Baseline information (CHRIS COVID-19)
md_cc_0002
CHRIS COVID-19 baseline information
Educational qualification
Educational qualification
ccbq01Residential municipality
Residential municipality
ccbq02Residential municipality
Residential municipality
ccbq02aNumber of household members, including yourself
Number of inhabitants, including yourself
ccbq03Number of household members, including yourself (including imputation from household members)
Number of inhabitants, including yourself (including imputation from household members)
ccbq03aTotal number of rooms in the house
Total number of rooms in the house
ccbq04Total number of rooms in the house (including imputation from household members)
Total number of rooms in the house (including imputation from household members)
ccbq04aDoctor-diagnosis of any of the listed diseases
Has a doctor ever diagnosed you with any of the following diseases?
ccbq11Diabetes, self-reported diagnosis
Has a doctor ever diagnosed you with any of the following diseases? Diabetes
ccbq11aOther metabolic dysfunction, self-reported diagnosis
Has a doctor ever diagnosed you with any of the following diseases? Other metabolic dysfunction
ccbq11bRespiratory allergy, self-reported diagnosis
Has a doctor ever diagnosed you with any of the following diseases? Respiratory allergy
ccbq11cOther type of allergy, self-reported diagnosis
Has a doctor ever diagnosed you with any of the following diseases? Other type of allergy
ccbq11dAsthma, self-reported diagnosis
Has a doctor ever diagnosed you with any of the following diseases? Asthma
ccbq11eChronic bronchitis, self-reported diagnosis
Has a doctor ever diagnosed you with any of the following diseases? Chronic bronchitis
ccbq11fOther lung disease (excluding cancer), self-reported diagnosis
Has a doctor ever diagnosed you with any of the following diseases? Other lung disease (excluding cancer)
ccbq11gHypertension, self-reported diagnosis
Has a doctor ever diagnosed you with any of the following diseases? Hypertension
ccbq11hArrhythmia, self-reported diagnosis
Has a doctor ever diagnosed you with any of the following diseases? Arrhythmia
ccbq11iIschemic or cerebrovascular disease, self-reported diagnosis
Has a doctor ever diagnosed you with any of the following diseases? Ischemic or cerebrovascular disease
ccbq11jOther cardiovascular disease, self-reported diagnosis
Has a doctor ever diagnosed you with any of the following diseases? Other cardiovascular disease
ccbq11kKidney disease, self-reported diagnosis
Has a doctor ever diagnosed you with any of the following diseases? Kidney disease
ccbq11lLiver disease, self-reported diagnosis
Has a doctor ever diagnosed you with any of the following diseases? Liver disease
ccbq11mAutoimmune rheumatic disease, self-reported diagnosis
Has a doctor ever diagnosed you with any of the following diseases? Autoimmune rheumatic disease
ccbq11nMusculoskeletal disease, self-reported diagnosis
Has a doctor ever diagnosed you with any of the following diseases? Musculoskeletal disease
ccbq11oBlood disease, self-reported diagnosis
Has a doctor ever diagnosed you with any of the following diseases? Blood disease
ccbq11pMental or affective disease, self-reported diagnosis
Has a doctor ever diagnosed you with any of the following diseases? Mental or affective disease
ccbq11qCancer, self-reported diagnosis
Has a doctor ever diagnosed you with any of the following diseases? Cancer
ccbq11rHospitalised in the past 12 months
Have you been hospitalized in the past 12 months?
ccbq12Surgery under general anaesthesia in the past 12 months
Have you undergone surgery under general anaesthesia in the past 12 months?
ccbq13Chemo or radiotherapy in the past 12 months
Have you undergone chemo or radiation therapy in the past 12 months?
ccbq14Organ tranplantation, lifetime
Have you ever had an organ transplant, in your lifetime?
ccbq15Pregnancy over the past 6 months
Are you currently pregnant or have you been pregnant over the past 6 months?
ccbq16Seasonal flu vaccination in the past 12 months
In the past 12 months, have you received a vaccine for seasonal flu?
ccbq17Pneumococcal vaccination in the past 12 months
In the past 12 months, have you received a vaccine for pneumococcal infection?
ccbq18Other vaccination in the past 12 months
In the past 12 months, have you received any other vaccinations?
ccbq19Medication, last 4 weeks
In the past 4 weeks, have you regularly taken any of the following medications?
ccbq20Use of aspirin, last 4 weeks
In the past 4 weeks, have you regularly taken any of the following medications? Use of aspirin
ccbq20aUse of antithrombotics, last 4 weeks
In the past 4 weeks, have you regularly taken any of the following medications? Use of antithrombotics
ccbq20bBlood pressure lowering therapy, last 4 weeks
In the past 4 weeks, have you regularly taken any of the following medications? Blood pressure lowering therapy
ccbq20cCholesterol lowering therapy, last 4 weeks
In the past 4 weeks, have you regularly taken any of the following medications? Cholesterol lowering therapy
ccbq20dUse of diabetes medication, last 4 weeks
In the past 4 weeks, have you regularly taken any of the following medications? Use of diabetes medication
ccbq20eUse of thyroid disease drugs, last 4 weeks
In the past 4 weeks, have you regularly taken any of the following medications? Use of thyroid disease drugs
ccbq20fHormone therapy, last 4 weeks
In the past 4 weeks, have you regularly taken any of the following medications? Hormone therapy
ccbq20gUse of asthma-bronchitis medication, last 4 weeks
In the past 4 weeks, have you regularly taken any of the following medications? Use of Asthma-bronchitis medication
ccbq20hUse of cortisone or immunosuppressive drugs, last 4 weeks
In the past 4 weeks, have you regularly taken any of the following medications? Use of cortisone or immunosuppressive drugs
ccbq20iUse of pain-relief drugs (NSAID), last 4 weeks
In the past 4 weeks, have you regularly taken any of the following medications? Use of pain-relief drugs (NSAID)
ccbq20jUse of anxiety, sedative, or anti-depressant drugs, last 4 weeks
In the past 4 weeks, have you regularly taken any of the following medications? Use of anxiety, sedative, or anti-depressant drugs
ccbq20kUse of vitamin D, last 4 weeks
In the past 4 weeks, have you regularly taken any of the following medications? Use of vitamin D
ccbq20lPrimary occupational status, before coronavirus-related emergency
In the 12 months before the coronavirus-related emergency, what was your primary occupational status?
ccbq21Main sector of activity, before coronavirus-related emergency
What was your main sector of activity?
ccbq22Smoking status
Do you smoke cigarettes (or tobacco in general)?
ccbq23Current smoking quantitiy
How many cigarettes per day?
ccbq23aTime since quitting smoking
How long ago?
ccbq23bSelf-reported moderate or vigorous physical activity
Do you engage in moderate or vigorous physical activity, 2 days or more per week for at least 5 hours in total?
ccbq24Self-reported weight
What is your weight?
ccbq25Self-reported height
What is your height?
ccbq26Body-Mass-Index
Body-Mass-Index
ccbq27aBody-Mass-Index category
Body-Mass-Index category
ccbq27bSubmission date of CC19 baseline questionnaire
Submission date of CHRIS COVID-19 baseline questionnaire
ccbqdateLanguage used in CC19 baseline questionnaire
Language used in CHRIS COVID-19 baseline questionnaire
ccbqlangFor whom are you filling out this questionnaire?
For whom are you filling out this questionnaire?
ccbqrespVersion of CC19 baseline questionnaire
Version of CHRIS COVID-19 baseline questionnaire
ccbqverCHRIS Covid-19 Study Baseline information questionnaire documentation
Documentation regarding the questionnaire assessing self-reported sociodemographic characteristics, lifestyle, health status, and anthropometry
application/pdf
288.4 KB
CHRIS Covid-19 Study Baseline questionnaire v1.0 (German)
German version of the baseline questionnaire in use until 16 December 2020 assessing self-reported sociodemographic characteristics, lifestyle, health status, anthropometry as well as SARS-CoV-2 testing, symptoms related to SARS-CoV-2 infection, and contact with infected or symptomatic individuals.
application/pdf
395.6 KB
CHRIS Covid-19 Study Baseline questionnaire v1.0 (Italian)
Italian version of the baseline questionnaire in use until 16 December 2020 assessing self-reported sociodemographic characteristics, lifestyle, health status, anthropometry as well as SARS-CoV-2 testing, symptoms related to SARS-CoV-2 infection, and contact with infected or symptomatic individuals.
application/pdf
409.7 KB
CHRIS Covid-19 Study Baseline questionnaire v1.1 (German)
German version of the baseline questionnaire in use between 16 December 2020 and 19 January 2021 assessing self-reported sociodemographic characteristics, lifestyle, health status, anthropometry as well as SARS-CoV-2 testing, symptoms related to SARS-CoV-2 infection, and contact with infected or symptomatic individuals. Changes to the previous version: The SARS-CoV-2 testing section was redefined and a symptoms duration question was added.
application/pdf
408.6 KB
CHRIS Covid-19 Study Baseline questionnaire v1.1 (Italian)
Italian version of the baseline questionnaire in use between 16 December 2020 and 19 January 2021 assessing self-reported sociodemographic characteristics, lifestyle, health status, anthropometry as well as SARS-CoV-2 testing, symptoms related to SARS-CoV-2 infection, and contact with infected or symptomatic individuals. Changes to the previous version: The SARS-CoV-2 testing section was redefined and a symptoms duration question was added.
application/pdf
420.9 KB
CHRIS Covid-19 Study Baseline questionnaire v1.2 (German)
German version of the baseline questionnaire in use since 20 January 2021 assessing self-reported sociodemographic characteristics, lifestyle, health status, anthropometry as well as SARS-CoV-2 testing, symptoms related to SARS-CoV-2 infection, and contact with infected or symptomatic individuals. Changes to the previous version: A section regarding Covid-19 vaccination was added.
application/pdf
412.2 KB
CHRIS Covid-19 Study Baseline questionnaire v1.2 (Italian)
Italian version of the baseline questionnaire in use since 20 January 2021 assessing self-reported sociodemographic characteristics, lifestyle, health status, anthropometry as well as SARS-CoV-2 testing, symptoms related to SARS-CoV-2 infection, and contact with infected or symptomatic individuals. Changes to the previous version: A section regarding Covid-19 vaccination was added.
application/pdf
424.1 KB