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 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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TitelFrailty is associated with in-hospital mortality in older hospitalised COVID-19 patients in the Netherlands: the COVID-OLD study
Datum30 januari 2021
Tijdschrift naamAge and Aging
Tijdschrift nummer50(3):631-640 (OPEN ACCESS)
AuteursLaura C Blomaard, Carolien M J van der Linden, Jessica M van der Bol, Steffy W M Jansen, Harmke A Polinder-Bos, Hanna C Willems, Jan Festen, Dennis G Barten, Anke J Borgers, Jeannet C Bos, Frederiek van den Bos, Esther J M de Brouwer, Floor J A van Deudekom, Suzanne C van Dijk, Mariëlle H Emmelot-Vonk, Raya E S Geels, Esther M M van de Glind, Bas de Groot, Liesbeth Hempenius, Ad M Kamper, Linda M Kampschreur, Marre M M de Koning, Geert Labots, Roy Looman, Jacinta A Lucke, Huub A A M Maas, Francesco U S Mattace-Raso, Rachida el Moussaoui, Barbara C van Munster, Cees van Nieuwkoop, Leanne (B L E) Oosterwijk, Marlies (E M) Regtuijt, Sarah H M Robben, Rikje Ruiter, Aisha M Salarbaks, Henrike J Schouten, Orla M Smit, Rosalinde A L Smits, Petra E Spies, Ralph Vreeswijk, Oscar J de Vries, Marjolein A Wijngaarden, Caroline E Wyers & Simon P Mooijaart
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