1. Frailty is associated with in-hospital mortality in older hospitalised COVID-19 patients in the Netherlands: the COVID-OLD study
- Author
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Roy Looman, Harmke A Polinder-Bos, Marielle H. Emmelot-Vonk, Esther M.M. van de Glind, Esther J. M. de Brouwer, Huub A.A.M. Maas, Jeannet C Bos, Ralph Vreeswijk, Barbara C. van Munster, Laura C. Blomaard, Linda M Kampschreur, Jessica M. van der Bol, Steffy W. Jansen, Liesbeth Hempenius, Hanna C. Willems, Marjolein A. Wijngaarden, Anke J Borgers, Jan Festen, Petra E. Spies, Dennis G Barten, Aisha M Salarbaks, Rosalinde A L Smits, Ad M Kamper, Cees van Nieuwkoop, Sarah H M Robben, Marlies E M Regtuijt, Geert Labots, Frederiek van den Bos, Raya E S Geels, Carolien M. J. van der Linden, Francesco U.S. Mattace-Raso, Henrike J. Schouten, Marre M M de Koning, Bas de Groot, Leanne B L E Oosterwijk, Simon P. Mooijaart, Jacinta A. Lucke, Caroline E. Wyers, Rikje Ruiter, Rachida el Moussaoui, Oscar J. de Vries, Suzanne C. van Dijk, Floor J. van Deudekom, Orla M Smit, Internal Medicine, Epidemiology, Geriatrics, APH - Aging & Later Life, AMS - Amsterdam Movement Sciences, Infectious diseases, AMS - Ageing & Vitality, Value, Affordability and Sustainability (VALUE), and Molecular Neuroscience and Ageing Research (MOLAR)
- Subjects
Male ,Aging ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,Frail Elderly ,SCREENING TOOL ,clinical frailty scale ,03 medical and health sciences ,AcademicSubjects/MED00280 ,0302 clinical medicine ,Interquartile range ,Internal medicine ,Severity of illness ,medicine ,Humans ,030212 general & internal medicine ,Hospital Mortality ,Pandemics ,older adults ,Aged ,Netherlands ,Retrospective Studies ,Aged, 80 and over ,Frailty ,business.industry ,SARS-CoV-2 ,COVID-19 ,Retrospective cohort study ,Odds ratio ,General Medicine ,INPATIENTS ,MALNUTRITION ,medicine.disease ,Comorbidity ,Confidence interval ,Hospitalization ,Malnutrition ,Ageing ,Female ,Geriatrics and Gerontology ,business ,030217 neurology & neurosurgery ,Research Paper - 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.
- Published
- 2020