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

UPLC MS/MS method for the determination of bupropion and its main metabolites in human whole blood

A selective and sensitive ultra-performance liquid chromatography (UPLC)–electrospray ionization-tandem mass spectrometry (MS) method for simultaneous determination of bupropion and its main metabolites, hydroxybupropion, erythrohydrobupropion, and threohydrobupropion, in human whole blood is presented. The sample preparation consists of cleanup protein precipitation with methanol combined with a solid-phase extraction on Oasis HLB cartridges. Analytes were separated on a Waters Acquity UPLC® BEH phenyl column using a binary mobile phase consisting of ammonium formate buffer (2 mM, pH 4) and acetonitrile. Detection was performed on a Waters Acquity UPLC system coupled to a Quattro Premier triple-quadrupole MS in positive ion selected reaction monitoring. Internal standards were bupropion-d9 and hydroxybupropion-d6. Linearity was from 5 to 1000 ng/mL for bupropion and from 10 to 2000 ng/mL for metabolites. Accuracy profiles (80–120%), precision (< 15%), and limits of detection (1 ng/mL for bupropion and 2 ng/mL for metabolites) were also evaluated and responded to all criteria of validation. The aim of this study was to compare this presented method with a previously described method developed on a classic liquid chromatography–tandem MS system

Recent ozone trends in the Chinese free troposphere: role of the local emission reductions and meteorology

International audienceAbstract. Free tropospheric ozone (O3) trends in the Central East China (CEC) and export regions are investigated for 2008–2017 using the IASI (Infrared Atmospheric Sounding Interferometer) O3 observations and the LMDZ-OR-INCA model simulations, including the most recent Chinese emission inventory. The observed and modelled trends in the CEC region are −0.07 ± 0.02 and −0.08 ± 0.02 DU yr−1, respectively, for the lower free troposphere (3–6 km column) and −0.05 ± 0.02 and −0.06 ± 0.02 DU yr−1, respectively, for the upper free troposphere (6–9 km column). The statistical p value is smaller to 0.01 for all the derived trends. A good agreement between the observations and the model is also observed in the region, including the Korean Peninsula and Japan and corresponding to the region of pollution export from China. Based on sensitivity studies conducted with the model, we evaluate, at 60 % and 52 %, the contribution of the Chinese anthropogenic emissions to the trend in the lower and upper free troposphere, respectively. The second main contribution to the trend is the meteorological variability (34 % and 50 %, respectively). These results suggest that the reduction in NOx anthropogenic emissions that has occurred since 2013 in China led to a decrease in ozone in the Chinese free troposphere, contrary to the increase in ozone at the surface. We designed some tests to compare the trends derived by the IASI observations and the model to independent measurements, such as the In-service Aircraft for a Global Observing System (IAGOS) or other satellite measurements (Ozone Monitoring Instrument (OMI)/Microwave Limb Sounder (MLS)). These comparisons do not confirm the O3 decrease and stress the difficulty in analysing short-term trends using multiple data sets with various sampling and the risk of overinterpreting the results

No evidence for major adverse events related to suspicion of Ebola in France, 2014-2015

International audienc

The unintended consequence of SO₂ and NO₂ regulations over China: increase of ammonia levels and impact on PM_2,5 concentrations

International audienceAir pollution reaching hazardous levels in many Chinese cities has been a major concern in China over the past decades. New policies have been applied to regulate an-thropogenic pollutant emissions, leading to changes in atmospheric composition and in particulate matter (PM) production. Increasing levels of atmospheric ammonia columns have been observed by satellite during recent years. In particular , observations from the Infrared Atmospheric Sounding Interferometer (IASI) reveal an increase of these columns by 15 % and 65 % from 2011 to 2013 and 2015, respectively , over eastern China. In this paper we performed model simulations for 2011, 2013 and 2015 in order to understand the origin of this increase and to quantify the link between ammonia and the inorganic components of particles: NH + 4(p) /SO 2− 4(p) /NO − 3(p). Interannual change of meteorology can be excluded as a reason: year 2015 meteorology leads to enhanced sulfate production over eastern China, which increases the ammonium and decreases the ammonia content, which is contrary to satellite observations. Reductions in SO 2 and NO x emissions from 2011 to 2015 of 37.5 % and 21 % respectively, as constrained from satellite data, lead to decreased inorganic matter (by 14 % for NH + 4(p) + SO 2− 4(p) + NO − 3(p)). This in turn leads to increased gaseous NH 3(g) tropospheric columns by as much as 24 % and 49 % (sampled corresponding to IASI data availability) from 2011 to 2013 and 2015 respectively and thus can explain most of the observed increase

Toxiques et analyses biologiques en toxicologie hospitalière

peer reviewe