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

Autores da FMUP

• Ricardo Morais Pereira Neto

  Autor

• Ricardo Jorge Pimentel Soares Reis

  Autor

• Roberto Liberal Fernandes Roncon Albuquerque

  Autor

• Marta João Rodrigues Da Silva

  Autor

• João Paulo Fernandes Teixeira

  Autor

• Andreia Sofia Martins Pires Coelho

  Autor

• Susana Maria Gouveia Fernandes

  Autor

• Sérgio Mina Gaião

  Autor

Participantes de fora da FMUP

• Khan, C
• Khan, I
• Kho, ME
• Khoo, S
• Kida, Y
• Kiiza, P
• Kildal, AB
• Kimmoun, A
• Kindgen-Milles, D
• Kitamura, N
• Klenerman, P
• Bekken, GK
• Knight, S
• Kobbe, R
• Vasconcelos, MK
• Korten, V
• Kosgei, C
• Krawczyk, K
• Vecham, PK
• Kumar, D
• Kurtzman, E
• Kutsogiannis, D
• Kyriakoulis, K
• L?her, E
• Lachatre, M
• Lacoste, M
• Laffey, JG
• Lagrange, M
• Laine, F
• Lambert, M
• Lamontagne, F
• Langelot-Richard, M
• Lantang, EY
• Lanza, M
• Laou?nan, C
• Laribi, S
• Lariviere, D
• Launay, O
• Lavie-Badie, Y
• Law, A
• Le Bihan, C
• Le Bris, C
• Le Coustumier, E
• Le Falher, G
• Le Gac, S
• Le Hingrat, Q
• Le Mar?chal, M
• Le Mestre, S
• Le Moing, V
• Le Nagard, H
• Le Turnier, P
• Le?n, R
• Le, M
• Santos, ML
• Leal, E
• Lee, J
• Lee, SH
• Lee, T
• Leeming, G
• Lefebvre, B
• Lefebvre, L
• Lefevre, B
• Lellouche, F
• Lemaignen, A
• Lemee, V
• Lemmink, G
• Leone, M
• Lepiller, Q
• Lescure, F
• Lesens, O
• Lesouhaitier, M
• Levy-Marchal, C
• Levy, B
• Levy, Y
• Bassi, GL
• Liang, J
• Lim, WS
• Lina, B
• Lind, A
• Lingas, G
• Lion-Daolio, S
• Liu, K
• Loforte, A
• Lolong, N
• Lopes, D
• Lopez-Colon, D
• Loubet, P
• Lucet, JC
• Luna, CM
• Lungu, O
• Luong, L
• Luton, D
• Lyons, R
• M?ller, F
• M?ller, KE
• Maasikas, O
• Macdonald, S
• Machado, M
• Macheda, G
• Sanchez, JM
• Madhok, J
• Mahieu, R
• Mahy, S
• Maier, LS
• Maillet, M
• Maitre, T
• Malfertheiner, M
• Malik, N
• Maltez, F
• Malvy, D
• Mambert, M
• Manda, V
• Mandei, JM
• Manning, E
• Manuel, A
• Sant, CM
• Malaque, A
• Marino, F
• De Ara?jo Mariz, C
• Eid, CM
• Marques, A
• Marquis, C
• Marsh, B
• Marsh, L
• Marshall, J
• Martelli, CT
• Martin-Blondel, G
• Martin-Loeches, I
• Martin-Quiros, A
• Martin, D
• Martin, E
• Martinot, M
• Rego, CM
• Martins, A
• Martins, J
• Martucci, G
• Marwali, EM
• Jimenez, JFM
• Maslove, D
• Mason, S
• Matan, M
• Mathieu, D
• Mattei, M
• Matulevics, R
• Maulin, L
• Mc Evoy, N
• McCarthy, A
• McCloskey, C
• McConnochie, R
• McDermott, S
• McDonald, S
• McElwee, S
• McEvoy, N
• McGeer, A
• McGuinness, N
• McLean, KA
• McNicholas, B
• Meaney, E
• Mear-Passard, C
• Mechlin, M
• Mele, F
• Menon, K
• Mentr?, F
• Mentzer, AJ
• Mercier, N
• Merckx, A
• Mergler, B
• Merson, L
• Mesquita, A
• Meybeck, A
• Meynert, AM
• Meyssonnier, V
• Meziane, A
• Mezidi, M
• Michelanglei, C
• Mihnovit?, V
• Maldonado, HM
• Mone, M
• Moin, A
• Molina, D
• Molinos, E
• Monteiro, A
• Montes, C
• Montrucchio, G
• Moore, S
• Moore, SC
• Morales-Cely, L
• Moro, L
• Tutillo, DRM
• Motos, A
• Mouquet, H
• Perrot, CM
• Moyet, J
• Mullaert, J
• Munblit, D
• Murphy, D
• Murris, M
• Myrodia, DM
• N?guyen, Y
• Neant, N
• Neb, H
• Nekliudov, NA
• Neumann, E
• Neves, B
• Ng, PY
• Ng, WY
• Choileain, ON
• Nichol, A
• Nonas, S
• Noret, M
• Norman, L
• Notari, A
• Noursadeghi, M
• Nowicka, K
• Nseir, S
• Nunez, JI
• Nyamankolly, E
• O?Donnell, M
• O?Hearn, K
• O?Neil, C
• Occhipinti, G
• Ogston, T
• Ogura, T
• Oh, T
• Ohshimo, S
• Oinam, BCS
• Oliveira, AP
• Oliveira, J
• Olliaro, P
• Ong, DSY
• Oosthuyzen, W
• Openshaw, PJM
• Orozco-Chamorro, CM
• Orquera, A
• Osatnik, J
• Ouamara, N
• Ouissa, R
• Owyang, C
• Oziol, E
• P?voas, D
• Pagadoy, M
• Pages, J
• Palacios, M
• Palmarini, M
• Panarello, G
• Panda, PK
• Panigada, M
• Pansu, N
• Papadopoulos, A
• Parra, B
• Pasquier, J
• Patauner, F
• Patr?o, L
• Paul, C
• Paul, M
• Paulos, J
• Paxton, WA
• Payen, J
• Pearse, I
• Peek, GJ
• Peelman, F
• Peiffer-Smadja, N
• Peigne, V
• Pejkovska, M
• Peltan, ID
• Pereira, R
• Perez, D
• Perpoint, T
• Pesenti, A
• Petrou?ov?, L
• Petrov-Sanchez, V
• Peytavin, G
• Pharand, S
• Piagnerelli, M
• Picard, W
• Picone, O
• Piel-Julian, M
• Pierobon, C
• Pimentel, C
• Piroth, L
• Pius, R
• Piva, S
• Plantier, L
• Plotkin, D
• Poissy, J
• Pokorska-Spiewak, M
• Poli, S
• Pollakis, G
• Popielska, J
• Postma, DF
• Povoa, P
• Powis, J
• Prapa, S
• Prebensen, C
• Preiser, J
• Prestre, V
• Price, N
• Prinssen, A
• Pritchard, MG
• Proen?a, L
• Pu?chal, O
• Purcell, G
• Quesada, L
• Quist-Paulsen, E
• Quraishi, M
• R?tsep, I
• R?ssler, B
• Rabaud, C
• Rafiq, M
• Ragazzo, G
• Rainieri, F
• Ramakrishnan, N
• Ramanathan, K
• Rammaert, B
• Rapp, C
• Rasmin, M
• Rau, C
• Rebaudet, S
• Redl, S
• Reeve, B
• Reid, L
• Remppis, J
• Remy, M
• Renk, H
• Resende, L
• Resseguier, A
• Revest, M
• Rewa, O
• Reyes, LF
• Richardson, D
• Richier, L
• Riera, J
• Rios, AL
• Rishu, A
• Rispal, P
• Risso, K
• Nu?ez, MAR
• Rizer, N
• Roberto, A
• Roberts, S
• Robertson, DL
• Robineau, O
• Roche-Campo, F
• Rodari, P
• Rodeia, S
• Abreu, JR
• Roilides, E
• Rojek, A
• Romaru, J
• Roriz, M
• Rosa-Calatrava, M
• Rose, M
• Rosenberger, D
• Rossanese, A
• Rossignol, B
• Rossignol, P
• Roy, C
• Roze, B
• Russell, CD
• Ryckaert, S
• Holten, AR
• Choez, XS
• Saba, I
• Sadat, M
• Saidani, N
• Salazar, L
• Sales, G
• Sallaberry, S
• Salvator, H
• Sanchez-Miralles, A
• Sanchez, O
• Sancho-Shimizu, V
• Sandhu, G
• Sandulescu, O
• Santos, M
• Sarfo-Mensah, S
• Sarton, B
• Saviciute, E
• Savvidou, P
• Scarsbrook, J
• Schermer, T
• Scherpereel, A
• Schneider, M
• Schroll, S
• Schwameis, M
• Scott-Brown, J
• Scott, JT
• Sedillot, N
• Seitz, T
• Semaille, C
• Semple, MG
• Senneville, E
• Sequeira, F
• Sequeira, T
• Shadowitz, E
• Shamsah, M
• Sharma, P
• Shaw, CA
• Shaw, V
• Shiban, N
• Shime, N
• Shimizu, H
• Abdukahil, SA
• Abe, R
• Abel, L
• Absil, L
• Acker, A
• Adachi, S
• Adam, E
• Adri?o, D
• Ainscough, K
• Hssain, AA
• Tamlihat, YA
• Akimoto, T
• Al-Dabbous, T
• Al-Fares, A
• Al Qasim, E
• Alalqam, R
• Alex, B
• Alexandre, K
• Alfoudri, H
• Alidjnou, KE
• Aliudin, J
• Allavena, C
• Allou, N
• Alves, J
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• Amaral, M
• Ammerlaan, H
• Ampaw, P
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• Ansart, S
• Antonelli, M
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• Shrapnel, S
• Shum, HP
• Mohammed, NS
• Sigfrid, L
• Silva, C
• Sin, WC
• Skogen, V
• Smith, S
• Smood, B
• Smyth, M
• Snacken, M
• So, D
• Solis, M
• Solomon, J
• Solomon, T
• Somers, E
• Sommet, A
• Song, MJ
• Song, R
• Song, T
• Sonntagbauer, M
• Soum, E
• Uva, MS
• Sousa, M
• Souza-Dantas, V
• Sperry, A
• Sriskandan, S
• Staudinger, T
• Stecher, S
• Stienstra, Y
• Stiksrud, B
• Streinu-Cercel, A
• Strudwick, S
• Stuart, A
• Stuart, D
• Sultana, A
• Summers, C
• Svistunov, MSAA
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• Tabrizi, S
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• Talarek, E
• Taleb, S
• Talsma, J
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• Tanaka, T
• Taniguchi, H
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• Taufik, MA
• Tedder, RS
• Tellier, M
• Terpstra, P
• Terrier, O
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• Thibault, V
• Thiberville, S
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• Thompson, S
• Thomson, D
• Thomson, EC
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• Thwaites, RS
• Timashev, PS
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• Santos-Olmo, RMT
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• Tromeur, C
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• Kandamby, DH
• Kandel, C
• Kant, R
• Kartsonaki, C
• Kasugai, D
• Katz, K
• Johal, SK
• Keating, S
• Kelly, A
• Kelly, S
• Kennedy, L
• Kennon, K
• Kerroumi, Y
• Kestelyn, E
• Khalid, I
• Khalil, A

Unidades de investigação

• Ciências da Saúde Pública e Forenses, e Educação Médica

• Cirurgia e Fisiologia

• Ginecologia-Obstetrícia e Pediatria

• Laboratório Associado RISE- Rede de Investigação em Saúde

  

  Investigador

  Fernando Carlos De Landér Schmitt

• Medicina

• Neurociências Clínicas e Saúde Mental

• Patologia

• RISE-Health

  

  Investigador

  Fernando Carlos De Landér Schmitt

Abstract

<jats:title>Abstract</jats:title><jats:sec> <jats:title>Background</jats:title> <jats:p>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.</jats:p> </jats:sec><jats:sec> <jats:title>Methods</jats:title> <jats:p>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.</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>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 <jats:italic>P</jats:italic>?<?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.</jats:p> </jats:sec><jats:sec> <jats:title>Interpretation</jats:title> <jats:p>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.</jats:p> </jats:sec>

Keywords

• Aged; Child; COVID-19; Female; Hospitalization; Hospitals; Humans; Male; Middle Aged; Prospective Studies; SARS-CoV-2; abdominal pain; adolescent; adult; age; aged; anorexia; Article; bleeding; child; cohort analysis; confusion; conjunctivitis; controlled study; coronavirus disease 2019; coughing; dehydration; diarrhea; disease severity; dyspnea; fatigue; female; fever; headache; hospital admission; human; lymphadenopathy; major clinical study; male; multicenter study; myalgia; nausea and vomiting; observational study; otalgia; prevalence; prospective study; rash; rhinorrhea; seizure; Severe acute respiratory syndrome coronavirus 2; sex; smelling disorder; sore throat; thorax disease; thorax pain; walking difficulty; wheezing; case report; hospital; hospitalization; middle aged