The C19-YRS Assessment
The C19-YRS outcome measure is a clinically validated outcome measure recommended for use by NHS England to routinely capture the severity of symptoms that persist longer than 4 or more weeks after contracting COVID-19.
The original format was developed by clinical academics at The University of Leeds, Leeds Community Healthcare, and Leeds Teaching Hospitals NHS Trusts based on clinical research across the West Yorkshire region. It has now been adopted across the UK in the NHS and globally, with significant supporting evidence and references in the literature.
The digital platform has been developed by the digital health company, ELAROS, in a partnership with The University of Leeds, and both Leeds NHS Trusts. The digital system has been:
- Recommended by NHS England
- Funded by the National Institute for Health Research
- Recognised by NICE
- Developed with several NHS Trusts and is currently live across the UK
- Endorsed by the British Society for Rehabilitation Medicine
- Featured on BBC North West, ITV News, Daily Mail online and more, to demonstrate its success with patients and clinics

Photo credit: ITV News
‘Ground-breaking’ new app to help Long Covid patients first used in Salford
Long Covid: The Challenge
Long COVID is a term used to describe a new and emerging condition faced by patients presenting with symptoms that develop during or after contracting COVID-19 and persist for more than 4 weeks according to NICE.ย The complex condition affects people in different ways, with symptoms of breathlessness, cough,ย and severe fatigue being amongst the most prevalent symptoms. It is a new problem overwhelming clinics following the peak of the pandemic due to the lack of validated tools to effectively assess and manage the sheer numbers of patients seeking support.
The Office for National Statistics (ONS) estimates there to be 1.1 million people suffering from Long Covid, and as of January 24th 2021 the World Health Organisation estimates there have 97.4 million confirmed cases of (acute) COVID-19, with theย Office for National Statisticsย estimating that:
Around 20% of patients testing positive for COVID-19 exhibit symptoms for a period of 5 weeks or longer
Around 10% of patients testing positive for COVID-19 exhibit symptoms for a period of 12 weeks or longer
C19-YRS: The Solution
Elarosโ C19-YRS boasts a secure web portal for clinicians to set up and manage patients to assist with the initial triage, assessment and short-to-long-term monitoring process using graded scores for a spectrum of symptoms and grouped scores forย symptom severity, functional disability and overall health. Extensive reporting tools help support health organisations better deploy, evidence and account for the complex mix of resources used for long COVID patients.
Patients can access theย questionnaire following referral from their healthcare professional, available on iOS and Android or any internet webย browser,ย allowing them to track their condition with a quantitative assessment of improvement or deterioration. The platform seeks to improve patient outcomes, clinical intervention methods and help to understand long COVID as a condition by providing The University of Leedsโ research team with anonymised data to further validate the scale and develop a robust measure of the condition.
Scoring of symptom severity and functional disability performance
Easy to use, secure and scalable platform to oversee patients
User friendly with visual aids for patients to monitor recovery progress
A not-for-profit initiative for NHS organisations
Features
Features of the clinical web portal
- Report of symptoms severity score and functional disability score generated for clinical decision making
- Covers all components for the WHO International Classification of Functioning, Disability and Health (ICF) framework
- Online web portal to oversee patients for remote monitoring and rehabilitation
- Easy to use, secure and scalable platform
- Extension reporting tools to support health organisations better deploy, evidence and account for the complex mix of resources used for long COVID patients
Features of the patient app
- Clinically validated C19-YRS questionnaire recommended by NHS England and NICE
- Dedicated profile for patients
- Secure, discrete and automatic entries with encrypted data
- Easy to use and convenience for patients
- 15-item questionnaire to assess core problems relating to long COVID with opportunity to add more symptoms
- Compare multiple assessments to track recovery trajectory over time
- Accessible on smartphone, web-link or via telephone with a HCP
- 20 minutes to complete at home
Recommended by NHS England
NHS England has recommended routine use of C19-YRS at first assessment, 6 weeks and 6 months to monitor Long COVID in their National Guidance published in December 2020 and April 2021. The tool has also been recognised by NICE in their rapid guidelines for managing the long-term effects of COVID-19.


Created by clinical academics, supported by the NIHR
C19-YRS is a clinically validated outcome measure developed by clinical academics at The University of Leeds during the first wave of the pandemic. Its ongoing development and optimisation for delivery has been funded by the National Institute for Health Research.


Developed with NHS Trusts
Developed by clinicians across Leeds, Hull, and Airedale, with support from clinicians around the UK.
Supported by our first adopters in Salford Royal, Pennine Acute, and Liverpool University Hospitals NHS Trusts.


Enhanced by UK industry experts
Digitally enhanced by ELAROS 24/7 Ltd, building on their established CE-marked medical device, the Digital Bladder Diary platform. This project has been supported by Innovate UK.


Validation for clinical assurance
The digital C19-YRS has been independently validated by ORCHA as being compliant with national standards for usability, clinical safety, and information governance.
ELAROS has also met all standards for the NHS DSPT and obtained the CyberEssentials certification, demonstrating good practice in data security and protection.


Award winning system developed by an award-winning consortium
ELAROS and The University of Leeds won Medipex’s 2021 Innovation Awards in its ‘Management of Long Term Conditions’ category for the development of the digital C19-YRS, alongside Leeds Community Healthcare and Leeds Teaching Hospitals NHS Trust for their design and implementation of the first long covid rehabilitation service.
Separately, Leeds Community Healthcare and Leeds Teaching Hospitals won the 2021 BMJ Awards for the ‘Clinical Leadership Team of the Year’, for the development of the UK’s first long covid rehabilitation service, which is considered a benchmark for the country.
Our Supporters
The digital C19-YRS has been developed by UK-based digital health company, ELAROS 24/7 Ltd, working closely with clinical researchers at The University of Leeds who developed the original self-report and provided initial funding to initiate the digital development with ELAROS’ third-party strategic partner software development company, Pipe & Piper in order to rapidly develop the platform to an industrial, clinically safe and secure standard. The scale was developed by clinicians at Leeds Teaching Hospitals Trust, Leeds Community Healthcare NHS Trust, and Airedale and Hull NHS Trusts.
It has been recommended for routine use by NHS England, funded by the NIHR, recognised by NICE, published in the ACNR, and endorsed by the British Society for Rehabilitation Medicine.
















Benefits
For clinicians
- A suite of PROMs available to use
- Multiple patients managed in one place
- Helps capture symptoms and guide rehabilitation interventions for patients
- Digitally enhanced integrated care
- Clear clinical audit trail
- Supports reporting to NHS Improvement
- Powerful reporting and research tools
- Long term capture and analysis
- Access to updates from world-leading long COVID researchers
- Free lifetime updates to the app and portal
For patients
- Access to the only validated tool designed for long Covid
- More reliable than a paper diary
- Automated data capture and assessment
- Completed anywhere, any time
- Digitally enhanced personalised care
- Completed alone or together with a carer or a HCP via telephone
- More informed rehabilitation interventions, potentially leading to better patient outcomes
- Sustainable remote patient monitoring
For research
- A research version of the platform is available to support projects using various PROMs
- Large scale remote data collection to drive research
- Supports clinics to conduct internal service evaluation
- Advanced vital research on post-COVID syndrome
- Development of a robust psychometric assessment of long COVID