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2020 ; 21
(7
): 928-932.e1
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Frailty and Mortality in Hospitalized Older Adults With COVID-19: Retrospective
Observational Study
#MMPMID32674821
De Smet R
; Mellaerts B
; Vandewinckele H
; Lybeert P
; Frans E
; Ombelet S
; Lemahieu W
; Symons R
; Ho E
; Frans J
; Smismans A
; Laurent MR
J Am Med Dir Assoc
2020[Jul]; 21
(7
): 928-932.e1
PMID32674821
show ga
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.
|*Hospital Mortality
[MESH]
|Aged
[MESH]
|Aged, 80 and over
[MESH]
|Belgium/epidemiology
[MESH]
|COVID-19
[MESH]
|Cohort Studies
[MESH]
|Coronavirus Infections/*epidemiology/prevention & control
[MESH]
|Disease Outbreaks/*statistics & numerical data
[MESH]
|Female
[MESH]
|Frail Elderly
[MESH]
|Frailty/*mortality
[MESH]
|Geriatric Assessment
[MESH]
|Hospitalization/statistics & numerical data
[MESH]
|Hospitals, General
[MESH]
|Humans
[MESH]
|Incidence
[MESH]
|Male
[MESH]
|Pandemics/prevention & control/*statistics & numerical data
[MESH]
|Pneumonia, Viral/*epidemiology/prevention & control
[MESH]
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