TY - JOUR
T1 - COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study
AU - ISARIC clinical characterisation group
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 - Azemar, Laurène
AU - Azoulay, Cécile
AU - Bach, Benjamin
AU - Bachelet, Delphine
AU - Baillie, J. Kenneth
AU - Bak, Erica
AU - Bakakos, Agamemnon
AU - Banisadr, Firouzé
AU - Barbalho, Renata
AU - Barclay, Wendy S.
AU - Barnikel, Michaela
AU - Barrelet, Audrey
AU - Barrigoto, Cleide
AU - Basmaci, Romain
AU - Rincon, Diego Fernando Bautista
AU - Bedossa, Alexandra
AU - Behilill, Sylvie
AU - Beljantsev, Aleksandr
AU - Bellemare, David
AU - Beltrame, Anna
AU - Beluze, Marine
AU - Benech, Nicolas
AU - Benkerrou, Dehbia
AU - Bennett, Suzanne
AU - Bento, LuÍs
AU - Berdal, Jan-Erik
AU - Bergeaud, Delphine
AU - Bertolino, Lorenzo
AU - Bessis, Simon
AU - Bevilcaqua, Sybille
AU - Bhavsar, Krishna
AU - Humaid, Felwa Bin
AU - Bissuel, François
AU - Biston, Patrick
AU - Bitker, Laurent
AU - Blanco-Schweizer, Pablo
AU - Blot, Mathieu
AU - Boccia, Filomena
AU - Bogaert, Debby
AU - Bompart, François
AU - Booth, Gareth
AU - Borges, Diogo
AU - Borie, Raphaël
AU - Bos, Jeannet
AU - Bosse, Hans Martin
AU - Botelho-Nevers, Elisabeth
AU - Bouadma, Lila
AU - Bouchaud, Olivier
AU - Bouchez, Sabelline
AU - Bouhmani, Dounia
AU - Bouhour, Damien
AU - Bouiller, Kévin
AU - Bouillet, Laurence
AU - Bouisse, Camille
AU - Boureau, Anne-Sophie
AU - Bouscambert, Maude
AU - Bouziotis, Jason
AU - Boxma, Bianca
AU - Boyer-Besseyre, Marielle
AU - Boylan, Maria
AU - Braga, Cynthia
AU - Brandenburger, Timo
AU - Brazzi, Luca
AU - Breen, Dorothy
AU - Breen, Patrick
AU - Brickell, Kathy
AU - Brozzi, Nicolas
AU - Buchtele, Nina
AU - Buesaquillo, Christian
AU - Bugaeva, Polina
AU - Buisson, Marielle
AU - Burhan, Erlina
AU - Bustos, Ingrid G.
AU - Butnaru, Denis
AU - Cárcel, Sheila
AU - Cabie, André
AU - Cabral, Susana
AU - Caceres, Eder
AU - Callahan, Mia
AU - Calligy, Kate
AU - Calvache, Jose Andres
AU - Camões, João
AU - Campana, Valentine
AU - Campbell, Paul
AU - Canepa, Cecilia
AU - Cantero, Mireia
AU - Caraux-Paz, Pauline
AU - Cardoso, Filipa
AU - Cardoso, Filipe
AU - Cardoso, Sofia
AU - Carelli, Simone
AU - Carlier, Nicolas
AU - Carney, Gayle
AU - Carpenter, Chloe
AU - Carret, Marie-Christine
AU - Carrier, François Martin
AU - Carson, Gail
AU - Casanova, Maire-Laure
AU - Cascão, Mariana
AU - Casimiro, José
AU - Cassandra, Bailey
AU - Castañeda, Silvia
AU - Castanheira, Nidyanara
AU - Castor-Alexandre, Guylaine
AU - Castrillón, Henry
AU - Castro, Ivo
AU - Catarino, Ana
AU - Catherine, François-Xavier
AU - Cavalin, Roberta
AU - Cavalli, Giulio Giovanni
AU - Cavayas, Alexandros
AU - Ceccato, Adrian
AU - Cervantes-Gonzalez, Minerva
AU - Chair, Anissa
AU - Chakveatze, Catherine
AU - Chan, Adrienne
AU - Chand, Meera
AU - Chas, Julie
AU - Chassin, Camille
AU - Chen, Anjellica
AU - Chen, Yih-Sharng
AU - Cheng, Matthew Pellan
AU - Cheret, Antoine
AU - Chiarabini, Thibault
AU - Chica, Julian
AU - Chirouze, Catherine
AU - Chiumello, Davide
AU - Cho, Hwa Jin
AU - Cho, Sung Min
AU - Cholley, Bernard
AU - Cidade, Jose Pedro
AU - Herreros, Jose Miguel Cisneros
AU - Citarella, Barbara Wanjiru
AU - Ciullo, Anna
AU - Clarke, Jennifer
AU - Clohisey, Sara
AU - Codan, Cassidy
AU - Cody, Caitriona
AU - Coelho, Alexandra
AU - Colin, Gwenhaël
AU - Collins, Michael
AU - Colombo, Sebastiano Maria
AU - Combs, Pamela
AU - Connelly, J. P.
AU - Connor, Marie
AU - Conrad, Anne
AU - Contreras, Sofía
AU - Cooke, Graham S.
AU - Copland, Mary
AU - Cordel, Hugues
AU - Corley, Amanda
AU - Cormican, Sarah
AU - Cornelis, Sabine
AU - Corpuz, Arianne Joy
AU - Corvaisier, Grégory
AU - Couffignal, Camille
AU - Couffin-Cadiergues, Sandrine
AU - Courtois, Roxane
AU - D’Orleans, Charles Crepy
AU - Croonen, Sabine
AU - Crowl, Gloria
AU - Crump, Jonathan
AU - Cruz, Claudina
AU - Csete, Marc
AU - Cucino, Alberto
AU - Cullen, Caroline
AU - Cummings, Matthew
AU - Curley, Gerard
AU - Curlier, Elodie
AU - Custodio, Paula
AU - D’Aragon, Frédérick
AU - Da Silva Filipe, Ana
AU - Da Silveira, Charlene
AU - D’Ortenzio, Eric
AU - Dabaliz, Al-Awwab
AU - Dagens, Andrew B.
AU - Dalton, Heidi
AU - Dalton, Jo
AU - Daneman, Nick
AU - Dankwa, Emmanuelle A.
AU - Dantas, Jorge
AU - De Castro, Nathalie
AU - De Mendoza, Diego
AU - De Oliveira França, Rafael Freitas
AU - De Rosa, Rosanna
AU - De Silva, Thushan
AU - De Vries, Peter
AU - Dean, David
AU - Debray, Marie-Pierre
AU - Dechert, William
AU - Deconninck, Lauren
AU - Decours, Romain
AU - Delacroix, Isabelle
AU - Delavigne, Karen
AU - Deligiannis, Ionna
AU - Dell’amore, Andrea
AU - Delobel, Pierre
AU - Demonchy, Elisa
AU - Denis, Emmanuelle
AU - Deplanque, Dominique
AU - Depuydt, Pieter
AU - Desai, Mehul
AU - Descamps, Diane
AU - Desvallée, Mathilde
AU - Dewayanti, Santi Rahayu
AU - Diallo, Alpha
AU - Diamantis, Sylvain
AU - Dias, André
AU - Diaz, Juan Jose Diaz
AU - Diaz, Rodrigo
AU - Didier, Kévin
AU - Diehl, Jean-Luc
AU - Dieperink, Wim
AU - Dimet, Jérôme
AU - Dinot, Vincent
AU - Diouf, Alphonsine
AU - Dishon, Yael
AU - Djossou, Félix
AU - Docherty, Annemarie B.
AU - Dong, Andy
AU - Donnelly, Christl A.
AU - Donnelly, Maria
AU - Donohue, Chloe
AU - Dorival, Céline
AU - Douglas, James Joshua
AU - Douma, Renee
AU - Dournon, Nathalie
AU - Downer, Triona
AU - Downing, Mark
AU - Drake, Tom
AU - Dubee, Vincent
AU - Dubos, François
AU - Ducancelle, Alexandra
AU - Dudman, Susanne
AU - Dunning, Jake
AU - Mangoni, Emanuele Durante
AU - Duranti, Silvia
AU - Durham, Lucian
AU - Dussol, Bertrand
AU - Duval, Xavier
AU - Dyrhol-Riise, Anne Margarita
AU - Eira, Carla
AU - Vidal, José Ernesto
AU - Sanharawi, Mohammed El
AU - Elapavaluru, Subbarao
AU - Elharrar, Brigitte
AU - Elkheir, Natalie
AU - Ellerbroek, Jacobien
AU - Ellis, Rachael
AU - Eloy, Philippine
AU - Elshazly, Tarek
AU - Group, ISARIC Clinical Characterisation
PY - 2021/10/1
Y1 - 2021/10/1
N2 - Background
The 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.
Methods
International, 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.
Interpretation
This 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 - Background
The 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.
Methods
International, 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.
Interpretation
This 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 - COVID-19
KW - SARS-CoV-2
KW - Symptoms
KW - Diagnosis
KW - Case definition
U2 - 10.1007/s15010-021-01599-5
DO - 10.1007/s15010-021-01599-5
M3 - Article
VL - 49
SP - 889
EP - 905
JO - Infection
JF - Infection
SN - 0300-8126
ER -