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

Bioimpedance Vector Patterns Changes in Response to Swimming Training: An Ecological Approach

Background and aim: Monitoring bioelectric phase angle (PhA) provides important information on the health and the condition of the athlete. Together with the vector length, PhA constitutes the bioimpedance vector analysis (BIVA) patterns, and their joint interpretation exceeds the limits of the evaluation of the PhA alone. The present investigation aimed to monitor changes in the BIVA patterns during a training macrocycle in swimmers, trying to ascertain if these parameters are sensitive to training load changes across a 13-week training period. Methods: Twelve national and international level swimmers (four females; eight males; 20.9 +/- 1.9 years; with a competitive swimming background of 11.3 +/- 1.8 years; undertaking 16-20 h of pool training and 4-5 h of dry-land training per week and 822.0 +/- 59.0 International Swimming Federation (FINA) points) were evaluated for resistance (R) and reactance (Xc) using a single frequency phase sensitive bioimpedance device at the beginning of the macrocycle (M1), just before the beginning of the taper period (M2), and just before the main competition of the macrocycle (M3). At the three-time assessment points, swimmers also performed a 50 m all-out first stroke sprint with track start (T50 m) while time was recorded. Results: The results of the Hotelling T(2)test showed a significant vector displacement due to simultaneous R and Xc changes (p< 0.001), where shifting from top to bottom along the major axis of the R-Xc graph from M1 to M2 was observed. From M2 to M3, a vector displacement up and left along the minor axis of the tolerance ellipses resulted in an increase in PhA (p< 0.01). The results suggest a gain in fluid with a decrease in cellular density from M1 to M2 due to decrements in R and Xc. Nevertheless, the reduced training load characterizing taper seemed to allow for an increase in PhA and, most importantly, an increase of Xc, thus demonstrating improved cellular health and physical condition, which was concomitant with a significant increase in the T50 m performance (p< 0.01). Conclusions: PhA, obtained by bioelectrical R and Xc, can be useful in monitoring the condition of swimmers preparing for competition. Monitoring BIVA patterns allows for an ecological approach to the swimmers' health and condition assessment without resorting to equations to predict the related body composition variables

The value of open-source clinical science in pandemic response: lessons from ISARIC

International audienc

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