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COVID-19 Severity Risk Score Questionnaire

Huma aims to model the risk of individuals developing complications due to COVID-19. The risk score is calculated using routinely-collected symptoms, demographics, pre-existing conditions and vital signs, all of which can be collected via the Huma App.

How it works​

Patients will answer questions from the COVID-19 severity risk score questionnaire and their results will be stored and shared with their care team.

In the Huma Portal, care teams will see the latest COVID-19 severity risk score for their patient. Concerning scores will be flagged for attention. In the Patient Summary, care teams will be able to see all historical data in graph or table form.

Questions​

Before you begin, are you experiencing any of the following?​

  • Severe pain in the centre of the chest like a tight band, heavy weight or squeezing
  • Face drooping on one side, difficulty moving your limbs and speaking
  • Severe difficulty in breathing, gasping for air, not being able to get words out, choking or lips turning blue
  • Heavy uncontrolled bleeding
  • Severe dizziness or loss of consciousness
  • Uncontrolled shaking or jerking because of a fit, or is unconscious (can't be woken up)
  • Sudden allergic reaction with rapid swelling of the eyes, lips, mouth, throat or tongue.

Answer yes or no

What is your date of birth?​

Select a date

What is your weight?​

Provide a numeric answer as kg or lbs

What is your height?​

Provide a numeric answer as cm or in

What is your blood type?​

Select one of the following

  • O-positive
  • O-negative
  • A-positive
  • A-negative
  • B-positive
  • B-negative
  • AB-positive
  • AB-negative
  • Unknown

Please select any/all conditions you have been diagnosed with, or are receiving treatment for​

Choose multiple of the following

  • Current Cancer
  • Diabetes
  • Heart failure
  • Chronic kidney disease
  • Chronic lung disease
  • Chronic liver disease
  • Other cardiovascular disease (e.g. previous heart attacks)
  • Stroke
  • Hypertension
  • Other
  • None

Do you currently have a fever, you feel hot to touch or experiencing chills?​

Answer yes or no

Are you experiencing any of these symptoms?​

Choose multiple of the following

  • Difficulty breathing
  • Chest tightness
  • Persistant new cough
  • Coughing up phlegm
  • Coughing up blood
  • Headache
  • Muscle aches throughout the body
  • Fatigue
  • Nausea and/or vomiting
  • Diarrhoea
  • Abdominal symptoms (Heartburn, indigestion, bloating or constipation)
  • No, I am not experiencing any of these symptoms

What is your Resting Heart Rate?​

Provide a numeric answer or collect from camera

What is your Resting Breathing Rate?​

Provide a numeric answer

What is your Blood Oxygen Level?​

Provide a numeric answer