Frailty is associated with in-hospital mortality in older hospitalised COVID-19 patients in the Netherlands: the COVID-OLD study. (30th January 2021)

• Record Type: Journal Article
• Authors: 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;
• Is Part Of: Age and ageing. Volume 50:Number 3(2021)
• Page Start: 631
• Page End: 640
• Publication Date: 2021-01-30
• Subjects: clinical frailty scale -- COVID-19 -- frailty -- SARS-CoV-2 -- older adults; Aging -- Periodicals; Geriatrics -- Periodicals; 618.97
• DOI: 10.1093/ageing/afab018
• Languages: English
• ISSNs: 0002-0729

Abstract

Abstract: 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.