Journal article
COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study
- Abstract:
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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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(Preview, Version of record, pdf, 1.8MB, Terms of use)
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- Publisher copy:
- 10.1007/s15010-021-01599-5
Authors
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:
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1439-0973
- ISSN:
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0300-8126
- Language:
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English
- Keywords:
- Pubs id:
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1174556
- Local pid:
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pubs:1174556
- Deposit date:
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2021-05-07
- ARK identifier:
Terms of use
- Copyright holder:
- Horby et al.
- Copyright date:
- 2021
- Rights statement:
- © The Author(s) 2021. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
- Licence:
- CC Attribution (CC BY)
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