Frailty is associated with in-hospital mortality in older hospitalised COVID-19 patients in the Netherlands: the COVID-OLD study

BACKGROUND: During the first wave of the coronavirus disease 2019 (COVID-19) pandemic, older patients had an increased risk of hospitalisation and death. Reports on the association of frailty with poor outcome have been conflicting. OBJECTIVE: The aim of the present study was to investigate the inde...

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Detalles Bibliográficos
Autores principales: Blomaard, Laura C, van der Linden, Carolien M J, van der Bol, Jessica M, Jansen, Steffy W M, Polinder-Bos, Harmke A, Willems, Hanna C, Festen, Jan, Barten, Dennis G, Borgers, Anke J, Bos, Jeannet C, van den Bos, Frederiek, de Brouwer, Esther J M, van Deudekom, Floor J A, van Dijk, Suzanne C, Emmelot-Vonk, Mariëlle H, Geels, Raya E S, van de Glind, Esther M M, de Groot, Bas, Hempenius, Liesbeth, Kamper, Ad M, Kampschreur, Linda M, de Koning, Marre M M, Labots, Geert, Looman, Roy, Lucke, Jacinta A, Maas, Huub A A M, Mattace-Raso, Francesco U S, el Moussaoui, Rachida, van Munster, Barbara C, van Nieuwkoop, Cees, Oosterwijk, Leanne (B L E), Regtuijt, Marlies (E M), Robben, Sarah H M, Ruiter, Rikje, Salarbaks, Aisha M, Schouten, Henrike J, Smit, Orla M, Smits, Rosalinde A L, Spies, Petra E, Vreeswijk, Ralph, de Vries, Oscar J, Wijngaarden, Marjolein A, Wyers, Caroline E, Mooijaart, Simon P
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2021
Materias:
Research Paper
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7929372/
https://www.ncbi.nlm.nih.gov/pubmed/33951156
http://dx.doi.org/10.1093/ageing/afab018
Descripción
Sumario:BACKGROUND: During the first wave of the coronavirus disease 2019 (COVID-19) pandemic, older patients had an increased risk of hospitalisation and death. Reports on the association of frailty with poor outcome have been conflicting. OBJECTIVE: The aim of the present study was to investigate the independent association between frailty and in-hospital mortality in older hospitalised COVID-19 patients in the Netherlands. METHODS: This was a multicentre retrospective cohort study in 15 hospitals in the Netherlands, including all patients aged ≥70 years, who were hospitalised with clinically confirmed COVID-19 between February and May 2020. Data were collected on demographics, co-morbidity, disease severity and Clinical Frailty Scale (CFS). Primary outcome was in-hospital mortality. RESULTS: A total of 1,376 patients were included (median age 78 years (interquartile range 74–84), 60% male). In total, 499 (38%) patients died during hospital admission. Parameters indicating presence of frailty (CFS 6–9) were associated with more co-morbidities, shorter symptom duration upon presentation (median 4 versus 7 days), lower oxygen demand and lower levels of C-reactive protein. In multivariable analyses, the CFS was independently associated with in-hospital mortality: compared with patients with CFS 1–3, patients with CFS 4–5 had a two times higher risk (odds ratio (OR) 2.0 (95% confidence interval (CI) 1.3–3.0)) and patients with CFS 6–9 had a three times higher risk of in-hospital mortality (OR 2.8 (95% CI 1.8–4.3)). CONCLUSIONS: The in-hospital mortality of older hospitalised COVID-19 patients in the Netherlands was 38%. Frailty was independently associated with higher in-hospital mortality, even though COVID-19 patients with frailty presented earlier to the hospital with less severe symptoms.

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