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COVID-19 Monthly Questionnaire

The Fenland Study for COVID-19 is looking to gather data on how many people have evidence in their blood of previous infection with COVID-19 and then to investigate whether it is possible to identify the COVID-19 pre-symptomatic phase using signs and symptoms collected via the Huma App. This information will help scientists develop better methods of early detection.

How it works​

Patients will answer questions about tests and symptoms of COVID-19 over the past month. Care teams can view new and historical results in the Huma Portal and 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.

The COVID-19 Monthly Questionnaire has 24 questions:

Questions​

Question 1: Overall, how would you rate your health over the past month?​

Select one of the following

  • Poor
  • Fair
  • Good
  • Excellent

Question 2: Have you had any form of test for COVID-19 in the last month?​

Answer yes or no

Question 3: In the past month, have you had an antigen test for COVID-19?​

Select one of the following

  • Yes
  • No
  • Don't know

Question 4: In the last month, what was the date of your first COVID-19 antigen test?​

Select a date

Question 5: Why did you have a COVID-19 antigen test?​

Choose multiple of the following

  • I had symptoms
  • I have been in contact with someone with symptoms
  • I have been in contact with someone who has tested positive for COVID-19
  • For my job
  • For a hospital visit or treatment
  • I have been travelling abroad
  • For a research study
  • Paid for it privately
  • Other

Question 6: Did you test positive for COVID-19 infection in any of the antigen tests taken this month?​

Select one of the following

  • Yes
  • No
  • Waiting for results
  • Unclear result

Question 7: How were you treated for COVID-19?​

Select one of the following

  • I didn't experience symptoms
  • I self-treated at home
  • I required a hospital stay
  • Prefer not to say

Question 8: Did you have an antibody test for COVID-19 in the last month?​

Select one of the following

  • Yes
  • No
  • Don't know

Question 9: In the last month, what was the date of your first COVID-19 antibody test?​

Select a date

Question 10: Why did you have the COVID-19 antibody test?​

Choose multiple of the following

  • I previously had symptoms
  • I have been in contact previously with someone with symptoms
  • I have been in contact with someone who has tested positive for COVID-19
  • For my job
  • For a hospital visit or treatment
  • For a surveillance study
  • Paid for it privately
  • Other

Question 11: Did you test positive for COVID-19 antibodies in any of the antibody tests taken this month?​

Select one of the following

  • Yes
  • No
  • Waiting for results
  • Unclear results

Question 12: In the last month have you experienced or are you still experiencing any possible COVID-19 symptoms?​

Choose multiple of the following

  • Persistent cough
  • Fever
  • Hoarseness (changes to the sound of your voice, particularly becoming strained)
  • Non-persistent cough (not coughing continuously)
  • Discharge or congestion in the nose
  • Sneezing
  • Sore throat
  • Feeling breathless
  • Wheeze (a whistling sound when breathing)
  • Headache
  • Muscle aches
  • Joint pains or aches
  • Unexplained tiredness
  • Being sick or feeling sick
  • Diarrhoea
  • Loss of taste or smell
  • Loss of appetite
  • Other
  • No symptoms

Question 13: Please enter any other symptoms.​

Write a descriptive answer

Question 14: When did the first of these symptoms start?​

Select a date

Question 15: In the past month or since first onset of your possible COVID-19 symptoms have you had close contact with someone who may have or has COVID-19?​

Select one of the following

  • Yes
  • No
  • Don't know

Question 16: Has the person you have been in contact with received confirmation from a doctor or laboratory that they have COVID-19?​

Select one of the following

  • Yes
  • No
  • Don't know

Question 17: Have you received a vaccine (injection) against COVID-19?​

Answer yes or no

Question 18: Was the vaccine part of the government roll out or a clinical trial?​

Select one of the following

  • Government roll out
  • Clinical trial

Question 19: Which vaccine did you receive?​

Select one of the following

  • Pfizer/BioNTech
  • Oxford/AstraZeneca
  • Moderna
  • Other
  • Not sure

Question 20: When was your first injection?​

Select a date

Question 21: Have you received a second dose (injection) of the vaccine?​

Answer yes or no

Question 22: When was your second injection?​

Select a date

Question 23: How are you feeling physically right now?​

Select one of the following

  • I feel well enough to do all of my usual daily activities
  • I feel well enough to do most of my usual daily activities
  • I feel unwell but can still do some of my usual daily activities
  • I've stopped doing everything I usually do

Question 24: Has there been any change to your medication(s) or supplements you are taking?​

Answer yes or no