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COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Abstract:

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.

Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1007/s15010-021-01599-5

Authors

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Institution:
University of Oxford
Division:
MSD
Department:
NDM
Role:
Author
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
NDM
Role:
Author
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
NDM
Role:
Author
ORCID:
0000-0001-8463-1341
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
NDM
Role:
Author
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
NDM
Role:
Author

Contributors

Division:
MSD
Department:
NDM
Role:
Contributor


Publisher:
Springer Nature
Journal:
Infection More from this journal
Volume:
49
Issue:
2021
Pages:
889-905
Publication date:
2021-06-25
Acceptance date:
2021-02-26
DOI:
EISSN:
1439-0973
ISSN:
0300-8126


Language:
English
Keywords:
Pubs id:
1174556
Local pid:
pubs:1174556
Deposit date:
2021-05-07
ARK identifier:

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