Age and frailty are independently associated with increased COVID-19 mortality and increased care needs in survivors: results of an international multi-centre study

Geriatric Medicine Research Collaborative, et al. (2021) Age and frailty are independently associated with increased COVID-19 mortality and increased care needs in survivors: results of an international multi-centre study. Age and Ageing, 50(3), pp. 617-630. (doi: 10.1093/ageing/afab026) (PMID:33543243) (PMCID:PMC7929433)

Abstract

Introduction: Increased mortality has been demonstrated in older adults with COVID-19, but the effect of frailty has been unclear. Methods: This multi-centre cohort study involved patients aged 18 years and older hospitalised with COVID-19, using routinely collected data. We used Cox regression analysis to assess the impact of age, frailty, and delirium on the risk of inpatient mortality, adjusting for sex, illness severity, inflammation, and co-morbidities. We used ordinal logistic regression analysis to assess the impact of age, Clinical Frailty Scale (CFS), and delirium on risk of increased care requirements on discharge, adjusting for the same variables. Results: Data from 5,711 patients from 55 hospitals in 12 countries were included (median age 74, IQR 54–83; 55.2% male). The risk of death increased independently with increasing age (>80 vs 18–49: HR 3.57, CI 2.54–5.02), frailty (CFS 8 vs 1–3: HR 3.03, CI 2.29–4.00) inflammation, renal disease, cardiovascular disease, and cancer, but not delirium. Age, frailty (CFS 7 vs 1–3: OR 7.00, CI 5.27–9.32), delirium, dementia, and mental health diagnoses were all associated with increased risk of higher care needs on discharge. The likelihood of adverse outcomes increased across all grades of CFS from 4 to 9. Conclusions: Age and frailty are independently associated with adverse outcomes in COVID-19. Risk of increased care needs was also increased in survivors of COVID-19 with frailty or older age.

• Item Type: Articles
• Additional Information: The Geriatric Medicine Research Collaborative has previously received funding from the British Geriatrics Society for administrative and running costs. No project specific funding was obtained for this research. MW and SR acknowledge support from the NIHR Newcastle Biomedical Research Centre.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Burton, Dr Jenni and Quinn, Professor Terry
• Authors: Geriatric Medicine Research Collaborative, , Alsahab, M., Beishon, L., Brown, B., Burn, E., Burton, J. K., Cox, N., Dani, M., Elhadi, M., Freshwater, S., Gaunt, V., Gordon, A., Goujon, M., Hale, M., Hughes, T., Jackson, T. A., Jelley, B., Khan, A., Khiroya, H., Lal, R., Madden, K., Magill, L., Masoli, J., Masud, T., McCluskey, L., McNeela, N., Mohammedseid-Nurhussien, A., Moorey, H., Lochlainn, M. N., Nirantharakumar, K., Okoth, K., Osuafor, C. N., Patterson, K., Pearson, G. M.E., Perry, R., Pettitt, M., Pigott, J., Pinkney, T., Quinn, T., Reynolds, A., Richardson, S., Sanyal, N., Seed, A., Sleeman, I., Soo, C., Steves, C., Strain, W. D., Taylor, J., Torsney, K., Welch, C., Wilson, D., and Witham, M.
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
• Journal Name: Age and Ageing
• Publisher: Oxford University Press
• ISSN: 0002-0729
• ISSN (Online): 1468-2834
• Published Online: 05 February 2021
• Copyright Holders: Copyright © 2021 The Authors
• First Published: First published in Age and Ageing 50(3): 617-630
• Publisher Policy: Reproduced under a Creative Commons License