84 research outputs found
HomĂ©ostasie des histones en rĂ©ponse au dommage Ă lâADN et Ă©tude dâinhibiteurs de dĂ©sacĂ©tylases dâimportance clinique
La chromatine possĂšde une plasticitĂ© complexe et essentielle pour rĂ©pondre Ă diffĂ©rents mĂ©canismes cellulaires fondamentaux tels la rĂ©plication, la transcription et la rĂ©paration de lâADN. Les histones sont les constituants essentiels de la formation des nuclĂ©osomes qui assurent le bon fonctionnement cellulaire dâoĂč lâintĂ©rĂȘt de cette thĂšse dây porter une attention particuliĂšre. Un dysfonctionnement de la chromatine est souvent associĂ© Ă lâĂ©mergence du cancer.
Le chapitre II de cette thĂšse focalise sur la rĂ©pression transcriptionnelle des gĂšnes dâhistones par le complexe HIR (HIstone gene Repressor) en rĂ©ponse au dommage Ă l'ADN chez Saccharomyces cerevisiae. Lors de dommage Ă lâADN en dĂ©but de phase S, les kinases du point de contrĂŽle Mec1, Tel1 et Rad53 sâassurent de bloquer les origines tardives de rĂ©plication pour limiter le nombre de collisions potentiellement mutagĂ©niques ou cytotoxiques entre les ADN polymĂ©rases et les lĂ©sions persistantes dans l'ADN. Lorsque la synthĂšse totale dâADN est soudainement ralentie par le point de contrĂŽle, lâaccumulation d'un excĂšs d'histones nouvellement synthĂ©tisĂ©es est nĂ©faste pour les cellules car les histones libres se lient de maniĂšre non-spĂ©cifique aux acides nuclĂ©iques. L'un des mĂ©canismes mis en place afin de minimiser la quantitĂ© dâhistones libres consiste Ă rĂ©primer la transcription des gĂšnes d'histones lors d'une chute rapide de la synthĂšse d'ADN, mais les bases molĂ©culaires de ce mĂ©canisme Ă©taient trĂšs mal connues. Notre Ă©tude sur la rĂ©pression des gĂšnes dâhistones en rĂ©ponse aux agents gĂ©notoxiques nous a permis dâidentifier que les kinases du point de contrĂŽle jouent un rĂŽle dans la rĂ©pression des gĂšnes dâhistones. Avant le dĂ©but de mon projet, il Ă©tait dĂ©jĂ connu que le complexe HIR est requis pour la rĂ©pression des gĂšnes dâhistones en phase G1, G2/M et lors de dommage Ă lâADN en phase S. Par contre, la rĂ©gulation du complexe HIR en rĂ©ponse au dommage Ă l'ADN n'Ă©tait pas connue. Nous avons dĂ©montrĂ© par des essais de spectromĂ©trie de
masse (SM) que Rad53 rĂ©gule le complexe HIR en phosphorylant directement une de ses sous-unitĂ©s, Hpc2, Ă de multiples rĂ©sidus in vivo et in vitro. La phosphorylation dâHpc2 est essentielle pour le recrutement aux promoteurs de gĂšnes dâhistones du complexe RSC (Remodels the Structure of Chromatin) dont la prĂ©sence sur les promoteurs des gĂšnes d'histones corrĂšle avec leur rĂ©pression. De plus, nous avons mis Ă jour un nouveau mĂ©canisme de rĂ©gulation du complexe HIR durant la progression normale Ă travers le cycle cellulaire ainsi qu'en rĂ©ponse aux agents gĂ©notoxiques. En effet, durant le cycle cellulaire normal, la protĂ©ine Hpc2 est trĂšs instable durant la transition G1/S afin de permettre la transcription des gĂšnes dâhistones et la production d'un pool d'histones nĂ©o-synthĂ©tisĂ©es juste avant l'initiation de la rĂ©plication de lâADN. Toutefois, Hpc2 n'est instable que pour une brĂšve pĂ©riode de temps durant la phase S. Ces rĂ©sultats suggĂšrent qu'Hpc2 est une protĂ©ine clef pour la rĂ©gulation de l'activitĂ© du complexe HIR et la rĂ©pression des gĂšnes dâhistones lors du cycle cellulaire normal ainsi qu'en rĂ©ponse au dommage Ă lâADN.
Dans le but de poursuivre notre Ă©tude sur la rĂ©gulation des histones, le chapitre III de ma thĂšse concerne lâanalyse globale de lâacĂ©tylation des histones induite par les inhibiteurs dâhistone dĂ©sacĂ©tylases (HDACi) dans les cellules normales et cancĂ©reuses. Les histones dĂ©sacĂ©tylases (HDACs) sont les enzymes qui enlĂšvent lâacĂ©tylation sur les lysines des histones. Dans plusieurs types de cancers, les HDACs contribuent Ă lâoncogenĂšse par leur fusion aberrante avec des complexes protĂ©iques oncogĂ©niques. Les perturbations causĂ©es mĂšnent souvent Ă un Ă©tat silencieux anormal des suppresseurs de tumeurs. Les HDACs sont donc une cible de choix dans le traitement des cancers engendrĂ©s par ces protĂ©ines de fusion.
Notre Ă©tude de lâeffet sur lâacĂ©tylation des histones de deux inhibiteurs d'HDACs de relevance clinique, le vorinostat (SAHA) et lâentinostat (MS-275), a permis de dĂ©montrer une augmentation Ă©levĂ©e de lâacĂ©tylation globale des histones
H3 et H4, contrairement Ă H2A et H2B, et ce, autant chez les cellules normales que cancĂ©reuses. Notre quantification en SM de l'acĂ©tylation des histones a rĂ©vĂ©lĂ© de façon inattendue que la stĆchiomĂ©trie d'acĂ©tylation sur la lysine 56 de lâhistone H3 (H3K56Ac) est de seulement 0,03% et, de maniĂšre surprenante, cette stĆchiomĂ©trie n'augmente pas dans des cellules traitĂ©es avec diffĂ©rents HDACi. Plusieurs Ă©tudes de H3K56Ac chez lâhumain prĂ©sentes dans la littĂ©rature ont rapportĂ© des rĂ©sultats irrĂ©conciliables. Qui plus est, H3K56Ac Ă©tait considĂ©rĂ© comme un biomarqueur potentiel dans le diagnostic et pronostic de plusieurs types de cancers. Câest pourquoi nous avons portĂ© notre attention sur la spĂ©cificitĂ© des anticorps utilisĂ©s et avons dĂ©terminĂ© quâune grande majoritĂ© dâanticorps utilisĂ©s dans la littĂ©rature reconnaissent dâautres sites d'acĂ©tylation de lâhistone H3, notamment H3K9Ac dont la stĆchiomĂ©trie d'acĂ©tylation in vivo est beaucoup plus Ă©levĂ©e que celle d'H3K56Ac. De plus, le chapitre IV fait suite Ă notre Ă©tude sur lâacĂ©tylation des histones et consiste en un rapport spĂ©cial de recherche dĂ©crivant la fonction de H3K56Ac chez la levure et lâhomme et comporte Ă©galement une Ă©valuation dâun anticorps supposĂ©ment spĂ©cifique d'H3K56Ac en tant qu'outil diagnostic du cancer chez lâhumain.The chromatin is a complex structure and its plasticity is essential to complete different fundamental cellular processes such as DNA replication, transcription and repair. Furthermore, chromatin malfunction is often associated with cancer emergence. The focus of this thesis will be on the function and regulation of histones, as they are essential components of nucleosomes and they ensure proper chromatin formation.
Chapter II of this thesis focuses on the transcriptional repression of histone genes by the HIR (HIstone gene Repressor) complex in response to DNA damage in Saccharomyces cerevisiae. When DNA damage occurs in early S phase, the DNA damage checkpoint kinases Mec1, Tel1 and Rad53 block late origins of replication to limit potentially mutagenic or cytotoxic collisions between DNA polymerases and remaining DNA lesions. When the total DNA synthesis rate drops suddenly in S- phase, following the checkpoint control activation, accumulation of newly synthesized histones becomes detrimental for the cells because free histones bind non-specifically to nucleic acids. One mechanism that contributes to a reduction in free histones at this time is the repression of histone gene transcription; however, the molecular basis of this repression was not known. Our study on histone gene repression in response to genotoxic agents allowed us to identify the checkpoint kinases as major players in the repression of histone genes. Before initiating this project, it was known that the HIR complex is required to repress histone genes in G1 and G2/M phases and during DNA damage. Nonetheless, HIR complex regulation was not well characterized. We demonstrated by mass spectrometry (MS) analyses that Rad53 regulates the HIR complex by directly phosphorylating one of its subunits, Hpc2, at many residues in vivo and in vitro. Hpc2 phosphorylation is essential to recruit the RSC complex (Remodels the Structure of Chromatin) to histone gene promoters where its presence correlates with histone gene repression. Moreover, we uncovered a novel mechanism for the HIR complex regulation during a normal cell cycle progression and in response to genotoxic agents. Indeed, during a
normal cell cycle, the Hpc2 protein is very unstable at the G1/S transition to allow histone gene transcription and production of a pool of newly synthesized histones just before DNA replication initiation. These results suggest that Hpc2 is a key player in the regulation of HIR complex activity and can repress histone gene expression both during a normal cell cycle and in response to DNA damage.
In order to pursue our study on histone regulation, chapter III of this thesis covers histone acetylation induced by histone deacetylase inhibitors (HDACi) in normal and cancer cells. Histone deacetylases (HDACs) are enzymes that remove acetyl groups from lysine residues on histones, condensing the chromatin and effectively repressing local transcription. Several types of cancers are characterized by epigenetic abnormalities and HDACs contribute to oncogenesis by aberrant fusion with oncogenic protein complexes. The disruptions often lead to an abnormal silent state of tumour suppressors. HDACs are then targets of interest in cancer treatment caused by those fusion proteins.
Our study of the effects of two clinically relevant HDAC inhibitors, vorinostat (SAHA) and entinostat (MS-275) on acetylation of histones demonstrated an obvious increase of histones H3 and H4 acetylation, unlike histones H2A and H2B in both normal and cancer cells. Unexpectedly, our MS quantification of histone acetylation revealed that the stoichiometry of histone H3 lysine 56 acetylation (H3K56Ac) was only 0.03% and, surprisingly, this stoichiometry did not increase upon HDACi treatments. Several reported studies in the literature of H3K56Ac in humans are irreconcilable. Furthermore, H3K56Ac was considered as a potential biomarker in diagnosis and prognosis in many cancer types. Therefore we focussed on antibody specificity and determined that the majority of antibodies used in the literature recognize other acetylation sites in histone H3, especially H3K9Ac whose stoichiometry of acetylation in vivo is much higher than H3K56Ac. Additionally, chapter IV is a follow-up of our study on histone acetylation and consists of a special report describing the function of H3K56Ac in yeast and human and also contains an evaluation of a supposedly specific H3K56Ac antibody as a diagnostic tool in human cancers
Facteurs de localisation des immigrants entrepreneurs francophones et potentiel attractif du Saguenay-Lac-St-Jean
Le bilan économique du Saguenay-Lac-St-Jean est alarmant. à titre d'exemple, l'agglomération urbaine du haut Saguenay possÚde le plus haut taux de chÎmage au Canada. La situation exige de trouver des moyens pour dynamiser la région. La régionalisation des immigrants entrepreneurs en est un.
Pour assurer le succÚs de la régionalisation, il doit y avoir concordance entre les besoins des immigrants et les possibilités régionales. à cet effet, il était nécessaire de savoir si le Saguenay-Lac-St-Jean disposait du potentiel nécessaire pour attirer les immigrants entrepreneurs. Pour y arriver, nous devions d'abord connaßtre les facteurs d'attraction qui incitent les immigrants entrepreneurs à se localiser en un lieu donné.
Notre recherche inclut cinq chapitres de présentation: le premier définit la problématique, le deuxiÚme introduit le corpus théorique et la recension des écrits, le troisiÚme expose la méthodologie suivie pour vérifier les hypothÚses soulevées. Les quatriÚme et cinquiÚme chapitres présentent, quant à eux, les résultats de notre recherche en fonction des objectifs fixés.
Deux enquĂȘtes furent rĂ©alisĂ©es pour recueillir les donnĂ©es de notre recherche. Une s'est d'abord effectuĂ©e auprĂšs de 29 immigrants entrepreneurs francophones pour connaĂźtre les facteurs d'attraction qui les incitent Ă se localiser en un lieu donnĂ©. Un questionnaire devait ĂȘtre prĂ©alablement construit avant d'amorcer l'enquĂȘte. Aucune des Ă©tudes recensĂ©es n?offrait rĂ©fĂ©rence sur ce plan. Une autre fut produite subsĂ©quemment pour vĂ©rifier, Ă l'aide de documentations rĂ©gionales et Ă partir des rĂ©sultats de localisation obtenus, les potentialitĂ©s du Saguenay-Lac-St-Jean. L'analyse descriptive a Ă©tĂ© privilĂ©giĂ©e pour traiter l'ensemble de nos donnĂ©es.
Les résultats obtenus sur les facteurs de choix de localisation ont confirmé notre premiÚre hypothÚse de recherche. Les facteurs incitatifs de localisation sont de nature diverse. Ils se définissent en terme de qualité de vie, de prix de revient, de famille et de réseaux de contacts. Les résultats montrent aussi toute l'importance accordée par nos répondants aux facteurs extraéconomiques de localisation. Les facteurs économiques sont, pour leur part, des agents incitatifs de second ordre.
Les rĂ©sultats obtenus sur le potentiel rĂ©gional ont confirmĂ© que partiellement notre seconde hypothĂšse. Ils ont dĂ©montrĂ© que le Saguenay-Lac-St-Jean ne dispose pas de tout le potentiel nĂ©cessaire pour attirer les immigrants entrepreneurs. L'enquĂȘte a tout de mĂȘme dĂ©nombrĂ© plusieurs atouts qui rendent cette rĂ©gion attractive. Les atouts dĂ©coulent surtout de la qualitĂ© de vie mais aussi des ressources Ă©conomiques. Une concordance s'est ainsi faite entre le vouloir des immigrants entrepreneurs et les possibilitĂ©s du Saguenay-Lac-St-Jean rendant ainsi la rĂ©gionalisation possible
Dynamique et modĂ©lisation de lâoxygĂšne dissous en riviĂšre
La concentration en oxygĂšne dissous en milieu fluvial varie selon un cycle diurne (24 h) quâil est essentiel de considĂ©rer dans lâĂ©valuation de lâĂ©tat dâoxygĂ©nation dâun cours dâeau. En principe, seules des mesures en continu recueillies au cours de cycles de 24 h permettent dâĂ©valuer correctement lâĂ©tat dâoxygĂ©nation dâune riviĂšre, ce que, en pratique, les contraintes logistiques et budgĂ©taires ne permettent pas de rĂ©aliser. Le prĂ©sent article vise Ă faire la synthĂšse des connaissances sur les facteurs de contrĂŽle et la modĂ©lisation des variations diurnes de la concentration en oxygĂšne dissous en riviĂšre. Parmi les facteurs biologiques et physico-chimiques, les activitĂ©s autotrophe et hĂ©tĂ©rotrophe sont les facteurs dominants responsables des variations diurnes de lâoxygĂšne dissous. Certains modĂšles de qualitĂ© de lâeau permettent de modĂ©liser la teneur en oxygĂšne et, dans certains cas, la variation diurne. Toutefois, ces modĂšles sont souvent complexes, dâutilisation ardue et impliquent la mesure directe sur des cycles de 24 h des variables qui rĂ©gissent la concentration en oxygĂšne dans le milieu. Une dĂ©marche est proposĂ©e pour lâĂ©laboration dâun modĂšle et a Ă©tĂ© appliquĂ©e dans une Ă©tude de cas rĂ©alisĂ©e dans la riviĂšre Saint-Charles (QuĂ©bec, Canada). Un modĂšle simple (une fonction sinusoĂŻdale) dont les paramĂštres ont Ă©tĂ© corrĂ©lĂ©s Ă la tempĂ©rature et Ă la concentration moyenne en nitrate a permis de gĂ©nĂ©rer des valeurs simulĂ©es dâoxygĂšne dissous trĂšs proches des valeurs observĂ©es in situ. Un modĂšle alternatif utilisant des valeurs ponctuelles de tempĂ©rature et de concentration de nitrate a donnĂ© des rĂ©sultats Ă©quivalents. Lâapproche proposĂ©e constitue donc une alternative simple et pratique Ă la mesure en continu de lâoxygĂšne et permet une Ă©valuation plus rĂ©aliste de lâĂ©tat rĂ©el dâoxygĂ©nation dâune riviĂšre que la prise de mesures ponctuelles.In rivers, dissolved oxygen concentrations typically show diel variations with maximum values during daytime and minimum values at night. The diel cycle must be taken into account when assessing the state of oxygenation of a watercourse. However, in water quality monitoring programs, dissolved oxygen concentrations are usually obtained from single measurements taken during daytime. The resulting data do not represent the real overall oxygen levels of a watercourse and thus can lead to erroneous conclusions regarding the oxygen status of a river. Continuous data collected over 24âhour cycles are required for an accurate oxygen status assessment, but in practice, logistic and budget constraints do not allow such samplings. Modelling can be a convenient alternative to direct measurements. However, the water quality models that take into account the diel cycle of oxygen are generally complex to run. The purpose of this study was to review the information relating to the dynamics and the modelling of the diel variations in dissolved oxygen in rivers and to apply a simple model in a case study involving dissolved oxygen, nutrients, temperature and chlorophyll a data collected over 24âhour cycles in the St. Charles River near Quebec City (Canada).Photosynthesis by algae, both benthic and planktonic, as well as by macrophytes, is an important and sometimes dominant factor in the oxygen budget of a river. Sediments and heterotrophic activity by bacteria, particularly in rivers receiving important loads of wastewaters, can be important sinks for oxygen. Temperature determines the solubility of oxygen, thereby directly influencing oxygen concentrations. Diel variations in oxygen thus reflect diel variations in temperature. Temperature also has an effect on biological processes such as respiration and photosynthesis. Reaeration varies not only with temperature, but also with the type of flow (laminar vs. turbulent) and current velocity. In rivers with important slopes and current velocities, reaeration can be sufficient to make up for oxygen losses due to high heterotrophic activity. Nevertheless, light is the first causative factor for the diel variations in oxygen, determining both autotrophic activity and water temperature. However, suspended matter in the water column reduces light penetration. Higher levels of suspended matter result in lower levels of photosynthesis and oxygen production. The sudden or large influx of runoff waters after heavy rain or snowmelt can also have an important impact on the oxygen budget of a river. Finally, chemical factors can have an influence on the diel variations in oxygen: nutrient inputs, in particular, can stimulate the rate of photosynthesis and oxygen production. Overall, oxygen dynamics are determined by the relative importance of biological, physical and chemical factors, which vary in time and space. However, biological processes often dominate over the other causative factors affecting diel variations in oxygen. In temperate climates, biological processes have a controlling function only during warmer months, with temperature and flow being the dominant controlling factors during colder months.Water quality models that take into account diel variations in oxygen are often designed to assess primary production and respiration. These models are based on either ODUMâs (1956) concept of oxygen curves or on direct and continuous measurements of dissolved oxygen. Periodic functions or Fourier series are also used to simulate diel variations in oxygen. The widely used USEPA QUAL2e model predicts diel variations in oxygen from different measurements including light intensity and from computation of the rates of photosynthesis and respiration. Several other modelling approaches use various combinations of indirect methods to predict the variations in oxygen, based on light intensity, algal biomass, primary production, and reaeration. Specific models are sometimes necessary due to particular regional characteristics or environmental issues.In general, water quality models designed for water management purposes are complex and require the measurement of a large number of parameters, which necessitates elaborate and costly logistics. Estimating the parameters controlling the oxygen budget in a river thus ends up being more time and labour consuming than the direct measurement of diel variations in oxygen. A simpler model leading to the estimation of the concentrations and the amplitude of the variations of dissolved oxygen was developed and applied to the St. Charles River.The St. Charles River flows from the Laurentians north of Quebec City to the St. Lawrence River. The vast upper watershed is mostly forested, but the lower part is heavily urbanized. Two stations were located in the upper watershed and one in the section of the river within Quebec City. Water quality was excellent at the upstream stations and poor at the downstream station, due to wastewater inputs and low flow rates. Sampling was carried out in the months of July and August of 1996 and 1997. Physico-chemical and light measurements were made every two hours for periods of 24 hours. Nutrient and chlorophyll a samples were collected every four hours. Small diel variations in oxygen (amplitude: 1.48 mg/L) were observed at the upstream station, while much larger ones (amplitude: 4.23 mg/L) were measured at the downstream station. Modelling of the diel variations in oxygen was carried out using a sine function. Oxygen concentrations over 24 hours were successfully predicted from average concentration of dissolved oxygen, amplitude, and phase of the cycle. Average oxygen concentrations and amplitude can be derived from physico-chemical and/or biological variables easily measured in standard water quality monitoring programs. Average oxygen concentrations showed a very strong correlation with temperature (r2 = 0.91) and amplitude of oxygen level variations was strongly correlated with average nitrate concentration (r2 = 0.58). These relations were used in the sine function and resulted in significantly correlated modelled and measured oxygen concentrations for six of the seven cycles. Overall correlation between modelled and observed values was high (r2 = 0.77). Modelled values obtained with single measurements of temperature (taken at 2:30 P.M.) and nitrate concentration (which shows no diel variation) were also highly correlated with observed data (r2 = 0.75). Absolute and relative bias as well as root-mean-square error also showed the validity and the equivalence of the two approaches.This study shows that simple models based on available water quality data may generate realistic oxygen values over 24âhour cycles. These models would be a valuable diagnostic and decision making tool for the management of water quality in rivers
Relationship between smoothing temperature, storage time, syneresis and rheological properties of stirred yogurt
Six different smoothing temperatures were compared for nonfat yogurt and the changes in syneresis and rheological properties observed for up to 22 days. Multiple linear regressions were used to describe the syneresis, firmness, flow time, viscosity, and flow resistance and the relationship between these properties, the smoothing temperature and the storage time. During storage, viscosity, firmness, and flow time increased; syneresis and flow resistance remained stable. Syneresis increased significantly (P †0.05) with smoothing temperature (10â35 °C). Other properties increased slightly (P > 0.05), and properties started to decrease above 30 °C. Syneresis, viscosity, and flow resistance were more sensitive to smoothing temperature; firmness and flow time were more sensitive to storage time. Lower smoothing temperature (10 °C) should be used to minimize syneresis while smoothing temperature ranging from 25 to 30 °C is better to improve rheological properties. Storage time must be considered to optimize these properties
How do smoothing conditions and storage time change syneresis, rheological and microstructural properties of nonfat stirred acid milk gel?
Nonfat acid milk gel, acidified by GDL, was used to simulate microbial fermentation of milk to produce stirred yoghurt. Acid milk gel preparation at laboratory scale included stirring, pumping, smoothing and cooling operations. Two filters (pre-smoothed, 1 mm; smoothed, 500 Όm), three smoothing temperatures (13, 22 and 35 °C) and two storage times (1 and 22 days) were studied. Syneresis, microgels size and smoothness of microgels were analysed for pre-smoothed and smoothed gels; viscosity, storage modulus, firmness and total pore area were only analysed for smoothed gel. After 1 and 22 days of storage, pre-smoothed gels developed lower syneresis and smaller microgels than smoothed gels at 22 °C. For smoothed gels, regardless of the smoothing temperature, syneresis, firmness, microgels size and smoothness increased during storage, while total pore area decreased and viscosity remained stable. Viscosity was lower when smoothing was performed at 35 °C and was correlated to rougher microgels
Soil and land use research in Europe: lessons learned from INSPIRATION bottom-up strategic research agenda setting
We introduce the INSPIRATION bottom-up approach for the development of a strategic research agenda for spatial planning, land use and soil-sediment-water-system management in Europe. Research and innovation needs were identified by more than 500 European funders, endusers, scientists, policy makers, public administrators and consultants. We report both on the concept and on the implementation of the bottom-up approach, provide a critique of the process and draw key lessons for the development of research agendas in the future. Based on identified strengths and weaknesses we identified as key opportunities and threats 1) a high ranking and attentiveness for the research topics on the political agenda, in press and media or in public awareness, 2) availability of funding for research, 3) the resources available for creating the agenda itself, 4) the role of the sponsor of the agenda development, and 5) the continuity of stakeholder engagement as bases for identification of windows of opportunity, creating ownership for the agenda and facilitating its implementation. Our derived key recommendations are 1) a clear definition of the area for which the agenda is to be developed and for the targeted user, 2) a conceptual model to structure the agenda, 3) making clear the expected roles, tasks, input formats regarding the involvement and communication with the stakeholders and project partners, 4) a sufficient number of iterations and checks of the agenda with stakeholders to insure completeness, relevance and creation of co-ownership for the agenda, and 5) from the beginning prepare the infrastructure for the network to implement the agenda
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 60â109 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:
âTypicalâ 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 (â€â18 years: 69, 48, 23; 85%), older adults (â„â70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each Pâ<â0.001). 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
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