23 research outputs found

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

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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

    Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

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    IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

    Maßtrise de la qualité biochimique de la graine pour deux légumineuses (soja, haricot)

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    La qualitĂ© des produits vĂ©gĂ©taux constitue une attente majeure de la sociĂ©tĂ©. Dans le cas des lĂ©gumineuses Ă©tudiĂ©es, soja et haricot, les producteurs et l'ensemble de la filiĂšre jusqu'Ă  la commercialisation portent un intĂ©rĂȘt marquĂ© Ă  l'amĂ©lioration de la composition des graines pour leur utilisation dans l'industrie alimentaire ou non alimentaire. Notre dĂ©marche s'inscrit dans ce contexte et vise Ă  caractĂ©riser les moyens d'Ă©laboration de la qualitĂ© recherchĂ©e et de production satisfaisante par le choix du gĂ©notype et de l'adaptation des conduites de culture. La premiĂšre partie de ce travail met en Ă©vidence les variations de composition de la graine sous l'effet des conditions agro-climatiques (date de semis, irrigation, choix gĂ©notypique et annĂ©e culturale). Pour les deux lĂ©gumineuses, la disponibilitĂ© hydrique pendant les phases de formation et de grossissement des graines joue un rĂŽle dĂ©terminant sur la concentration en protĂ©ines et en Oligosaccharide de la famille du Raffinose (RFO). L'effet de dĂ©calage de semis et l'effet de l'annĂ©e culturale sont significativement plus marquĂ©s pour le soja que pour le haricot. La seconde partie dĂ©crit l'Ă©volution des Ă©quilibres entre les constituants de la graine dans les diffĂ©rentes conditions. Elle met en Ă©vidence la compĂ©tition entre les accumulations de protĂ©ines et d'huile (soja) entre protĂ©ines et RFO (soja, haricot), entre les diffĂ©rents acides gras (soja). La troisiĂšme partie souligne les relations entre la composition et les indicateurs de la production (rendement / Poids Moyen d'une Graine ou PMG). Pour les gĂ©notypes amĂ©liorĂ©s Ă©tudiĂ©s, les relations rendement / teneur en protĂ©ines et rendement / teneur en RFO sont gĂ©nĂ©ralement peu significatives; ceci suggĂšre une relative indĂ©pendance entre les processus de formation des organes fructifĂšres et ceux des synthĂšses des composĂ©s. En conclusion, ce travail dĂ©gage des Ă©lĂ©ments de connaissance sur l'Ă©laboration de la composition des graines de soja et de haricot rĂ©coltĂ©es dans des conditions de culture diversifiĂ©es. Il propose quelques voies pour maĂźtriser l'orientation des synthĂšses des constituants recherchĂ©s par les utilisateurs et les consommateurs sans prĂ©judice apprĂ©ciable pour la production.TOULOUSE-ENSAT-Documentation (315552324) / SudocSudocFranceF

    Differences for traits associated with early N acquisition in a grain legume and early complementarity in grain legume-triticale mixtures

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    Early strategies of crop growth and N acquisition can be critical for determining competitive interactions between weeds and crops. Grain legumes and especially lupins are known to be poor competitors against weeds. Grain legumes are known to have low mineral soil N uptake abilities. However, inter-and intraspecific differences in N uptake ability in relation to below-ground traits have received little attention. Our objectives were (i) to measure differences among lupins for a set of traits associated with early growth and N acquisition; (ii) to examine how this variation compares to differences between lupin and a cereal, triticale, and (iii) to assess if mixing lupin with triticale provides a higher potential than does pure lupin regarding plant biomass and mineral soil N acquisition early in the crop cycle. Lupin (12 genotypes) and triticale plants were grown separately and in mixed species pairs in a replacement design for 1 and 2 months in three rhizotron experiments. Shoot and root biomass, root length, root expansion dynamics, N(2) fixation and mineral soil N uptake were measured. Differences among lupin species and genotypes regarding traits related to early growth and to mineral soil N uptake were observed, but all lupins demonstrated slow early growth and low ability to absorb mineral soil N compared to triticale. In lupin-triticale mixture, a contrast in early growth strategies between species induced a higher total soil mineral N uptake compared with pure lupin. Complementarity between lupin and triticale persisted during the second month, when interactions began. This complementarity may allow for reduced competition between species, favouring higher triticale biomass production than in pure triticale, without compromising lupin growth

    Calibration of rapid test and sampling for measurement of phosphorus nutrition status in maize

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    Fertilization management of intensive crops requires control methods to adjust the mineral fertilizer input to the actual needs of the crop. This paper outlines a method to estimate phosphorus (P) nutrient status of maize (Zea mays hybrid c.v. Volga) by analyzing the plant sap extracted from vascular tissue of the stem base. Phosphate concentration is analyzed with phosphomolybdic complex reaction, using test strip with a small autonomous pocket reflectometer. The experimental conditions for maize diagnosis P nutrition are: stem base harvested between 10 and 12 a.m., phosphate concentration measured in sap squeezed by a hand hydraulic press. The critical level of P nutrition should be between 20 and 25 ppm. The validation of this method by comparison of colorimetry and chromatography measurement on different plant P status indicates a reverse correlation between weight production and P lower stem sap concentration

    Species Choice Influences Weed Suppression, N Sharing and Crop Productivity in Oilseed Rape–Legume Intercrops

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    Increasing crop trait diversity in oilseed rape (OR, Brassica napus L.) cropping systems by introducing frost-sensitive legume species could improve weed suppression and crop productivity. Intercrops and sole crops were compared over two years in the field in Western France. Winter OR was intercropped simultaneously with either spring faba bean (Vicia faba L.) or common vetch (Vicia sativa L.) in a row replacement design without herbicides. Each species was sown at 50% of the recommended sole crop density in alternate rows. Due to the high values of faba bean aboveground traits (height, leaf area, and biomass) and the strong competitive ability for soil N of OR, both species appeared complementary in resource utilization, and thus less soil N and light were available for weeds. The OR–faba bean intercrop was able to reduce weed biomass by 41% compared to the OR–common vetch intercrop. Furthermore, growth and competitive ability of OR for soil N were increased when intercropped with faba bean. Both grain yield and number per plant were three times higher in OR–faba bean intercrops compared to OR sole crops. Under high weed infestation, the presence of faba bean with OR reduced weed aboveground biomass by 35% and weed N accumulation by 11% compared to the OR sole crop. No change was observed in the weed community composition. We observed that a level of aboveground biomass greater than 2 t ha−1 and a soil N uptake at approximately 80 kg ha−1 was needed to reduce biomass and N content of weeds

    Traits affecting early season nitrogen uptake in nine legume species

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    Legume crops are known to have low soil N uptake early in their life cycle, which can weaken their ability to compete with other species, such as weeds or other crops in intercropping systems. However, there is limited knowledge on the main traits involved in soil N uptake during early growth and for a range of species. The objective of this research was to identify the main traits explaining the variability among legume species in soil N uptake and to study the effect of the soil mineral N supply on the legume strategy for the use of available N sources during early growth. Nine legume species were grown in rhizotrons with or without N supply. Root expansion, shoot and root biomass, nodule establishment, N2 fixation and mineral soil N uptake were measured. A large interspecific variability was observed for all traits affecting soil N uptake. Root lateral expansion and early biomass in relation to seed mass were the major traits influencing soil N uptake regardless of the level of soil N availability. Fenugreek, lentil, alfalfa, and common vetch could be considered weak competitors for soil N due to their low plant biomass and low lateral root expansion. Conversely, peanut, pea, chickpea and soybean had a greater soil N uptake. Faba bean was separated from other species having a higher nodule biomass, a higher N2 fixation and a lower seed reserve depletion. Faba bean was able to simultaneously fix N2 and take up soil N. This work has identified traits of seed mass, shoot and root biomass, root lateral expansion, N2 fixation and seed reserve depletion that allowing classification of legume species regarding their soil N uptake ability during early growt

    Species Choice Influences Weed Suppression, N Sharing and Crop Productivity in Oilseed Rape–Legume Intercrops

    No full text
    Increasing crop trait diversity in oilseed rape (OR, Brassica napus L.) cropping systems by introducing frost-sensitive legume species could improve weed suppression and crop productivity. Intercrops and sole crops were compared over two years in the field in Western France. Winter OR was intercropped simultaneously with either spring faba bean (Vicia faba L.) or common vetch (Vicia sativa L.) in a row replacement design without herbicides. Each species was sown at 50% of the recommended sole crop density in alternate rows. Due to the high values of faba bean aboveground traits (height, leaf area, and biomass) and the strong competitive ability for soil N of OR, both species appeared complementary in resource utilization, and thus less soil N and light were available for weeds. The OR–faba bean intercrop was able to reduce weed biomass by 41% compared to the OR–common vetch intercrop. Furthermore, growth and competitive ability of OR for soil N were increased when intercropped with faba bean. Both grain yield and number per plant were three times higher in OR–faba bean intercrops compared to OR sole crops. Under high weed infestation, the presence of faba bean with OR reduced weed aboveground biomass by 35% and weed N accumulation by 11% compared to the OR sole crop. No change was observed in the weed community composition. We observed that a level of aboveground biomass greater than 2 t ha−1 and a soil N uptake at approximately 80 kg ha−1 was needed to reduce biomass and N content of weeds

    Interactions entre facteurs biotiques et fonctionnement des associations végétales

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    article prĂ©sentĂ© lors du colloque "Associations VĂ©gĂ©tales" Angers 20 novembre 2014International audienceLes associations vĂ©gĂ©tales, par la complexitĂ© du couvert vĂ©gĂ©tal qu’elles crĂ©ent, sont le siĂšge d’interactions biotiques particuliĂšres avec les ravageurs, les prĂ©dateurs, les champignons pathogĂšnes, les adventices ou encore les organismes non pathogĂšnes du sol. Cet article traite de la diversitĂ© des mĂ©canismes en jeu (modification de paramĂštres tels que la disponibilitĂ©, la compĂ©tition et la complĂ©mentaritĂ© temporelle et spatiale pour les ressources, le microclimat, les stimuli variĂ©s, l’allĂ©lopathie) permettant de mieux comprendre leurs effets potentiels sur ces interactions pour diverses combinaisons d’espĂšces. De nombreux exemples mettent en avant l’intĂ©rĂȘt des associations vĂ©gĂ©tales pour lutter contre les bioagresseurs. Par ailleurs de nouveaux mĂ©canismes sont aujourd’hui explorĂ©s notamment au niveau de la biologie des sols, qui semblent avoir un effet important sur le fonctionnement des associations vĂ©gĂ©tales. Cependant, mĂȘme si les travaux de recherche se dĂ©veloppent sur l’analyse des facteurs biotiques pour une diversitĂ© de combinaisons d’espĂšces, ils restent encore rares en France et doivent se poursuivre tout en s’appuyant sur les observations (rĂ©ussites et Ă©checs) des agriculteurs et sur plusieurs essais en conditions agricoles avant leur dĂ©ploiement pour un objectif donnĂ© bien identifiĂ©
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