TY - JOUR
T1 - COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study
AU - Abdukahil, Sheryl Ann
AU - Abe, Ryuzo
AU - Abel, Laurent
AU - Absil, Lara
AU - Acker, Andrew
AU - Adachi, Shingo
AU - Adam, Elisabeth
AU - Adrião, Diana
AU - Ainscough, Kate
AU - Hssain, Ali Ait
AU - Tamlihat, Younes Ait
AU - Akimoto, Takako
AU - Al-Dabbous, Tala
AU - Al-Fares, Abdulrahman
AU - Al Qasim, Eman
AU - Alalqam, Razi
AU - Alex, Beatrice
AU - Alexandre, Kévin
AU - Alfoudri, Huda
AU - Alidjnou, Kazali Enagnon
AU - Aliudin, Jeffrey
AU - Allavena, Clotilde
AU - Allou, Nathalie
AU - Alves, João
AU - Alves, Rita
AU - Amaral, Maria
AU - Ammerlaan, Heidi
AU - Ampaw, Phoebe
AU - Andini, Roberto
AU - Andrejak, Claire
AU - Angheben, Andrea
AU - Angoulvant, François
AU - Ansart, Séverine
AU - Antonelli, Massimo
AU - De Brito, Carlos Alexandre Antunes
AU - Arabi, Yaseen
AU - Aragao, Irene
AU - Arcadipane, Antonio
AU - Arenz, Lukas
AU - Arlet, Jean Benoît
AU - Arnold-Day, Christel
AU - Arora, Lovkesh
AU - Artaud-Macari, Elise
AU - Asensio, Angel
AU - Assie, Jean Baptiste
AU - Atique, Anika
AU - Auchabie, Johann
AU - Aumaitre, Hugues
AU - Fletcher, Tom
AU - Stienstra, Ymkje
PY - 2021/6/25
Y1 - 2021/6/25
N2 - BackgroundThe ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms.MethodsInternational, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms.Results‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P < 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country.InterpretationThis international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men.
AB - BackgroundThe ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms.MethodsInternational, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms.Results‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P < 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country.InterpretationThis international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men.
KW - Case definition
KW - COVID-19
KW - Diagnosis
KW - SARS-CoV-2
KW - Symptoms
U2 - 10.1007/s15010-021-01599-5
DO - 10.1007/s15010-021-01599-5
M3 - Article
SN - 0300-8126
VL - 49
SP - 889
EP - 905
JO - Infection
JF - Infection
IS - 5
ER -