Coronerve surveillance survey

Please complete The Surveillance Study of COVID19-associated Neurological and Psychiatric Conditions.  

Dear Colleagues

Please support The Surveillance Study of COVID19-associated Neurological and Psychiatric Conditions. The RCPsych is one of several organisations supporting a programme run by Benedict Michael (NIHR Health Protection Research Unit for Emerging and Zoonotic Infection, University of Liverpool). The programme seeks cases of neurological and psychiatric syndromes associated with suspected or confirmed COVID-19 infection.

Please report cases via this RCPsych web portal – it is very brief and will take < 5 minutes.

No patient identifiable details will be needed. The Health Research Authority have reviewed and approved the collection of these data for health surveillance.

The data being collected is a very brief survey with four questions: the patient's SARS-CoV2 status (COVID 19 virus), their psychiatric status and their neurological status if known to you.

Please keep your own record. Before you click 'Submit', please print the completed page and keep it alongside a note of the patient’s medical record number, so that you can provide more details when Dr Michael’s team contacts you, as we will seek more details on these cases in the fullness of time. We will remind members about this form via our weekly COVID-19 email, until there’s no need for continued surveillance.

Thank you for your support.

Best wishes,

  • Dr Adrian James (President)
  • Dr Mike Dilley (Neuropsychiatry Faculty Chair).
  • Benedict Michael (NIHR Health Protection Research Unit for Emerging and Zoonotic Infection

On behalf of:

  • NIHR Health Protection Research Unit for Emerging and Zoonotic Infection Programme Study Management Group: Rhys Thomas, Rachael Kneen, Ian Galea, and Sarah Pett.
  • RCPsych Group: Alan Carson, Tony David, Mike Dilley, Tim Nicholson, Tom Pollak, Valerie Voon.
Ethical approval: The Health Research Authority have reviewed this study and confirmed that clinicians sending anonymised patient data for this study is permitted and falls within the remit of routine health surveillance. 

Your details 

I consent to my personal data being shared with the institutions involved in the National Disease Surveillance Project, which will process this data solely in relation to the COVID 19 project.

Patient's information

Has this patient already been recruited to the ISARIC CCP study?

Sex at birth

Testing and diagnosis 

Please indicate the patient's SARS-CoV2 test status:

Please indicate how the SARS-CoV2 infection was diagnosed:

Neurological and psychiatric status

Please indicate the patient's psychiatric status. Tick all that apply.

In the following list, you will find descriptions of eight neurological conditions. Please categorise the patient’s neurological status by ticking the appropriate box below the list. You can also select 'none', or 'unknown' if you are uncertain.

  • Encephalopathy: Altered consciousness, including altered behaviour.
  • Encephalitis: Encephalopathy with evidence of inflammation in the CNS [cerebrospinal fluid (CSF) white cell count >4/ml, protein >0.45g/dL, or MRI consistent with inflammation].
  • Myelitis: Sensory and/or motor symptoms and signs attributable to a spinal cord lesion, with evidence of inflammation in the CNS (as above).
  • Radiculitis: Sensory and/or motor symptoms and signs attributable to inflammation of the spinal nerve roots.
  • Guillain-Barre/Fisher syndrome: Ascending sensory-motor flaccid, areflexic paralysis or the triad of ophthalmoplegia, ataxia and areflexia.
  • Peripheral neuropathy: Sensory and/or motor symptoms and signs attributable to peripheral nerve pathology.
  • Myositis: Symptoms and signs attributable to muscle inflammation including elevation of peripheral muscle enzymes.
  • Cerebrovascular Event: Symptoms, signs, and neuroimaging consistent with an ischaemic or haemorrhagic cerebrovascular accident, cerebral haemorrhage.
Select the patient's neurological status.

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