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.

Maternal depression has consistently demonstrated reliability as a predictor of major depression in children. However, the effect of gender as a potential moderator remains under-researched. This study examined gender differences in depression and hypothesized that maternal depression would be more greatly associated with depression in girls by early adolescence. A representative sample of 7237 participants from the Growing Up in Ireland national longitudinal study of Irish children was examined across two waves when participants were aged 9 and 13. Separate multiple regression analyses were run for girls and boys to ascertain if maternal depression and other key variables predicted child depression by age 13. A third analysis looked at the effect of gender. Maternal depression when the children were aged 9 was found predictive of depressive symptomology by age 13 in girls but not for boys.Additionally, conflict with caregivers, household income, and bullying were significant predictors for both genders.Gender significantly predicted youth depression when the child was female (R² = .13, ƒ 2 = .25). These findings indicate that late childhood to early adolescence is a vulnerable period for girls during which they appear more

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