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

An Alternative Measurement of Central Obesity: Abdominobesity Index (ABI)

Obesity has reached epidemic proportions in the developed world. Approximately 35.0% of men and 40.4% of women in the United States were considered obese in 2013-2014. Obesity, and more specifically central obesity, is associated with a myriad of health problems. Central obesity, also known as abdominal obesity, refers to an excess fat deposit around and within the abdominal cavity. Central obesity has been linked to hypercholesterolemia, high blood pressure, type 2 diabetes, coronary artery disease, and other health concerns. We have established the concept of Abdominobesity Index (ABI), a new measurement to be used in quantifying a person’s central obesity. We propose such a new measurement because obesity rates continue to rise in our country and various places around the world. To best solve a problem, one must understand it, in this case by measuring it as accurately as possible. Therefore, we propose this new measurement as a supplement to those that already exist for measuring obesity, such as Body Mass Index (BMI) and Waist to Hip Ratio (WHR). Our measurement is an important supplement because it specifically focuses on quantifying a person’s degree of central obesity. ABI departs from previous measurements in that it specifically targets the abdominal fat by comparing abdominal circumference with chest circumference. We set forth the formula for our new ABI measurement along with a discussion of the preliminary data analysis that demonstrates the utility of ABI as a measurement distinct from BMI. In the future, we hope to conduct further studies that also track patient outcomes. In conjunction with other obesity measurements, we believe ABI will help advance further obesity research and improve risk stratification in obese patients

The Multiple Lives of the General Relativity Community, 1955–1974

The history of general relativity presents intriguing challenges for historians and philosophers of science. Its origins and receptions have figured prominently in debates about conceptual transformations, the dynamics of theory change, relationships between theory and experiment and, of course, physical and philosophical notions of space and time