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Frailty and Mortality in Hospitalized Older Adults With COVID-19: Retrospective Observational Study
OBJECTIVES: To determine the association between frailty and short-term mortality in older adults hospitalized for coronavirus disease 2019 (COVID-19). DESIGN: Retrospective single-center observational study. SETTING AND PARTICIPANTS: Eighty-one patients with COVID-19 confirmed by reverse-transcript...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
AMDA - The Society for Post-Acute and Long-Term Care Medicine.
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7280137/ https://www.ncbi.nlm.nih.gov/pubmed/32674821 http://dx.doi.org/10.1016/j.jamda.2020.06.008 |
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author | De Smet, Robert Mellaerts, Bea Vandewinckele, Hannelore Lybeert, Peter Frans, Eric Ombelet, Sara Lemahieu, Wim Symons, Rolf Ho, Erwin Frans, Johan Smismans, Annick Laurent, Michaël R. |
author_facet | De Smet, Robert Mellaerts, Bea Vandewinckele, Hannelore Lybeert, Peter Frans, Eric Ombelet, Sara Lemahieu, Wim Symons, Rolf Ho, Erwin Frans, Johan Smismans, Annick Laurent, Michaël R. |
author_sort | De Smet, Robert |
collection | PubMed |
description | OBJECTIVES: To determine the association between frailty and short-term mortality in older adults hospitalized for coronavirus disease 2019 (COVID-19). DESIGN: Retrospective single-center observational study. SETTING AND PARTICIPANTS: Eighty-one patients with COVID-19 confirmed by reverse-transcriptase polymerase chain reaction (RT-PCR), at the Geriatrics department of a general hospital in Belgium. MEASUREMENTS: Frailty was graded according to the Rockwood Clinical Frailty Scale (CFS). Demographic, biochemical, and radiologic variables, comorbidities, symptoms, and treatment were extracted from electronic medical records. RESULTS: Participants (N = 48 women, 59%) had a median age of 85 years (range 65-97 years) and a median CFS score of 7 (range 2-9); 42 (52%) were long-term care residents. Within 6 weeks, 18 patients died. Mortality was significantly but weakly associated with age (Spearman r = 0.241, P = .03) and CFS score (r = 0.282, P = .011), baseline lactate dehydrogenase (LDH; r = 0.301, P = .009), lymphocyte count (r = −0.262, P = .02), and RT-PCR cycle threshold (Ct, r = −0.285, P = .015). Mortality was not associated with long-term care residence, dementia, delirium, or polypharmacy. In multivariable logistic regression analyses, CFS, LDH, and RT-PCR Ct (but not age) remained independently associated with mortality. Both age and frailty had poor specificity to predict survival. A multivariable model combining age, CFS, LDH, and viral load significantly predicted survival. CONCLUSIONS AND IMPLICATIONS: Although their prognosis is worse, even the oldest and most severely frail patients may benefit from hospitalization for COVID-19, if sufficient resources are available. |
format | Online Article Text |
id | pubmed-7280137 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | AMDA - The Society for Post-Acute and Long-Term Care Medicine. |
record_format | MEDLINE/PubMed |
spelling | pubmed-72801372020-06-09 Frailty and Mortality in Hospitalized Older Adults With COVID-19: Retrospective Observational Study De Smet, Robert Mellaerts, Bea Vandewinckele, Hannelore Lybeert, Peter Frans, Eric Ombelet, Sara Lemahieu, Wim Symons, Rolf Ho, Erwin Frans, Johan Smismans, Annick Laurent, Michaël R. J Am Med Dir Assoc Original Study - Brief Report OBJECTIVES: To determine the association between frailty and short-term mortality in older adults hospitalized for coronavirus disease 2019 (COVID-19). DESIGN: Retrospective single-center observational study. SETTING AND PARTICIPANTS: Eighty-one patients with COVID-19 confirmed by reverse-transcriptase polymerase chain reaction (RT-PCR), at the Geriatrics department of a general hospital in Belgium. MEASUREMENTS: Frailty was graded according to the Rockwood Clinical Frailty Scale (CFS). Demographic, biochemical, and radiologic variables, comorbidities, symptoms, and treatment were extracted from electronic medical records. RESULTS: Participants (N = 48 women, 59%) had a median age of 85 years (range 65-97 years) and a median CFS score of 7 (range 2-9); 42 (52%) were long-term care residents. Within 6 weeks, 18 patients died. Mortality was significantly but weakly associated with age (Spearman r = 0.241, P = .03) and CFS score (r = 0.282, P = .011), baseline lactate dehydrogenase (LDH; r = 0.301, P = .009), lymphocyte count (r = −0.262, P = .02), and RT-PCR cycle threshold (Ct, r = −0.285, P = .015). Mortality was not associated with long-term care residence, dementia, delirium, or polypharmacy. In multivariable logistic regression analyses, CFS, LDH, and RT-PCR Ct (but not age) remained independently associated with mortality. Both age and frailty had poor specificity to predict survival. A multivariable model combining age, CFS, LDH, and viral load significantly predicted survival. CONCLUSIONS AND IMPLICATIONS: Although their prognosis is worse, even the oldest and most severely frail patients may benefit from hospitalization for COVID-19, if sufficient resources are available. AMDA - The Society for Post-Acute and Long-Term Care Medicine. 2020-07 2020-06-09 /pmc/articles/PMC7280137/ /pubmed/32674821 http://dx.doi.org/10.1016/j.jamda.2020.06.008 Text en © 2020 AMDA - The Society for Post-Acute and Long-Term Care Medicine. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. |
spellingShingle | Original Study - Brief Report De Smet, Robert Mellaerts, Bea Vandewinckele, Hannelore Lybeert, Peter Frans, Eric Ombelet, Sara Lemahieu, Wim Symons, Rolf Ho, Erwin Frans, Johan Smismans, Annick Laurent, Michaël R. Frailty and Mortality in Hospitalized Older Adults With COVID-19: Retrospective Observational Study |
title | Frailty and Mortality in Hospitalized Older Adults With COVID-19: Retrospective Observational Study |
title_full | Frailty and Mortality in Hospitalized Older Adults With COVID-19: Retrospective Observational Study |
title_fullStr | Frailty and Mortality in Hospitalized Older Adults With COVID-19: Retrospective Observational Study |
title_full_unstemmed | Frailty and Mortality in Hospitalized Older Adults With COVID-19: Retrospective Observational Study |
title_short | Frailty and Mortality in Hospitalized Older Adults With COVID-19: Retrospective Observational Study |
title_sort | frailty and mortality in hospitalized older adults with covid-19: retrospective observational study |
topic | Original Study - Brief Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7280137/ https://www.ncbi.nlm.nih.gov/pubmed/32674821 http://dx.doi.org/10.1016/j.jamda.2020.06.008 |
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