Symptoms at presentation for patients admitted to hospital with Covid-19: results from the ISARIC prospective multinational observational study (preprint)

ABSTRACT

BackgroundThe 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. MethodsInternational, prospective observational study of 60109 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%). The most common atypical presentation under 60 years of age was nausea and vomiting, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. InterpretationAdults 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. SummaryAdults over 60 and children admitted to hospital with COVID-19 are less likely to have typical symptoms. Nausea and vomiting are common atypical presentations under 30 and confusion over 60. Women are less likely to experience typical symptoms than men.