# Introduction
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IMPORTANT NOTE: This guide is no longer updated, and it is maintained only as a historical reference.
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## Background
On March 11, 2020, the World Health Organization formally characterized coronavirus, COVID-19, as a [global pandemic](https://www.who.int/emergencies/diseases/novel-coronavirus-2019/events-as-they-happen) and health systems globally are continuing their efforts to manage the outbreak. Coronavirus disease COVID-19 is an infectious disease caused by a newly discovered coronavirus.
As part of the global effort to manage and contain this global 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 the January 31st 2020 International Edition of SNOMED CT, with updated descriptions and SNOMED CT to ICD-10 maps in the interim [March 2020 International Edition release](https://mlds.ihtsdotools.org/#/viewReleases/viewRelease/167). Since then, SNOMED International has published additional COVID-19 related content requested by the international community. This SNOMED CT Coronavirus Content will be made available as part of the [Global Patient Set (GPS)](https://gps.snomed.org/) 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, the [Creative Commons Attribution 4.0 International License](https://creativecommons.org/licenses/by/4.0/).
## Purpose
As the global terminology for health, SNOMED CT can serve as a common language for recording, sharing, integrating and analyzing COVID-19 related data. 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, pandemic surveillance, international collaboration and retrospective data analysis. A set of computable [SNOMED CT subset artefacts](https://github.com/SNOMED-Documents/snomed-covid19-guide/blob/main/1%20introduction/Appendix-A---Example-Subsets_106705678.html) also accompanies this guide.
For more information on performing data analytics using SNOMED CT please refer to Data Analytics with SNOMED CT. Additional guidance can be found in the SNOMED CT Document Library.
## Scope
The scope of this document has been guided by the collective needs and experiences of our SNOMED International Members.
The primary focus of the guide is to provide example SNOMED CT subsets for data elements covering the following key areas:
* Provider and facility details - e.g. healthcare profession, site of care, personal protective equipment
* 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 national 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](https://www.theific.org/wp-content/uploads/2016/04/6-Audits_2016.pdf), IFIC Basic Concepts of Infection Control (Chapter 6), 3rd edition, 2016, International Federation of Infection Control
* [Caution on Kidney Dysfunctions of COVID-19 Patients](https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3559601)
* [*Coronavirus Disease 2019 (COVID-19)*](https://www.cdc.gov/coronavirus/2019-ncov/php/reporting-pui.html)*, Centers for Disease Control and Prevention, U.S.*
* [*Coronavirus Disease (COVID-19) Pandemic*](https://www.who.int/emergencies/diseases/novel-coronavirus-2019) *, World Health Organization*
* [*Coronavirus: what are asymptomatic and mild COVID-19?*](https://patient.info/news-and-features/coronavirus-what-are-asymptomatic-and-mild-covid-19)*, Patient.info*
* [Coronavirus: what are moderate, severe and critical COVID-19?](https://patient.info/news-and-features/coronavirus-what-are-moderate-severe-and-critical-covid-19), Patient.info
* [COVID-19 and the Cardiovascular System](https://www.nature.com/articles/s41569-020-0360-5?fbclid=IwAR3w4wcTno9A798v1fuYbALPLUHU5dNsVNVFKDc6GW-6yED2mXcyxrJY7dc)
* [COVID-19 Dataset Specification](https://www.hse.ie/eng/services/news/newsfeatures/covid19-updates/covid-19-dataset-specification-for-patient-assessment-and-tracking.pdf), Feidhmeannacht na Seirbhise Slainte, Health Service Executive, Ireland.
* [COVID-19: Gastrointestinal Manifestations and Potential Fecal-Oral Transmission](https://www.gastrojournal.org/article/S0016-5085\(20\)30281-X/fulltext)
* [COVID-19 Hospitalisation in England Surveillance System (CHESS) Daily Reporting](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), NHS, UK
* [COVID-19 Penomics](https://covid19-phenomics.org/), UCL, Health Data Research UK.
* [COVID-19 Response Home](https://confluence.hl7.org/display/CR/COVID-19+Response+Home), HL7 International
* [Dysregulation of Immune Response in Patients with COVID-19 in Wuhan, China](https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3541136)
* [*Emergency use ICD codes for COVID-19 disease outbreak*](https://www.who.int/classifications/icd/covid19/en/) , World Health Organization
* [Global Research on Coronavirus Disease (COVID-19)](https://www.who.int/emergencies/diseases/novel-coronavirus-2019/global-research-on-novel-coronavirus-2019-ncov), World Health Organization
* [Guidance document on appropriate management of suspect/confirmed cases of COVID-19 - Types of Covid-19 dedicated facilities](https://www.mohfw.gov.in/pdf/FinalGuidanceonMangaementofCovidcasesversion2.pdf), Ministry of Health and Family Welfare (MoHFW), Govt. of India
* [*HISO 10082:2020 Community Based Assessment Data Standard*](https://www.health.govt.nz/publication/hiso-100822020-covid-19-community-based-assessment-data-standard) , Wellington: Ministry of Health 2020, New Zealand
* [Holistic care for patients with severe coronavirus disease 2019: An expert consensus](https://www.sciencedirect.com/science/article/pii/S235201322030048X), International Journal of Nursing Sciences, Volume 7, Issue 2, 10 April 2020, Pages 128-134
* [*Interoperability for COVID-19 Novel Coronavirus Pandemic*](https://www.healthit.gov/isa/covid-19) , The Office of the National Coordinator for Health Information Technology, U.S.
* [Logica Implementation Guide: Covid-19 - Terminology Value Sets](https://covid-19-ig.logicahealth.org/artifacts.html#terminology-value-sets), U.S.
* [Neurological Manifestations of Hospitalized Patients with COVID-19 in Wuhan, China: A Retrospective Case Series Study](https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3544840)
* [Novel Coronavirus (COVID-19) Case Record Form](https://www.who.int/docs/default-source/coronaviruse/who-ncov-crf.pdf?sfvrsn=84766e69_2), Global COVID-19 Clinical Platform, World Health Organization
* [openEHR Clinical Knowledge Manager](https://openehr.org/ckm/archetypes) (COVID-19 incubator)
* [Revised National Clinical Management Guidelines for COVID-19](https://www.mohfw.gov.in/pdf/RevisedNationalClinicalManagementGuidelineforCOVID1931032020.pdf), Ministry of Health and Family Welfare (MoHFW), Govt. of India
* [Rhabdomyolysis as Potential Late Complication Associated with COVID-19](https://www.ncbi.nlm.nih.gov/pubmed/32197060)
* [SARS Coronavirus 2](https://loinc.org/sars-coronavirus-2/), Regenstrief Institute
* [SNOMED CT Coronavirus Content](http://snomed.org/covid-19), \_SNOMED International
* [Solidarity Clinical Trials for COVID-19 Treatment](https://www.who.int/emergencies/diseases/novel-coronavirus-2019/global-research-on-novel-coronavirus-2019-ncov/solidarity-clinical-trial-for-covid-19-treatments), World Health Organization
* [Standard Operating Procedure (SOP) for transporting a suspect/confirmed case of COVID-19](https://www.mohfw.gov.in/pdf/StandardOperatingProcedureSOPfortransportingasuspectorconfirmedcaseofCOVID19.pdf), Ministry of Health and Family Welfare (MoHFW), Govt of India.
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