COVID-19 symptoms at hospital admission vary with age and sex: ISARIC multinational study

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Abstract

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%). 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.

Interpretation

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.

Summary

Adults 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.

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Most cited references 23

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Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China

Chaolin Huang, Yeming Wang, Xingwang Li … (2020)

Summary Background A recent cluster of pneumonia cases in Wuhan, China, was caused by a novel betacoronavirus, the 2019 novel coronavirus (2019-nCoV). We report the epidemiological, clinical, laboratory, and radiological characteristics and treatment and clinical outcomes of these patients. Methods All patients with suspected 2019-nCoV were admitted to a designated hospital in Wuhan. We prospectively collected and analysed data on patients with laboratory-confirmed 2019-nCoV infection by real-time RT-PCR and next-generation sequencing. Data were obtained with standardised data collection forms shared by WHO and the International Severe Acute Respiratory and Emerging Infection Consortium from electronic medical records. Researchers also directly communicated with patients or their families to ascertain epidemiological and symptom data. Outcomes were also compared between patients who had been admitted to the intensive care unit (ICU) and those who had not. Findings By Jan 2, 2020, 41 admitted hospital patients had been identified as having laboratory-confirmed 2019-nCoV infection. Most of the infected patients were men (30 [73%] of 41); less than half had underlying diseases (13 [32%]), including diabetes (eight [20%]), hypertension (six [15%]), and cardiovascular disease (six [15%]). Median age was 49·0 years (IQR 41·0–58·0). 27 (66%) of 41 patients had been exposed to Huanan seafood market. One family cluster was found. Common symptoms at onset of illness were fever (40 [98%] of 41 patients), cough (31 [76%]), and myalgia or fatigue (18 [44%]); less common symptoms were sputum production (11 [28%] of 39), headache (three [8%] of 38), haemoptysis (two [5%] of 39), and diarrhoea (one [3%] of 38). Dyspnoea developed in 22 (55%) of 40 patients (median time from illness onset to dyspnoea 8·0 days [IQR 5·0–13·0]). 26 (63%) of 41 patients had lymphopenia. All 41 patients had pneumonia with abnormal findings on chest CT. Complications included acute respiratory distress syndrome (12 [29%]), RNAaemia (six [15%]), acute cardiac injury (five [12%]) and secondary infection (four [10%]). 13 (32%) patients were admitted to an ICU and six (15%) died. Compared with non-ICU patients, ICU patients had higher plasma levels of IL2, IL7, IL10, GSCF, IP10, MCP1, MIP1A, and TNFα. Interpretation The 2019-nCoV infection caused clusters of severe respiratory illness similar to severe acute respiratory syndrome coronavirus and was associated with ICU admission and high mortality. Major gaps in our knowledge of the origin, epidemiology, duration of human transmission, and clinical spectrum of disease need fulfilment by future studies. Funding Ministry of Science and Technology, Chinese Academy of Medical Sciences, National Natural Science Foundation of China, and Beijing Municipal Science and Technology Commission.

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Clinical Characteristics of Coronavirus Disease 2019 in China

Wei-jie Guan, Zheng-yi Ni, Yu Hu … (2020)

Abstract Background Since December 2019, when coronavirus disease 2019 (Covid-19) emerged in Wuhan city and rapidly spread throughout China, data have been needed on the clinical characteristics of the affected patients. Methods We extracted data regarding 1099 patients with laboratory-confirmed Covid-19 from 552 hospitals in 30 provinces, autonomous regions, and municipalities in mainland China through January 29, 2020. The primary composite end point was admission to an intensive care unit (ICU), the use of mechanical ventilation, or death. Results The median age of the patients was 47 years; 41.9% of the patients were female. The primary composite end point occurred in 67 patients (6.1%), including 5.0% who were admitted to the ICU, 2.3% who underwent invasive mechanical ventilation, and 1.4% who died. Only 1.9% of the patients had a history of direct contact with wildlife. Among nonresidents of Wuhan, 72.3% had contact with residents of Wuhan, including 31.3% who had visited the city. The most common symptoms were fever (43.8% on admission and 88.7% during hospitalization) and cough (67.8%). Diarrhea was uncommon (3.8%). The median incubation period was 4 days (interquartile range, 2 to 7). On admission, ground-glass opacity was the most common radiologic finding on chest computed tomography (CT) (56.4%). No radiographic or CT abnormality was found in 157 of 877 patients (17.9%) with nonsevere disease and in 5 of 173 patients (2.9%) with severe disease. Lymphocytopenia was present in 83.2% of the patients on admission. Conclusions During the first 2 months of the current outbreak, Covid-19 spread rapidly throughout China and caused varying degrees of illness. Patients often presented without fever, and many did not have abnormal radiologic findings. (Funded by the National Health Commission of China and others.)

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Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study

Fei Zhou, Ting Yu, Ronghui Du … (2020)

Summary Background Since December, 2019, Wuhan, China, has experienced an outbreak of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Epidemiological and clinical characteristics of patients with COVID-19 have been reported but risk factors for mortality and a detailed clinical course of illness, including viral shedding, have not been well described. Methods In this retrospective, multicentre cohort study, we included all adult inpatients (≥18 years old) with laboratory-confirmed COVID-19 from Jinyintan Hospital and Wuhan Pulmonary Hospital (Wuhan, China) who had been discharged or had died by Jan 31, 2020. Demographic, clinical, treatment, and laboratory data, including serial samples for viral RNA detection, were extracted from electronic medical records and compared between survivors and non-survivors. We used univariable and multivariable logistic regression methods to explore the risk factors associated with in-hospital death. Findings 191 patients (135 from Jinyintan Hospital and 56 from Wuhan Pulmonary Hospital) were included in this study, of whom 137 were discharged and 54 died in hospital. 91 (48%) patients had a comorbidity, with hypertension being the most common (58 [30%] patients), followed by diabetes (36 [19%] patients) and coronary heart disease (15 [8%] patients). Multivariable regression showed increasing odds of in-hospital death associated with older age (odds ratio 1·10, 95% CI 1·03–1·17, per year increase; p=0·0043), higher Sequential Organ Failure Assessment (SOFA) score (5·65, 2·61–12·23; p<0·0001), and d-dimer greater than 1 μg/mL (18·42, 2·64–128·55; p=0·0033) on admission. Median duration of viral shedding was 20·0 days (IQR 17·0–24·0) in survivors, but SARS-CoV-2 was detectable until death in non-survivors. The longest observed duration of viral shedding in survivors was 37 days. Interpretation The potential risk factors of older age, high SOFA score, and d-dimer greater than 1 μg/mL could help clinicians to identify patients with poor prognosis at an early stage. Prolonged viral shedding provides the rationale for a strategy of isolation of infected patients and optimal antiviral interventions in the future. Funding Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences; National Science Grant for Distinguished Young Scholars; National Key Research and Development Program of China; The Beijing Science and Technology Project; and Major Projects of National Science and Technology on New Drug Creation and Development.

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Author and article information

Journal

Journal ID (nlm-ta): medRxiv

Journal ID (publisher-id): MEDRXIV

Title: medRxiv

Publisher: Cold Spring Harbor Laboratory

Publication date (Electronic): 19 November 2020

Electronic Location Identifier: 2020.10.26.20219519

Affiliations

[* ]Members listed at end of manuscript

Author notes

Authors’ contributions

Author contributions are listed in the supplementary material.

ISARIC Clinical Characterisation Group

Sheryl Ann Abdukahil, Ryuzo Abe, Laurent Abel, Lara Absil, Andrew Acker, Shingo Adachi, Elisabeth Adam, Diana Adrião, Kate Ainscough, Ali Ait Hssain, Younes Ait Tamlihat, Takako Akimoto, Tala Al-Dabbous, Abdulrahman Al-Fares, Eman Al Qasim, Razi Alalqam, Beatrice Alex, Kévin Alexandre, Huda Alfoudri, Kazali Enagnon Alidjnou, Jeffrey Aliudin, Clotilde Allavena, Nathalie Allou, João Alves, Rita Alves, Maria Amaral, Heidi Ammerlaan, Phoebe Ampaw, Roberto Andini, Claire Andrejak, Andrea Angheben, François Angoulvant, Séverine Ansart, Massimo Antonelli, Carlos Alexandre Antunes De Brito, Yaseen Arabi, Irene Aragao, Antonio Arcadipane, Lukas Arenz, Jean-Benoît Arlet, Christel Arnold-Day, Lovkesh Arora, Elise Artaud-Macari, Angel Asensio, Jean Baptiste Assie, Anika Atique, Johann Auchabie, Hugues Aumaitre, Laurène Azemar, Cécile Azoulay, Benjamin Bach, Delphine Bachelet, J. Kenneth Baillie, Erica Bak, Agamemnon Bakakos, Firouzé Banisadr, Renata Barbalho, Wendy S. Barclay, Michaela Barnikel, Audrey Barrelet, Cleide Barrigoto, Romain Basmaci, Diego Fernando Bautista Rincon, Alexandra Bedossa, Sylvie Behilill, Aleksandr Beljantsev, David Bellemare, Anna Beltrame, Marine Beluze, Nicolas Benech, Dehbia Benkerrou, Suzanne Bennett, LuÍs Bento, Jan-Erik Berdal, Delphine Bergeaud, Lorenzo Bertolino, Simon Bessis, Sybille Bevilcaqua, Krishna Bhavsar, Felwa Bin Humaid, François Bissuel, Patrick Biston, Laurent Bitker, Pablo Blanco-Schweizer, Mathieu Blot, Filomena Boccia, Debby Bogaert, François Bompart, Gareth Booth, Diogo Borges, Raphaël Borie, Jeannet Bos, Hans Martin Bosse, Elisabeth Botelho-Nevers, Lila Bouadma, Olivier Bouchaud, Sabelline Bouchez, Dounia Bouhmani, Damien Bouhour, Kévin Bouiller, Laurence Bouillet, Camille Bouisse, Anne-Sophie Boureau, Maude Bouscambert, Jason Bouziotis, Bianca Boxma, Marielle Boyer-Besseyre, Maria Boylan, Cynthia Braga, Timo Brandenburger, Luca Brazzi, Dorothy Breen, Patrick Breen, Kathy Brickell, Nicolas Brozzi, Nina Buchtele, Christian Buesaquillo, Polina Bugaeva, Marielle Buisson, Erlina Burhan, Ingrid G. Bustos, Denis Butnaru, Sheila Cárcel, André Cabie, Susana Cabral, Eder Caceres, Mia Callahan, Kate Calligy, Jose Andres Calvache, João Camões, Valentine Campana, Paul Campbell, Cecilia Canepa, Mireia Cantero, Pauline Caraux-Paz, Filipa Cardoso, Filipe Cardoso, Sofia Cardoso, Simone Carelli, Nicolas Carlier, Gayle Carney, Chloe Carpenter, Marie-Christine Carret, François Martin Carrier, Gail Carson, Maire-Laure Casanova, Mariana Cascão, José Casimiro, Bailey Cassandra, Silvia Castañeda, Nidyanara Castanheira, Guylaine Castor-Alexandre, Henry Castrillón, Ivo Castro, Ana Catarino, François-Xavier Catherine, Roberta Cavalin, Giulio Giovanni Cavalli, Alexandros Cavayas, Adrian Ceccato, Minerva Cervantes-Gonzalez, Anissa Chair, Catherine Chakveatze, Adrienne Chan, Meera Chand, Julie Chas, Camille Chassin, Anjellica Chen, Yih-Sharng Chen, Matthew Pellan Cheng, Antoine Cheret, Thibault Chiarabini, Julian Chica, Catherine Chirouze, Davide Chiumello, Hwa Jin Cho, Sung Min Cho, Bernard Cholley, Jose Pedro Cidade, Jose Miguel Cisneros Herreros, Barbara Wanjiru Citarella, Anna Ciullo, Jennifer Clarke, Sara Clohisey, Cassidy Codan, Caitriona Cody, Alexandra Coelho, Gwenhaël Colin, Michael Collins, Sebastiano Maria Colombo, Pamela Combs, JP Connelly, Marie Connor, Anne Conrad, Sofía Contreras, Graham S. Cooke, Mary Copland, Hugues Cordel, Amanda Corley, Sarah Cormican, Sabine Cornelis, Arianne Joy Corpuz, Grégory Corvaisier, Camille Couffignal, Sandrine Couffin-Cadiergues, Roxane Courtois, Charles Crepy D’Orleans, Sabine Croonen, Gloria Crowl, Jonathan Crump, Claudina Cruz, Marc Csete, Alberto Cucino, Caroline Cullen, Matthew Cummings, Gerard Curley, Elodie Curlier, Paula Custodio, Frédérick D’Aragon, Ana Da Silva Filipe, Charlene Da Silveira, Eric D’Ortenzio, Al-Awwab Dabaliz, Andrew B. Dagens, Heidi Dalton, Jo Dalton, Nick Daneman, Emmanuelle A. Dankwa, Jorge Dantas, Nathalie De Castro, Diego De Mendoza, Rafael Freitas De Oliveira França, Rosanna De Rosa, Thushan De Silva, Peter De Vries, David Dean, Marie-Pierre Debray, William Dechert, Lauren Deconninck, Romain Decours, Isabelle Delacroix, Karen Delavigne, Ionna Deligiannis, Andrea Dell’amore, Pierre Delobel, Elisa Demonchy, Emmanuelle Denis, Dominique Deplanque, Dominique Deplanque, Pieter Depuydt, Mehul Desai, Diane Descamps, Mathilde Desvallée, Santi Rahayu Dewayanti, Alpha Diallo, Sylvain Diamantis, André Dias, Juan Jose Diaz Diaz, Rodrigo Diaz, Kévin Didier, Jean-Luc Diehl, Wim Dieperink, Jérôme Dimet, Vincent Dinot, Alphonsine Diouf, Yael Dishon, Félix Djossou, Annemarie B. Docherty, Andy Dong, Christl A. Donnelly, Maria Donnelly, Chloe Donohue, Céline Dorival, James Joshua Douglas, Renee Douma, Nathalie Dournon, Triona Downer, Mark Downing, Tom Drake, Vincent Dubee, François Dubos, Alexandra Ducancelle, Susanne Dudman, Jake Dunning, Emanuele Durante Mangoni, Silvia Duranti, Lucian Durham III, Bertrand Dussol, Xavier Duval, Anne Margarita Dyrhol-Riise, Carla Eira, José Ernesto Vidal, Mohammed El Sanharawi, Subbarao Elapavaluru, Brigitte Elharrar, Natalie Elkheir, Jacobien Ellerbroek, Rachael Ellis, Philippine Eloy, Tarek Elshazly, Isabelle Enderle, Ilka Engelmann, Vincent Enouf, Olivier Epaulard, Mariano Esperatti, Hélène Esperou, Marina Esposito-Farese, João Estevão, Manuel Etienne, Manuel Etienne, Nadia Ettalhaoui, Anna Greti Everding, Mirjam Evers, Isabelle Fabre, Amna Faheem, Arabella Fahy, Cameron J. Fairfield, Pedro Faria, Nataly Farshait, Arie Zainul Fatoni, Karine Faure, Mohamed Fayed, Niamh Feely, Jorge Fernandes, Marília Fernandes, Susana Fernandes, Joana Ferrão, Eglantine Ferrand Devouge, Mário Ferraz, Benigno Ferreira, Ricard Ferrer-Roca, Claudia Figueiredo-Mello, Clara Flateau, Tom Fletcher, Letizia Lucia Florio, Claire Foley, Victor Fomin, Claudio Duarte Fonseca, Tatiana Fonseca, Patricia Fontela, Simon Forsyth, Giuseppe Foti, Erwan Fourn, Rob Fowler, Diego Franch-Llasat, Christophe Fraser, John Fraser, Marcela Vieira Freire, Ana Freitas Ribeiro, Caren Friedrich, Stéphane Fry, Nora Fuentes, Masahiro Fukuda, Joan Gómez-Junyent, Valérie Gaborieau, Benoît Gachet, Rostane Gaci, Massimo Gagliardi, Jean-Charles Gagnard, Amandine Gagneux-Brunon, Sérgio Gaião, Phil Gallagher, Elena Gallego Curto, Carrol Gamble, Arthur Garan, Esteban Garcia-Gallo, Rebekha Garcia, Denis Garot, Valérie Garrait, Nathalie Gault, Aisling Gavin, Alexandre Gaymard, Johannes Gebauer, Louis Gerbaud Morlaes, Nuno Germano, Jade Ghosn, Marco Giani, Carlo Giaquinto, Jess Gibson, Tristan Gigante, Morgane Gilg, Guillermo Giordano, Michelle Girvan, Valérie Gissot, Gezy Giwangkancana, Daniel Glikman, Petr Glybochko, Eric Gnall, Geraldine Goco, François Goehringer, Siri Goepel, Jean-Christophe Goffard, Jonathan Golob, Isabelle Gorenne, Cécile Goujard, Tiphaine Goulenok, Margarite Grable, Edward Wilson Grandin, Pascal Granier, Giacomo Grasselli, Christopher A. Green, William Greenhalf, Segolène Greffe, Domenico Luca Grieco, Matthew Griffee, Fiona Griffiths, Ioana Grigoras, Albert Groenendijk, Anja Grosse Lordemann, Heidi Gruner, Yusing Gu, Jérémie Guedj, Dewi Guellec, Anne-Marie Guerguerian, Daniela Guerreiro, Romain Guery, Anne Guillaumot, Laurent Guilleminault, Thomas Guimard, Daniel Haber, Sheeba Hakak, Matthew Hall, Sophie Halpin, Ansley Hamer, Rebecca Hamidfar, Terese Hammond, Hayley Hardwick, Kristen Harley, Ewen M. Harrison, Janet Harrison, Leanne Hays, Jan Heerman, Lars Heggelund, Ross Hendry, Martina Hennessy, Aquiles Henriquez-Trujillo, Maxime Hentzien, Jaime Hernandez-Montfort, Astarini Hidayah, Dawn Higgins, Eibhilin Higgins, Samuel Hinton, Ana Hipólito -Reis, Hiroaki Hiraiwa, Julian A. Hiscox, Antonia Ying Wai Ho, Alexandre Hoctin, Isabelle Hoffmann, Oscar Hoiting, Rebecca Holt, Jan Cato Holter, Peter Horby, Juan Pablo Horcajada, Koji Hoshino, Kota Hoshino, Catherine L. Hough, Jimmy Ming-Yang Hsu, Jean-Sébastien Hulot, Samreen Ijaz, Hajnal-Gabriela Illes, Hugo Inácio, Carmen Infante Dominguez, Elias Iosifidis, Lacey Irvine, Sarah Isgett, Tiago Isidoro, Margaux Isnard, Junji Itai, Daniel Ivulich, Salma Jaafoura, Julien Jabot, Clare Jackson, Nina Jamieson, Stéphane Jaureguiberry, Jeffrey Javidfar, Zabbe Jean-Benoît, Florence Jego, Synne Jenum, Ruth Jimbo Sotomayor, Ruth Noemí Jorge GarcÍa, Cédric Joseph, Mark Joseph, Philippe Jouvet, Hanna Jung, Ouifiya Kafif, Florentia Kaguelidou, Sabina Kali, Smaragdi Kalomoiri, Darshana Hewa Kandamby, Chris Kandel, Ravi Kant, Christiana Kartsonaki, Daisuke Kasugai, Kevin Katz, Simreen Kaur Johal, Sean Keating, Andrea Kelly, Sadie Kelly, Lisa Kennedy, Kalynn Kennon, Younes Kerroumi, Evelyne Kestelyn, Imrana Khalid, Antoine Khalil, Coralie Khan, Irfan Khan, Michelle E Kho, Saye Khoo, Yuri Kida, Peter Kiiza, Anders Benjamin Kildal, Antoine Kimmoun, Detlef Kindgen-Milles, Nobuya Kitamura, Paul Klenerman, Gry Kloumann Bekken, Stephen Knight, Robin Kobbe, Malte Kohns Vasconcelos, Volkan Korten, Caroline Kosgei, Karolina Krawczyk, Pavan Kumar Vecham, Deepali Kumar, Ethan Kurtzman, Demetrios Kutsogiannis, Konstantinos Kyriakoulis, Erwan L’her, Marie Lachatre, Marie Lacoste, John G Laffey, Marie Lagrange, Fabrice Laine, Marc Lambert, François Lamontagne, Marie Langelot-Richard, Eka Yudha Lantang, Marina Lanza, Cédric Laouénan, Samira Laribi, Delphine Lariviere, Odile Launay, Yoan Lavie-Badie, Andrew Law, Clément Le Bihan, Cyril Le Bris, Eve Le Coustumier, Georges Le Falher, Sylvie Le Gac, Quentin Le Hingrat, Marion Le Maréchal, Soizic Le Mestre, Vincent Le Moing, Hervé Le Nagard, Paul Le Turnier, Rafael León, Minh Le, Marta Leal Santos, Ema Leal, James Lee, Su Hwan Lee, Todd Lee, Gary Leeming, Bénédicte Lefebvre, Laurent Lefebvre, Benjamin Lefevre, François Lellouche, Adrien Lemaignen, Véronique Lemee, Gretchen Lemmink, Michela Leone, Quentin Lepiller, François-Xavier Lescure, Olivier Lesens, Mathieu Lesouhaitier, Claire Levy-Marchal, Bruno Levy, Yves Levy, Gianluigi Li Bassi, Janet Liang, Wei Shen Lim, Bruno Lina, Andreas Lind, Guillaume Lingas, Sylvie Lion-Daolio, Keibun Liu, Antonio Loforte, Navy Lolong, Diogo Lopes, Dalia Lopez-Colon, Paul Loubet, Jean Christophe Lucet, Carlos M. Luna, Olguta Lungu, Liem Luong, Dominique Luton, Ruth Lyons, Fredrik Müller, Karl Erik Müller, Olavi Maasikas, Sarah Macdonald, Moïse Machado, Gabrielle Macheda, Juan Macias Sanchez, Jai Madhok, Rafael Mahieu, Sophie Mahy, Lars Siegfrid Maier, Mylène Maillet, Thomas Maitre, Maximilian Malfertheiner, Nadia Malik, Fernando Maltez, Denis Malvy, Marina Mambert, Victoria Manda, Jose M. Mandei, Edmund Manning, Aldric Manuel, Ceila Maria SantÀna Malaque, Flávio Marino, Carolline De Araújo Mariz, Charbel Maroun Eid, Ana Marques, Catherine Marquis, Brian Marsh, Laura Marsh, John Marshall, Celina Turchi Martelli, Guillaume Martin-Blondel, Ignacio Martin-Loeches, Alejandro Martin-Quiros, Dori-Ann Martin, Emily Martin, Martin Martinot, Caroline Martins Rego, Ana Martins, João Martins, Gennaro Martucci, Eva Miranda Marwali, Juan Fernado Masa Jimenez, David Maslove, Sabina Mason, Moshe Matan, Daniel Mathieu, Mathieu Mattei, Romans Matulevics, Laurence Maulin, Natalie Mc Evoy, Aine McCarthy, Anne McCarthy, Colin McCloskey, Rachael McConnochie, Sherry McDermott, Sarah McDonald, Samuel McElwee, Natalie McEvoy, Allison McGeer, Niki McGuinness, Kenneth A. McLean, Bairbre McNicholas, Edel Meaney, Cécile Mear-Passard, Maggie Mechlin, Ferruccio Mele, Kusum Menon, France Mentré, Alexander J. Mentzer, Noémie Mercier, Antoine Merckx, Blake Mergler, Laura Merson, António Mesquita, Agnès Meybeck, Alison M. Meynert, Vanina Meyssonnier, Amina Meziane, Medhi Mezidi, Céline Michelanglei, Vladislav Mihnovitš, Hugo Miranda Maldonado, Mary Mone, Asma Moin, David Molina, Elena Molinos, Agostinho Monteiro, Claudia Montes, Giorgia Montrucchio, Sarah Moore, Shona C. Moore, Lina Morales-Cely, Lucia Moro, Diego Rolando Morocho Tutillo, Ana Motos, Hugo Mouquet, Clara Mouton Perrot, Julien Moyet, Jimmy Mullaert, Daniel Munblit, Derek Murphy, Marlène Murris, Dimitra Melia Myrodia, Yohan N’guyen, Nadège Neant, Holger Neb, Nikita A Nekliudov, Raul Neto, Emily Neumann, Bernardo Neves, Pauline Yeung Ng, Wing Yiu Ng, Orna Ni Choileain, Alistair Nichol, Stephanie Nonas, Marion Noret, Lisa Norman, Alessandra Notari, Mahdad Noursadeghi, Karolina Nowicka, Saad Nseir, Jose I Nunez, Elsa Nyamankolly, Max O’Donnell, Katie O’Hearn, Conar O’Neil, Giovanna Occhipinti, Tawnya Ogston, Takayuki Ogura, Tak-Hyuk Oh, Shinichiro Ohshimo, Budha Charan Singh Oinam, Ana Pinho Oliveira, João Oliveira, Piero Olliaro, David S. Y. Ong, Wilna Oosthuyzen, Peter J.M. Openshaw, Claudia Milena Orozco-Chamorro, Andrés Orquera, Javier Osatnik, Nadia Ouamara, Rachida Ouissa, Clark Owyang, Eric Oziol, Diana Póvoas, Maïder Pagadoy, Justine Pages, Mario Palacios, Massimo Palmarini, Giovanna Panarello, Prasan Kumar Panda, Mauro Panigada, Nathalie Pansu, Aurélie Papadopoulos, Briseida Parra, Jérémie Pasquier, Fabian Patauner, Luís Patrão, Christelle Paul, Mical Paul, Jorge Paulos, William A. Paxton, Jean-François Payen, India Pearse, Giles J Peek, Florent Peelman, Nathan Peiffer-Smadja, Vincent Peigne, Mare Pejkovska, Ithan D. Peltan, Rui Pereira, Daniel Perez, Thomas Perpoint, Antonio Pesenti, Lenka Petroušová, Ventzislava Petrov-Sanchez, Gilles Peytavin, Scott Pharand, Michael Piagnerelli, Walter Picard, Olivier Picone, Marie Piel-Julian, Carola Pierobon, Carlos Pimentel, Lionel Piroth, Riinu Pius, Simone Piva, Laurent Plantier, Daniel Plotkin, Julien Poissy, Maria Pokorska-Spiewak, Sergio Poli, Georgios Pollakis, Jolanta Popielska, Douwe F. Postma, Pedro Povoa, Jeff Powis, Sofia Prapa, Christian Prebensen, Jean-Charles Preiser, Vincent Prestre, Nicholas Price, Anton Prinssen, Mark G. Pritchard, Lúcia Proença, Oriane Puéchal, Gregory Purcell, Luisa Quesada, Else Quist-Paulsen, Mohammed Quraishi, Indrek Rätsep, Bernhard Rössler, Christian Rabaud, Marie Rafiq, Gabrielle Ragazzo, Fernando Rainieri, Nagarajan Ramakrishnan, Kollengode Ramanathan, Blandine Rammaert, Christophe Rapp, Menaldi Rasmin, Cornelius Rau, Stanislas Rebaudet, Sarah Redl, Brenda Reeve, Liadain Reid, Renato Reis, Jonathan Remppis, Martine Remy, Hanna Renk, Liliana Resende, Anne-Sophie Resseguier, Matthieu Revest, Oleksa Rewa, Luis Felipe Reyes, David Richardson, Denise Richardson, Laurent Richier, Jordi Riera, Ana Lúcia Rios, Asgar Rishu, Patrick Rispal, Karine Risso, Maria Angelica Rivera Nuñez, Nicholas Rizer, André Roberto, Stephanie Roberts, David L. Robertson, Olivier Robineau, Ferran Roche-Campo, Paola Rodari, Simão Rodeia, Julia Rodriguez Abreu, Emmanuel Roilides, Amanda Rojek, Juliette Romaru, Roberto Roncon-Albuquerque Jr, Mélanie Roriz, Manuel Rosa-Calatrava, Michael Rose, Dorothea Rosenberger, Andrea Rossanese, Bénédicte Rossignol, Patrick Rossignol, Carine Roy, Benoît Roze, Clark D. Russell, Steffi Ryckaert, Aleksander Rygh Holten, Xavier Sánchez Choez, Isabela Saba, Musharaf Sadat, Nadia Saidani, Leonardo Salazar, Gabriele Sales, Stéphane Sallaberry, Hélène Salvator, Angel Sanchez-Miralles, Olivier Sanchez, Vanessa Sancho-Shimizu, Gyan Sandhu, Oana Sandulescu, Marlene Santos, Shirley Sarfo-Mensah, Benjamine Sarton, Egle Saviciute, Parthena Savvidou, Joshua Scarsbrook, Tjard Schermer, Arnaud Scherpereel, Marion Schneider, Stephan Schroll, Michael Schwameis, James Scott-Brown, Janet T. Scott, Nicholas Sedillot, Tamara Seitz, Caroline Semaille, Malcolm G. Semple, Eric Senneville, Filipa Sequeira, Tânia Sequeira, Ellen Shadowitz, Mohammad Shamsah, Pratima Sharma, Catherine A. Shaw, Victoria Shaw, Nisreen Shiban, Nobuaki Shime, Hiroaki Shimizu, Keiki Shimizu, Sally Shrapnel, Hoi Ping Shum, Nassima Si Mohammed, Louise Sigfrid, Catarina Silva, Maria Joao Silva, Wai Ching Sin, Vegard Skogen, Sue Smith, Benjamin Smood, Michelle Smyth, Morgane Snacken, Dominic So, Monserrat Solis, Joshua Solomon, Tom Solomon, Emily Somers, Agnès Sommet, Myung Jin Song, Rima Song, Tae Song, Michael Sonntagbauer, Edouard Soum, Maria Sousa Uva, Marta Sousa, Vicente Souza-Dantas, Alexandra Sperry, Shiranee Sriskandan, Thomas Staudinger, Stephanie-Susanne Stecher, Ymkje Stienstra, Birgitte Stiksrud, Adrian Streinu-Cercel, Anca Streinu-Cercel, Samantha Strudwick, Ami Stuart, David Stuart, Asfia Sultana, Charlotte Summers, Magdalena Surovcová Andrey A Svistunov, Konstantinos Syrigos, Jaques Sztajnbok, Konstanty Szuldrzynski, François Téoulé, Shirin Tabrizi, Lysa Tagherset, Ewa Talarek, Sara Taleb, Jelmer Talsma, Le Van Tan, Hiroyuki Tanaka, Taku Tanaka, Hayato Taniguchi, Coralie Tardivon, Pierre Tattevin, M Azhari Taufik, Richard S. Tedder, João Teixeira, Marie-Capucine Tellier, Pleun Terpstra, Olivier Terrier, Nicolas Terzi, Hubert Tessier-Grenier, Vincent Thibault, Simon-Djamel Thiberville, Benoît Thill, A.A. Roger Thompson, Shaun Thompson, David Thomson, Emma C. Thomson, Duong Bich Thuy, Ryan S. Thwaites, Peter S. Timashev, Jean-François Timsit, Bharath Kumar Tirupakuzhi Vijayaraghavan, Maria Toki, Kristian Tonby, Rosario Maria Torres Santos-Olmo, Antoni Torres, Margarida Torres, Théo Trioux, Huynh Trung Trieu, Cécile Tromeur, Ioannis Trontzas, Jonathan Troost, Tiffany Trouillon, Christelle Tual, Sarah Tubiana, Helen Tuite, Lance C.W. Turtle, Pawel Twardowski, Makoto Uchiyama, Roman Ullrich, Alberto Uribe, Asad Usman, Luís Val-Flores, Stijn Van De Velde, Marcel Van Den Berge, Machteld Van Der Feltz, Nicky Van Der Vekens, Peter Van Der Voort, Sylvie Van Der Werf, Marlice Van Dyk, Laura Van Gulik, Jarne Van Hattem, Steven Van Lelyveld, Carolien Van Netten, Noémie Vanel, Henk Vanoverschelde, Charline Vauchy, Aurélie Veislinger, Jorge Velazco, Sara Ventura, Annelies Verbon, César Vieira, Joy Ann Villanueva, Judit Villar, Pierre-Marc Villeneuve, Andrea Villoldo, Nguyen Van Vinh Chau, Benoit Visseaux, Hannah Visser, Aapeli Vuorinen, Fanny Vuotto, Chih-Hsien Wang, Jia Wei, Katharina Weil, Sanne Wesselius, Murray Wham, Bryan Whelan, Nicole White, Aurélie Wiedemann, Keith Wille, Evert-Jan Wils, Ioannis Xynogalas, Jacky Y Suen, Sophie Yacoub, Masaki Yamazaki, Yazdan Yazdanpanah, Cécile Yelnik, Stephanie Yerkovich, Toshiki Yokoyama, Hodane Yonis, Paul Young, Saptadi Yuliarto, Marion Zabbe, Kai Zacharowski, Maram Zahran, Maria Zambon, Alberto Zanella, Konrad Zawadka, Hiba Zayyad, Alexander Zoufaly, David Zucman; The PETAL Network Investigators, The Western Australian Covid-19 Research Response.

Correspondence to: Dr Mark G Pritchard, Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK, Tel: 07973163696, mark.pritchard@ 123456ndm.ox.ac.uk , ORCID http://orcid.org/0000-0003-1726-8989

Article

DOI: 10.1101/2020.10.26.20219519

PMC ID: 7605573

PubMed ID: 33140062

SO-VID: c4064572-186f-433a-bd6d-3d6d6c3ba5cc

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Novel Coronavirus Disease COVID-19

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