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

Utilisation de l'oxygène en salle de naissance (enquête dans les maternités françaises)

TOURS-BU Médecine (372612103) / SudocSudocFranceF

Macroinvertebrate identity mediates the effects of litter quality and microbial conditioning on leaf litter recycling in temperate streams

International audienc

Effets de la qualité de la litière et de son conditionnement sur les traits d’alimentation de 11 macroinvertébrés aquatiques

International audienc

Functional importance of freshwater amphipods in the leaf litter recycling process: the role of leaf litter characteristics

International audienceImpact of leaf characteristics on the keystone amphipod species for litter decomposition process

Functional importance of freshwater amphipods in the leaf litter recycling process : the role of leaf litter characteristics

International audienc

Studying One and Two-Finger Perception of Tactile Directional Cues

ISBN: 978-3-319-42324-1 ; 978-3-319-42323-4International audienceIn this paper, we study the perception of tactile directional cues by one or two fingers, using either the index, middle, or ring finger, or any of their combination. Therefore, we use tactile devices able to stretch the skin of the fingertips in 2 DOF along four directions: horizontal, vertical, and the two diagonals. We measure the recognition rate in each direction, as well as the subjective preference, depending on the (couple of) finger(s) stimulated. Our results show first that using the index and/or middle finger performs significantly better than using the ring finger on both qualitative and quantitative measures. The results when comparing one versus two-finger configurations are more contrasted. The recognition rate of the diagonals is higher when using one finger than two, whereas two fingers enable a better perception of the horizontal direction. These results pave the way to other studies on one versus two-finger perception, and raise methodological considerations for the design of multi-finger tactile devices

COBRAPed cohort: Do sensitization patterns differentiate children with severe asthma from those with a milder disease?

International audienceAbstract Background It is unclear whether sensitization patterns differentiate children with severe recurrent wheeze (SRW)/severe asthma (SA) from those with non‐severe recurrent wheeze (NSRW)/non‐severe asthma (NSA). Our objective was to determine whether sensitization patterns can discriminate between children from the French COBRAPed cohort with NSRW/NSA and those with SRW/SA. Methods IgE to 112 components (c‐sIgE) (ImmunoCAP® ISAC) were analyzed in 125 preschools (3–6 years) and 170 school‐age children (7–12 years). Supervised analyses and clustering methods were applied to identify patterns of sensitization among children with positive c‐sIgE. Results We observed c‐sIgE sensitization in 51% of preschool and 75% of school‐age children. Sensitization to house dust mite (HDM) components was more frequent among NSRW than SRW (53% vs. 24%, p < .01). Sensitization to non‐specific lipid transfer protein (nsLTP) components was more frequent among SA than NSA (16% vs. 4%, p < .01) and associated with an FEV1/FVC < −1.64 z ‐score. Among sensitized children, seven clusters with varying patterns were identified. The two broader clusters identified in each age group were characterized by “few sensitizations, mainly to HDM.” One cluster ( n = 4) with “multiple sensitizations, mainly to grass pollen, HDM, PR‐10, and nsLTP” was associated with SA in school‐age children. Conclusions Although children with wheeze/asthma display frequent occurrences and high levels of sensitization, sensitization patterns did not provide strong signals to discriminate children with severe disease from those with milder disease. These results suggest that the severity of wheeze/asthma may depend on both IgE‐ and non‐IgE‐mediated mechanisms

Factors Associated with Asthma Severity in Children: Data from the French COBRAPed Cohort

International audienc

Paediatric COVID-19 mortality: a database analysis of the impact of health resource disparity

Background The impact of the COVID-19 pandemic on paediatric populations varied between high-income countries (HICs) versus low-income to middle-income countries (LMICs). We sought to investigate differences in paediatric clinical outcomes and identify factors contributing to disparity between countries.Methods The International Severe Acute Respiratory and Emerging Infections Consortium (ISARIC) COVID-19 database was queried to include children under 19 years of age admitted to hospital from January 2020 to April 2021 with suspected or confirmed COVID-19 diagnosis. Univariate and multivariable analysis of contributing factors for mortality were assessed by country group (HICs vs LMICs) as defined by the World Bank criteria.Results A total of 12 860 children (3819 from 21 HICs and 9041 from 15 LMICs) participated in this study. Of these, 8961 were laboratory-confirmed and 3899 suspected COVID-19 cases. About 52% of LMICs children were black, and more than 40% were infants and adolescent. Overall in-hospital mortality rate (95% CI) was 3.3% [=(3.0% to 3.6%), higher in LMICs than HICs (4.0% (3.6% to 4.4%) and 1.7% (1.3% to 2.1%), respectively). There were significant differences between country income groups in intervention profile, with higher use of antibiotics, antivirals, corticosteroids, prone positioning, high flow nasal cannula, non-invasive and invasive mechanical ventilation in HICs. Out of the 439 mechanically ventilated children, mortality occurred in 106 (24.1%) subjects, which was higher in LMICs than HICs (89 (43.6%) vs 17 (7.2%) respectively). Pre-existing infectious comorbidities (tuberculosis and HIV) and some complications (bacterial pneumonia, acute respiratory distress syndrome and myocarditis) were significantly higher in LMICs compared with HICs. On multivariable analysis, LMIC as country income group was associated with increased risk of mortality (adjusted HR 4.73 (3.16 to 7.10)).Conclusion Mortality and morbidities were higher in LMICs than HICs, and it may be attributable to differences in patient demographics, complications and access to supportive and treatment modalities