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Comparison of two different frailty measurements and risk of hospitalisation or death from COVID-19: findings from UK Biobank

BACKGROUND: Frailty has been associated with worse prognosis following COVID-19 infection. While several studies have reported the association between frailty and COVID-19 mortality or length of hospital stay, there have been no community-based studies on the association between frailty and risk of...

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Autores principales: Petermann-Rocha, Fanny, Hanlon, Peter, Gray, Stuart R., Welsh, Paul, Gill, Jason M. R., Foster, Hamish, Katikireddi, S. Vittal, Lyall, Donald, Mackay, Daniel F., O’Donnell, Catherine A., Sattar, Naveed, Nicholl, Barbara I., Pell, Jill P., Jani, Bhautesh D., Ho, Frederick K., Mair, Frances S., Celis-Morales, Carlos
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7652674/
https://www.ncbi.nlm.nih.gov/pubmed/33167965
http://dx.doi.org/10.1186/s12916-020-01822-4
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author Petermann-Rocha, Fanny
Hanlon, Peter
Gray, Stuart R.
Welsh, Paul
Gill, Jason M. R.
Foster, Hamish
Katikireddi, S. Vittal
Lyall, Donald
Mackay, Daniel F.
O’Donnell, Catherine A.
Sattar, Naveed
Nicholl, Barbara I.
Pell, Jill P.
Jani, Bhautesh D.
Ho, Frederick K.
Mair, Frances S.
Celis-Morales, Carlos
author_facet Petermann-Rocha, Fanny
Hanlon, Peter
Gray, Stuart R.
Welsh, Paul
Gill, Jason M. R.
Foster, Hamish
Katikireddi, S. Vittal
Lyall, Donald
Mackay, Daniel F.
O’Donnell, Catherine A.
Sattar, Naveed
Nicholl, Barbara I.
Pell, Jill P.
Jani, Bhautesh D.
Ho, Frederick K.
Mair, Frances S.
Celis-Morales, Carlos
author_sort Petermann-Rocha, Fanny
collection PubMed
description BACKGROUND: Frailty has been associated with worse prognosis following COVID-19 infection. While several studies have reported the association between frailty and COVID-19 mortality or length of hospital stay, there have been no community-based studies on the association between frailty and risk of severe infection. Considering that different definitions have been identified to assess frailty, this study aimed to compare the association between frailty and severe COVID-19 infection in UK Biobank using two frailty classifications: the frailty phenotype and the frailty index. METHODS: A total of 383,845 UK Biobank participants recruited 2006–2010 in England (211,310 [55.1%] women, baseline age 37–73 years) were included. COVID-19 test data were provided by Public Health England (available up to 28 June 2020). An adapted version of the frailty phenotype derived by Fried et al. was used to define frailty phenotype (robust, pre-frail, or frail). A previously validated frailty index was derived from 49 self-reported questionnaire items related to health, disease and disability, and mental wellbeing (robust, mild frailty, and moderate/severe frailty). Both classifications were derived from baseline data (2006–2010). Poisson regression models with robust standard errors were used to analyse the associations between both frailty classifications and severe COVID-19 infection (resulting in hospital admission or death), adjusted for sociodemographic and lifestyle factors. RESULTS: Of UK Biobank participants included, 802 were admitted to hospital with and/or died from COVID19 (323 deaths and 479 hospitalisations). After analyses were adjusted for sociodemographic and lifestyle factors, a higher risk of COVID-19 was observed for pre-frail (risk ratio (RR) 1.47 [95% CI 1.26; 1.71]) and frail (RR 2.66 [95% CI 2.04; 3.47]) individuals compared to those classified as robust using the frailty phenotype. Similar results were observed when the frailty index was used (RR mildly frail 1.46 [95% CI 1.26; 1.71] and RR moderate/severe frailty 2.43 [95% CI 1.91; 3.10]). CONCLUSIONS: Frailty was associated with a higher risk of severe COVID-19 infection resulting in hospital admission or death, irrespective of how it was measured and independent of sociodemographic and lifestyle factors. Public health strategies need to consider the additional risk that COVID-19 poses in individuals with frailty, including which additional preventive measures might be required.
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spelling pubmed-76526742020-11-10 Comparison of two different frailty measurements and risk of hospitalisation or death from COVID-19: findings from UK Biobank Petermann-Rocha, Fanny Hanlon, Peter Gray, Stuart R. Welsh, Paul Gill, Jason M. R. Foster, Hamish Katikireddi, S. Vittal Lyall, Donald Mackay, Daniel F. O’Donnell, Catherine A. Sattar, Naveed Nicholl, Barbara I. Pell, Jill P. Jani, Bhautesh D. Ho, Frederick K. Mair, Frances S. Celis-Morales, Carlos BMC Med Research Article BACKGROUND: Frailty has been associated with worse prognosis following COVID-19 infection. While several studies have reported the association between frailty and COVID-19 mortality or length of hospital stay, there have been no community-based studies on the association between frailty and risk of severe infection. Considering that different definitions have been identified to assess frailty, this study aimed to compare the association between frailty and severe COVID-19 infection in UK Biobank using two frailty classifications: the frailty phenotype and the frailty index. METHODS: A total of 383,845 UK Biobank participants recruited 2006–2010 in England (211,310 [55.1%] women, baseline age 37–73 years) were included. COVID-19 test data were provided by Public Health England (available up to 28 June 2020). An adapted version of the frailty phenotype derived by Fried et al. was used to define frailty phenotype (robust, pre-frail, or frail). A previously validated frailty index was derived from 49 self-reported questionnaire items related to health, disease and disability, and mental wellbeing (robust, mild frailty, and moderate/severe frailty). Both classifications were derived from baseline data (2006–2010). Poisson regression models with robust standard errors were used to analyse the associations between both frailty classifications and severe COVID-19 infection (resulting in hospital admission or death), adjusted for sociodemographic and lifestyle factors. RESULTS: Of UK Biobank participants included, 802 were admitted to hospital with and/or died from COVID19 (323 deaths and 479 hospitalisations). After analyses were adjusted for sociodemographic and lifestyle factors, a higher risk of COVID-19 was observed for pre-frail (risk ratio (RR) 1.47 [95% CI 1.26; 1.71]) and frail (RR 2.66 [95% CI 2.04; 3.47]) individuals compared to those classified as robust using the frailty phenotype. Similar results were observed when the frailty index was used (RR mildly frail 1.46 [95% CI 1.26; 1.71] and RR moderate/severe frailty 2.43 [95% CI 1.91; 3.10]). CONCLUSIONS: Frailty was associated with a higher risk of severe COVID-19 infection resulting in hospital admission or death, irrespective of how it was measured and independent of sociodemographic and lifestyle factors. Public health strategies need to consider the additional risk that COVID-19 poses in individuals with frailty, including which additional preventive measures might be required. BioMed Central 2020-11-10 /pmc/articles/PMC7652674/ /pubmed/33167965 http://dx.doi.org/10.1186/s12916-020-01822-4 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Petermann-Rocha, Fanny
Hanlon, Peter
Gray, Stuart R.
Welsh, Paul
Gill, Jason M. R.
Foster, Hamish
Katikireddi, S. Vittal
Lyall, Donald
Mackay, Daniel F.
O’Donnell, Catherine A.
Sattar, Naveed
Nicholl, Barbara I.
Pell, Jill P.
Jani, Bhautesh D.
Ho, Frederick K.
Mair, Frances S.
Celis-Morales, Carlos
Comparison of two different frailty measurements and risk of hospitalisation or death from COVID-19: findings from UK Biobank
title Comparison of two different frailty measurements and risk of hospitalisation or death from COVID-19: findings from UK Biobank
title_full Comparison of two different frailty measurements and risk of hospitalisation or death from COVID-19: findings from UK Biobank
title_fullStr Comparison of two different frailty measurements and risk of hospitalisation or death from COVID-19: findings from UK Biobank
title_full_unstemmed Comparison of two different frailty measurements and risk of hospitalisation or death from COVID-19: findings from UK Biobank
title_short Comparison of two different frailty measurements and risk of hospitalisation or death from COVID-19: findings from UK Biobank
title_sort comparison of two different frailty measurements and risk of hospitalisation or death from covid-19: findings from uk biobank
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7652674/
https://www.ncbi.nlm.nih.gov/pubmed/33167965
http://dx.doi.org/10.1186/s12916-020-01822-4
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