. 2021 May 28;153:104508. doi: 10.1016/j.ijmedinf.2021.104508

Table 3.

Survey questions of the three risk categories.

Risk category	Questions
Contact factors	1 During the last 14 days have you traveled, had close contact with people who have traveled outside the country or who have come from abroad?
	2 Have you had close contact with someone with signs of COVID-19 (cough, fever, shortness of breath), even though they have not had the confirmation test?
	3 Have you had close contact with someone who tested positive for COVID-19 or was with the disease by a doctor?
Signs and symptoms	4 During the last 7 days, have you had these two symptoms, cough and fever higher than 37.5 °C?
	5 During the last 7 days, have you had any of these symptoms: headache, muscle aches, extreme tiredness, sore throat, joint pain, diarrhea?
	6 During the last 7 days, have you had any other respiratory additional symptoms such as shortness of breath, and chest pain?
High risk and comorbidity factors	7 Do you have one or more of these conditions: pregnancy, 65 years or older, work in a place where you serve people (gas station, food store, banks, informal work)?
High risk and comorbidity factors	8 Do you have one or more of these diseases: diabetes, hypertension, heart problems, liver problems, asthma, COPD, HIV/AIDS, cancer, chronic kidney failure, obesity, smoking?