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* 1. Name of Clinician

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* 2. E-Mail address of Clinician

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* 3. Center 

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* 4. Country

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* 5. How firm is the diagnosis of the COVID-19 infection in this patient?

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* 6. Gender 

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* 7. Age (years)

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* 8. Body weight (kg)

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* 9. Height (cm)

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* 10. Number of days since onset of illness (days)

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* 11. Symptoms at presentation

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* 12. Pre-existing pulmonary disease

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* 13. Pre-existing cardiac disease

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* 14. Current main renal diagnosis requiring immunosuppressant treatment

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* 15. On chronic dialysis 

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* 16. Immunosuppressant medication prior to COVID-19 illness (please specify the dose where applicable)

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* 17. Duration of (any) immunosuppressive therapy prior to the onset of infection (months)

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* 18. Was immunosuppressant therapy modified during the COVID-19 disease episode?

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* 19. White blood cell count (cells/ul)

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* 20. C-reactive protein level (mg/L)

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* 21. Serum creatinine (in umol/l or mg/dl)

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* 22. Did the patient receive renal replacement therapy (including CRRT in intensive care) as part of the COVID-19 disease episode?

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* 23. Level of respiratory support needed at peak of COVID-19 illness

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* 24. Specific therapies directed to COVID-19

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* 25. If known at this stage, what´s the patient`s outcome of the COVID-19 disease episode?

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