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

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

Las Asociaciones Público - Privadas en Colombia: una reflexión sobre el mecanismo en el país entre 2018 y 2019

Fiscal deficit in developing countries implies a deterioration in public investment in aspects such as infrastructure, considerably affecting economic growth and social development of a country as a result. This scenario has entailed the implementation of mechanisms that permit solving this problem, among which boosting private investment has been preferred. Thus, Public-Private Partnerships —known as PPP— have been established as a model for the improvement of the country, by consolidating both a relationship and joint work between the public and private sectors to provide Colombians with goods and services. This article firstly contextualizes about the current PPP regulatory framework; secondly, a number of papers addressing this mechanism are briefly reviewed; thirdly, a description of PPP projects according to RUAPP as of February 2019 and 2018 is presented; and finally, the observed results from the Departmental Competitiveness Index are related as a means to analyze and identify the aspects enabling the development of such mechanism in all the departments —Colombian states—.El déficit fiscal en los países en desarrollo supone un deterioro en la inversión estatal en aspectos como infraestructura, repercutiendo considerablemente en el crecimiento económico y desarrollo social de un país. Este panorama ha hecho necesario acoger mecanismos que permitan responder a dicha problemática, entre los cuales se ha optado por impulsar la inversión privada. Es así como las Asociaciones Público-Privadas —conocidas como APP— se han establecido como modelo para la mejora del país, al consolidarse una relación y trabajo conjunto entre el sector público y privado para proveer bienes y servicios a los colombianos. En este artículo, se contextualiza en primer lugar acerca del marco regulatorio de APP vigente, se expone en segundo lugar una breve revisión de trabajos donde se aborda el mecanismo, luego se presenta una descripción de los proyectos APP a febrero de 2019 y 2018 según el RUAPP, y por último se relacionan los resultados observados con el Índice Departamental de Competitividad con el fin de analizar e identificar qué aspectos posibilitan el desarrollo de este mecanismo en los departamentos

ISARIC-COVID-19 dataset: A Prospective, Standardized, Global Dataset of Patients Hospitalized with COVID-19

The International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC) COVID-19 dataset is one of the largest international databases of prospectively collected clinical data on people hospitalized with COVID-19. This dataset was compiled during the COVID-19 pandemic by a network of hospitals that collect data using the ISARIC-World Health Organization Clinical Characterization Protocol and data tools. The database includes data from more than 705,000 patients, collected in more than 60 countries and 1,500 centres worldwide. Patient data are available from acute hospital admissions with COVID-19 and outpatient follow-ups. The data include signs and symptoms, pre-existing comorbidities, vital signs, chronic and acute treatments, complications, dates of hospitalization and discharge, mortality, viral strains, vaccination status, and other data. Here, we present the dataset characteristics, explain its architecture and how to gain access, and provide tools to facilitate its use