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

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

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

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

La qualité des produits végétaux constitue une attente majeure de la société. Dans le cas des légumineuses étudiées, soja et haricot, les producteurs et l'ensemble de la filière jusqu'à la commercialisation portent un intérêt marqué à l'amélioration de la composition des graines pour leur utilisation dans l'industrie alimentaire ou non alimentaire. Notre démarche s'inscrit dans ce contexte et vise à caractériser les moyens d'élaboration de la qualité recherchée et de production satisfaisante par le choix du génotype et de l'adaptation des conduites de culture. La première partie de ce travail met en évidence les variations de composition de la graine sous l'effet des conditions agro-climatiques (date de semis, irrigation, choix génotypique et année culturale). Pour les deux légumineuses, la disponibilité hydrique pendant les phases de formation et de grossissement des graines joue un rôle déterminant sur la concentration en protéines et en Oligosaccharide de la famille du Raffinose (RFO). L'effet de décalage de semis et l'effet de l'année culturale sont significativement plus marqués pour le soja que pour le haricot. La seconde partie décrit l'évolution des équilibres entre les constituants de la graine dans les différentes conditions. Elle met en évidence la compétition entre les accumulations de protéines et d'huile (soja) entre protéines et RFO (soja, haricot), entre les différents acides gras (soja). La troisième partie souligne les relations entre la composition et les indicateurs de la production (rendement / Poids Moyen d'une Graine ou PMG). Pour les génotypes améliorés étudiés, les relations rendement / teneur en protéines et rendement / teneur en RFO sont généralement peu significatives; ceci suggère une relative indépendance entre les processus de formation des organes fructifères et ceux des synthèses des composés. En conclusion, ce travail dégage des éléments de connaissance sur l'élaboration de la composition des graines de soja et de haricot récoltées dans des conditions de culture diversifiées. Il propose quelques voies pour maîtriser l'orientation des synthèses des constituants recherchés par les utilisateurs et les consommateurs sans préjudice appréciable 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

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

Intercropping Winter Lupin and Triticale Increases Weed Suppression and Total Yield

International audienceLupin (Lupinus sp.) produces protein-rich grains, but its adoption in cropping systems suffers from both its low competitive ability against weeds and its high yield variability. Compared with legume sole cropping, grain legume–cereal intercropping benefits include better weed suppression and higher yield and yield stability. However, the potential of enhancing crop competitive ability against weeds in additive winter grain legume–cereal intercrops is not well-known, and this potential in long crop cycles is even less studied. We studied how intercropping with a triticale (×Triticosecale) alters weed biomass and productivity of winter white lupin (Lupinus albus L.). The experimental setup consisted of eleven sites during a two-year period in western France. In each site-year, winter white lupin sole cropping was compared to winter white lupin-triticale intercropping in an additive sowing design. We found that intercropping reduced weed biomass at lupin flowering by an average of 63%. The rapid growth and high soil N acquisition of triticale compensated for the low competitive ability of lupin against weeds until lupin flowering. Competition from triticale in the intercrop reduced lupin grain yield (−34%), but intercropping produced a higher total grain yield (+37%) than did lupin sole cropping while maintaining the total protein grain yield

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

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

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

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

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

Capitalizing knowledge on pests to supports the design of pesticide-free systems

International audienc