused by severe acute respiratory syndrome coronavirus complication from COVID-19
2 infection (finding) infection

40
B.3.9 Comorbidities
No known extension concepts have been published for this COVID-19 subset.

The following extension concepts have been published for this COVID-19 data element

CV19-ASS-ExposureEvent
Concept id Fully Specified Name National Preferred Term Edition
1240431000000 Exposure to severe acute respiratory syndrome Exposure to SARS-CoV-2 (severe acute UK 20200401
104 coronavirus 2 infection (event) respiratory syndrome coronavirus 2) infection

1240441000000 Close exposure to severe acute respiratory syndrome Close exposure to SARS-CoV-2 (severe acute UK 20200401
108 coronavirus 2 infection (event) respiratory syndrome coronavirus 2) infection

B.3.11 Covid-19 and Viral Co-Infections

No known extension concepts have been published for this COVID-19 data element.

Footnotes
1 https://pubmed.ncbi.nlm.nih.gov/?term=covid+19&filter=pubt.review

B.4 Extension Concepts - Tests and Investigations

2.4 Tests and Investigations.
Please note: This extension content should only be used in clinical systems that implement the relevant SNOMED
CT Edition.

The following extension concepts have been published for this COVID-19 data element.

CV19-INV-Specimen
Concept id Fully Specified Name National Preferred Term Edition
429931000124105 Nasal aspirate specimen (specimen) Nasal aspirate specimen US 20140301
433801000124107 Nasopharyngeal and oropharyngeal swab (specimen) Nasopharyngeal and oropharyngeal US 20130301
swab

The following extension concepts have been published for this COVID-19 data element.

CV19-INV-LaboratoryTests
Concept id Fully Specified Name National Preferred Term Edition
14454310001 2019 novel coronavirus nucleic acid assay (procedure) COVID-19 nucleic acid assay AU 20200331
68101
14544110001 Nucleic acid assay of severe acute respiratory syndrome coronavirus 2 Nasopharyngeal swab AU 20200331
68105 in nasopharyngeal swab specimen (procedure) COVID-19 nucleic acid assay

41
CV19-INV-LaboratoryTests
14544910001 Nucleic acid assay of severe acute respiratory syndrome coronavirus 2 Oropharyngeal swab AU 20200331
68101 in oropharyngeal swab specimen (procedure) COVID-19 nucleic acid assay
14545610001 Nucleic acid assay of severe acute respiratory syndrome coronavirus 2 Sputum COVID-19 nucleic AU 20200331
68109 in sputum specimen (procedure) acid assay
14545810001 Nucleic acid assay of severe acute respiratory syndrome coronavirus 2 Bronchoalveolar lavage AU 20200331
68100 in bronchoalveolar lavage fluid specimen (procedure) fluid COVID-19 nucleic acid
assay
14546510001 COVID-19 serology (procedure) COVID-19 serology AU 20200331
68108
12405110000 Detection of severe acute respiratory syndrome coronavirus 2 using Detection of SARS-CoV-2 UK 20200401
00106 polymerase chain reaction technique (procedure) (severe acute respiratory
syndrome coronavirus 2)
using polymerase chain
reaction technique
12404610000 Measurement of severe acute respiratory syndrome coronavirus 2 Measurement of SARS- UK 20200401
00109 antibody (procedure) CoV-2 (severe acute
respiratory syndrome
coronavirus 2) antibody
12404710000 Measurement of severe acute respiratory syndrome coronavirus 2 Measurement of SARS- UK 20200401
00102 antigen (procedure) CoV-2 (severe acute
respiratory syndrome
coronavirus 2) antigen
12407410000 Severe acute respiratory syndrome coronavirus 2 serology (observable SARS-CoV-2 (severe acute UK 20200401
00103 entity) respiratory syndrome
coronavirus 2) serology

CV19-INV-LaboratoryTestSituations
Concept id Fully Specified Name National Preferred Term Edition
132104100000 Self-taking of swab for severe acute respiratory Self-taking of swab for SARS-CoV-2 (severe acute UK
0101 syndrome coronavirus 2 offered (situation) respiratory syndrome coronavirus 2) offered 20200401
132105100000 Swab for severe acute respiratory syndrome Swab for SARS-CoV-2 (severe acute respiratory UK
0103 coronavirus 2 taken by healthcare professional syndrome coronavirus 2) taken by healthcare 20200401
(situation) professional
132103100000 Swab for severe acute respiratory syndrome Self-taken swab for SARS-CoV-2 (severe acute UK
0105 coronavirus 2 taken by subject (situation) respiratory syndrome coronavirus 2) 20200401

The following extensions concepts have been published for this COVID-19 data element.

CV19-INV-SubstancesAndVirus
Concept id Fully Specified Name National Preferred Term Edition
124040100000 Antibody to severe acute respiratory syndrome Antibody to SARS-CoV-2 (severe acute respiratory UK
0105 coronavirus 2 (substance) syndrome coronavirus 2) 20200401
124039100000 Antigen of severe acute respiratory syndrome Antigen of SARS-CoV-2 (severe acute respiratory UK
0107 coronavirus 2 (substance) syndrome coronavirus 2) 20200401
124041100000 Ribonucleic acid of severe acute respiratory Ribonucleic acid of SARS-CoV-2 (severe acute UK
0107 syndrome coronavirus 2 (substance) respiratory syndrome coronavirus 2) 20200401
124042100000 Serotype severe acute respiratory syndrome Serotype SARS-CoV-2 (severe acute respiratory UK
0101 coronavirus 2 (qualifier value) syndrome coronavirus 2) 20200401
124038100000 Severe acute respiratory syndrome coronavirus 2 SARS-CoV-2 - severe acute respiratory syndrome UK
0105 (organism) coronavirus 2 20200401

42
The following extensions concepts have been published for this COVID-19 data element

CV19-INV-LaboratoryTestResults
Concept id Fully Specified Name National Preferred Term Edition
13007210000001 Coronavirus disease 19 caused by severe acute COVID-19 confirmed by laboratory test UK 20200401
09 respiratory syndrome coronavirus 2 confirmed
by laboratory test (situation)
13007310000001 Coronavirus disease 19 caused by severe acute COVID-19 confirmed using clinical diagnostic UK 20200401
06 respiratory syndrome coronavirus 2 confirmed criteria
using clinical diagnostic criteria (situation)
13211210000001 Coronavirus disease 19 caused by severe acute COVID-19 excluded using clinical diagnostic UK 20200401
07 respiratory syndrome coronavirus 2 excluded criteria
using clinical diagnostic criteria (situation)
13211110000001 Coronavirus disease 19 caused by severe acute COVID-19 excluded by laboratory test UK 20200401
01 respiratory syndrome coronavirus 2 excluded by
laboratory test (situation)
12405810000001 Severe acute respiratory syndrome coronavirus SARS-CoV-2 (severe acute respiratory UK 20200401
04 2 detected (finding) syndrome coronavirus 2) detected
12405910000001 Severe acute respiratory syndrome coronavirus SARS-CoV-2 (severe acute respiratory UK 20200401
02 2 not detected (finding) syndrome coronavirus 2) not detected

The following extensions concepts have been published for this COVID-19 data element.

CV19-INV-OtherInvestigation
Concept id Fully Specified Name National Preferred Term Edition
13006810000001 Assessment using coronavirus disease 19 severity Assessment using COVID-19 severity scale UK
02 scale (procedure) 20200401
13209710000001 Taking of swab for severe acute respiratory syndrome Taking of swab for SARS-CoV-2 (severe acute UK
02 coronavirus 2 (procedure) respiratory syndrome coronavirus 2) 20200401
12404510000001 Telephone consultation for suspected severe acute Telephone consultation for suspected SARS- UK
06 respiratory syndrome coronavirus 2 (procedure) CoV-2 (severe acute respiratory syndrome 20200401
coronavirus 2)
In addition, the following extension concepts related to investigation situations have been published.

Other Investigation Situations

Concept id Fully Specified Name National Preferred Term Edition
1321221000000103 Consultation via video conference not available Consultation via video conference not UK 20200401
(situation) available

Footnotes
1 https://thenativeantigencompany.com/why-we-need-antigen-and-antibody-tests-for-covid-19/

B.5 Extension Concepts - Prevention, Treatment and Education

2.5 Prevention, Treatment
and Education.
Please note: This extension content should only be used in clinical systems that implement the relevant SNOMED
CT Edition.

43
The following extensions concepts have been published for this data element.

CV19-PTE-PreventionProcedures
Concept id Fully Specified Name National Preferred Term Edition
1321161000000 Household isolation to prevent exposure of Household isolation to prevent exposure of community UK 20200401
104 community to contagion (procedure) to contagion
1321141000000 Reverse isolation of household to prevent exposure Shielding of household to prevent exposure of UK 20200401
100 of uninfected subject to contagion (procedure) uninfected subject to contagion
1321151000000 Reverse self-isolation of uninfected subject to Shielding of uninfected subject to prevent exposure to UK 20200401
102 prevent exposure to contagion (procedure) contagion
1321131000000 Self-isolation to prevent exposure of community to Self-isolation to prevent exposure of community to UK 20200401
109 contagion (procedure) contagion
1240491000000 Severe acute respiratory syndrome coronavirus 2 SARS-CoV-2 (severe acute respiratory syndrome UK 20200401
103 vaccination (procedure) coronavirus 2) vaccination
1321231000000 Signposting to coronavirus disease 19 Home Signposting to CHMS (COVID-19 Home Management UK 20200401
101 Management Service (procedure) Service)
1321061000000 Signposting to National Health Service online Signposting to NHS online isolation note service UK 20200401
100 isolation note service (procedure)
In addition, the following extension concepts for prevention-related situations have been published.

Prevention Situations
Concept id Fully Specified Name National Preferred Term Edition
1240681000000 Severe acute respiratory syndrome coronavirus 2 SARS-CoV-2 (severe acute respiratory syndrome UK 20200401
103 vaccination not done (situation) coronavirus 2) vaccination not done
1240701000000 Severe acute respiratory syndrome coronavirus 2 SARS-CoV-2 (severe acute respiratory syndrome UK 20200401
101 vaccine not available (situation) coronavirus 2) vaccine not available
1240781000000 Severe acute respiratory syndrome coronavirus 2 SARS-CoV-2 (severe acute respiratory syndrome UK 20200401
106 vaccination invitation short message service text coronavirus 2) vaccination invitation short message
message sent (situation) service text message sent
1240651000000 Severe acute respiratory syndrome coronavirus 2 SARS-CoV-2 (severe acute respiratory syndrome UK 20200401
109 vaccination declined (situation) coronavirus 2) vaccination declined
1240661000000 Severe acute respiratory syndrome coronavirus 2 SARS-CoV-2 (severe acute respiratory syndrome UK 20200401
107 vaccination contraindicated (situation) coronavirus 2) vaccination contraindicated
1240671000000 Severe acute respiratory syndrome coronavirus 2 SARS-CoV-2 (severe acute respiratory syndrome UK 20200401
100 vaccination not indicated (situation) coronavirus 2) vaccination not indicated
And, the following extension concepts for prevention-related findings have been published.

Prevention Findings
Concept id Fully Specified Name National Preferred Term Edition
1240631000000 Did not attend severe acute respiratory syndrome Did not attend SARS-CoV-2 (severe acute respiratory UK
102 coronavirus 2 vaccination (finding) syndrome coronavirus 2) vaccination 20200401
1321071000000 Has National Health Service digital isolation note Has NHS digital isolation note UK
107 (finding) 20200401
1240601000000 High priority for severe acute respiratory syndrome High priority for SARS-CoV-2 (severe acute UK
108 coronavirus 2 vaccination (finding) respiratory syndrome coronavirus 2) vaccination 20200401
1321091000000 Household isolation note issued to patient (finding) Household isolation note issued to patient UK
106 20200401
1321081000000 Self-isolation note issued to patient (finding) Self-isolation note issued to patient UK
109 20200401

44
The following extension concepts have been published for this data element.

CV19-PTE-EducationSituation
Concept id Fully Specified Name National Preferred Term Edition
124073100000 Advice given about severe acute respiratory syndrome Advice given about SARS-CoV-2 (severe acute respiratory UK
0107 coronavirus 2 by telephone (situation) syndrome coronavirus 2) by telephone 20200401
124072100000 Advice given about severe acute respiratory syndrome Advice given about SARS-CoV-2 (severe acute respiratory UK
0105 coronavirus 2 infection (situation) syndrome coronavirus 2) infection 20200401
124071100000 Educated about severe acute respiratory syndrome Educated about SARS-CoV-2 (severe acute respiratory UK
0104 coronavirus 2 infection (situation) syndrome coronavirus 2) infection 20200401
132117100000 Provision of advice, assessment or treatment limited Provision of advice, assessment or treatment limited due UK
0106 due to coronavirus disease 19 caused by severe acute to COVID-19 pandemic 20200401
respiratory syndrome coronavirus 2 pandemic
(situation)

No known extension concepts for this data element have been published for the COVID-19 use case.

B.5.4 Therapeutic Procedures

The following extension concepts have been published for this data element.

CV19-PTE-EducationSituation
Concept id Fully Specified Name National Preferred Term Edition
311000220101 National adult early warning system bedside National early warning system bedside response IE 20200421
response (procedure)

301000220104 National adult early warning system emergency NEWS emergency response IE 20200421
response (procedure)

B.5.5 Treatment Findings

No known extension concepts for this data element have been published for the COVID-19 use case.

B.5.6 Treatment Equipment

No known extension concepts for this data element have been published for the COVID-19 use case.

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COVID-19 Data Coding

Uploaded by

COVID-19 Data Coding

Uploaded by

COVID-19 Data Coding

Web version link: http://snomed.org/cv19

© Copyright 2021 International Health Terminology Standards Development Organisation

SNOMED International owns and maintains SNOMED CT®.

1.1 How to Use this Guide

These three steps are explained in more detail below.

Step 1 - Identify Data Elements

Step 2 - Download Subsets

Subset Naming Convention

Subset Naming Convention Templates

Examples of Named Subset

Marital status subset including subtypes CV19-PAT-MaritalStatus-withSubtypes

Symptoms subset including subtypes CV19-ASS-Symptoms-withSubtypes

Step 3 - Review and Adapt

Data Group Data Element

2.1 Provider and Facility Details

2.1.1 Healthcare Profession

2.1.2 Site of Care

2.1.3 Health Management Finding

2.1.4 Personal Protective Equipment

2.2 Patient Demographics

2.2.1 Sex and Gender

248152002 |Female (finding)| ) and gender identity

The marital or partnership status of a patient elationship with their

158942005 |Residential child care worker (occupation)|

223496003 |Geographical and/or political region of the world (geographic location)|

2.3 Clinical Assessment

Covid-19 and Viral Co-Infections

364533002 Color of skin (observable entity) Color of skin 20020131

64779008 Blood coagulation disorder (disorder) Blood coagulation disorder 20020731

1119303003 Post-acute COVID-19 (disorder) Post-acute COVID-19 20210131

27624003 Chronic disease (disorder) Chronic disease 20020131

2.4 Tests and Investigations

119297000 Blood specimen (specimen) Blood specimen 20040731

258529004 Throat swab (specimen) Throat swab 20080731

2.4.3 Radiology Procedures

386053000 |Evaluation procedure (procedure)|

313333008 |Sample obtained (situation)|

2.5 Prevention, Treatment and Education

840534001 |SARS-CoV-2 vaccination| 225368008 |Contact tracing|

422181004 Antibiotic prophylaxis (procedure) Antibiotic prophylaxis 20060731

409686004 Disinfecting of equipment (procedure) Disinfecting of equipment 20040731

170499009 Isolation of infection contact (procedure) Isolation of infection contact 20020131

170500000 Isolation of infection carrier (procedure) Isolation of infection carrier 20020131

40174006 Isolation procedure (procedure) 20020131

concepts may be used to record this data.

2.5.6 Therapeutic Procedures

may be recorded using SNOMED CT.

371908008 Oxygen administration by mask (procedure) Oxygen administration by mask 20020731

SNOMED CT Example COVID-19 Subsets (RF2+FSN):

SNOMED CT Example COVID-19 Subsets (RF2+PT):

B.1 Extension Concepts - Provider and Facility Details

B.1.1 Healthcare Profession

B.1.3 Health Management Finding

B.1.4 Personal Protective Equipment

B.2 Extension Concepts - Patient Demographics

B.2.4 Racial Group

Concept id Fully Specified Name National Preferred Term Edition

B.2.7 Residential Location Type

B.3 Extension Concepts - Clinical Assessment

Severity procedures and observable entities

B.3.11 Covid-19 and Viral Co-Infections

B.4 Extension Concepts - Tests and Investigations

Other Investigation Situations

B.5 Extension Concepts - Prevention, Treatment and Education

B.5.4 Therapeutic Procedures

B.5.5 Treatment Findings

B.5.6 Treatment Equipment

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