Age and frailty are independently associated with increased COVID-19 mortality and increased care needs in survivors: results of an international multi-centre study

被引：98

作者：

Alsahab, Mustafa ^{[14
]}

Beishon, Lucy ^{[21
,54
]}

Brown, Bryony ^{[8
]}

Burn, Elinor ^{[20
,54
]}

Burton, Jenni K. ^{[5
]}

Cox, Natalie ^{[23
]}

Dani, Melanie ^{[11
]}

Elhadi, Muhammed ^{[7
]}

Freshwater, Sarah ^{[25
]}

Gaunt, Victoria ^{[10
]}

Gordon, Adam ^{[6
]}

Goujon, Marie ^{[24
]}

Hale, Matthew ^{[8
]}

Hughes, Terry ^{[1
]}

Jackson, Thomas A. ^{[1
]}

Jelley, Benjamin ^{[9
]}

Khan, Asma ^{[29
]}

Khiroya, Heena ^{[30
]}

Lal, Rajni ^{[32
]}

Madden, Katy ^{[30
]}

Magill, Laura ^{[1
]}

Masoli, Jane ^{[19
]}

Masud, Tahir ^{[26
]}

McCluskey, Lauren ^{[1
]}

McNeela, Natalie ^{[28
]}

Mohammedseid-Nurhussien, Awolkhier ^{[31
]}

Moorey, Hannah ^{[1
]}

Lochlainn, Mary Ni ^{[4
]}

Nirantharakumar, Krishnarajah ^{[1
]}

Okoth, Kelvin ^{[1
]}

Osuafor, Christopher N. ^{[18
]}

Patterson, Katherine ^{[15
]}

Pearson, Grace M. E. ^{[27
]}

Perry, Rita ^{[1
]}

Pettitt, Michala ^{[1
]}

Pigott, Jennifer ^{[16
]}

Pinkney, Thomas ^{[1
]}

Quinn, Terence ^{[5
]}

Reynolds, Abigail

Richardson, Sarah ^{[2
,3
]}

Sanyal, Nik ^{[30
]}

Seed, Adam ^{[17
]}

Sleeman, Isobel ^{[13
]}

Soo, Chee ^{[12
]}

Steves, Claire ^{[4
]}

Strain, W. David ^{[19
]}

Taylor, Joanne ^{[22
]}

Torsney, Kelli ^{[18
]}

Welch, Carly ^{[1
]}

Wilson, Daisy ^{[1
]}

机构：

[1] Univ Birmingham, Coll Med & Dent Sci, Inst Inflammat & Ageing, Birmingham B15 2TT, W Midlands, England

[2] Univ Newcastle, NIHR Newcastle Biomed Res Ctr, AGE Res Grp, Newcastle Upon Tyne, Tyne & Wear, England

[3] Newcastle Upon Tyne Hosp NHS Fdn Trust, Newcastle Upon Tyne, Tyne & Wear, England

[4] Kings Coll London, London, England

[5] Univ Glasgow, Glasgow, Lanark, Scotland

[6] Univ Nottingham, Nottingham, England

[7] Alkhadra Hospital, Tripoli, Libya

[8] Bradford Teaching Hosp NHS Fdn Trust, Bradford, W Yorkshire, England

[9] Cardiff Univ, Cardiff, Wales

[10] Gloucestershire Hospitals NHS Fdn Trust, Gloucester, England

[11] Imperial Coll Healthcare NHS Trust, London, England

[12] Maidstone & Tunbridge Wells NHS Trust, Maidstone, Kent, England

[13] NHS Grampian, Aberdeen, Scotland

[14] Oxford Univ Hosp NHS Trust, Oxford, England

[15] Queens Univ Belfast, Belfast, Antrim, North Ireland

[16] Royal Free London NHS Fdn Trust, London, England

[17] Southport & Ormskirk Hosp NHS Trust, Southport, England

[18] Univ Cambridge, Cambridge, England

[19] Univ Exeter, Exeter, Devon, England

[20] Univ Hosp Leicester NHS Trust, Leicester, Leics, England

[21] Univ Leicester, Leicester, Leics, England

[22] Univ Manchester, Manchester, Lancs, England

[23] Univ Southampton, Southampton, Hants, England

[24] Cambridge Univ Hosp NHS Trust, Cambridge, England

[25] Hlth Educ West Midlands, Birmingham, W Midlands, England

[26] Nottingham Univ Hosp NHS Trust, Nottingham, England

[27] Univ Bristol, Bristol, Avon, England

[28] Royal Wolverhampton NHS Trust, Wolverhampton, England

[29] Sandwell & West Birmingham Hosp NHS Trust, Birmingham, W Midlands, England

[30] Univ Hosp Birmingham NHS Trust, Birmingham, W Midlands, England

[31] Univ Hosp Coventry & Warwickshire NHS Trust, Coventry, W Midlands, England

[32] Western Sydney Sydney Hlth Dist, Sydney, NSW, Australia

[33] Alazher Univ Hosp, Cairo, Egypt

[34] Alkhadra Hosp, Tripoli, Libya

[35] Assiut Univ Hosp, Assiut, Egypt

[36] Barnsley Hosp NHS Fdn Trust, Barnsley, England

[37] Birmingham Heartlands Hosp, Birmingham, W Midlands, England

[38] City Hosp, Birmingham, W Midlands, England

[39] Cairo Univ Hosp, Cairo, Egypt

[40] Clin San Pietro, A O U, Sassari, Italy

[41] Univ Molise, Dept Med & Hlth Sci V Tiberio, Molise, Italy

[42] East Surrey Hosp, Surrey, England

[43] Gen Univ Hosp Larissa, Larisa, Greece

[44] Glasgow Royal Infirmary, Glasgow, Lanark, Scotland

[45] Good Hope Hosp, Sutton, Surrey, England

[46] Great Western Hosp, Swindon, Wilts, England

[47] Hosp Gen Reina Sofia, Murcia, Spain

[48] Hosp Santa Babara, Ciudad Real, Spain

[49] IRCCS Ospedale Policlinico San Martino, Genoa, Italy

[50] Johns Hopkins Univ Hosp, Baltimore, MD USA

来源：

AGE AND AGEING | 2021年 / 50卷 / 03期

关键词：

frailty; COVID-19; mortality; transitions of care; delirium; HOSPITALIZED OLDER-ADULTS; CORONAVIRUS DISEASE 2019; DELIRIUM; ILLNESS; ADMISSION; INFECTION;

D O I：

10.1093/ageing/afab026

中图分类号：

R592 [老年病学]; C [社会科学总论];

学科分类号：

03 ; 0303 ; 100203 ;

摘要：

Introduction: Increased mortality has been demonstrated in older adults with coronavirus disease 2019 (COVID-19), but the effect of frailty has been unclear. Methods: This multi-centre cohort study involved patients aged 18 years and older hospitalised with COVID-19, using routinely collected data. We used Cox regression analysis to assess the impact of age, frailty and delirium on the risk of inpatient mortality, adjusting for sex, illness severity, inflammation and co-morbidities. We used ordinal logistic regression analysis to assess the impact of age, Clinical Frailty Scale (CFS) and delirium on risk of increased care requirements on discharge, adjusting for the same variables. Results: Data from 5,711 patients from 55 hospitals in 12 countries were included (median age 74, interquartile range [IQR] 54-83; 55.2% male). The risk of death increased independently with increasing age (>80 versus 18-49: hazard ratio [HR] 3.57, confidence interval [CI] 2.54-5.02), frailty (CFS 8 versus 1-3: HR 3.03, CI 2.29-4.00) inflammation, renal disease, cardiovascular disease and cancer, but not delirium. Age, frailty (CFS 7 versus 1-3: odds ratio 7.00, CI 5.27-9.32), delirium, dementia and mental health diagnoses were all associated with increased risk of higher care needs on discharge. The likelihood of adverse outcomes increased across all grades of CFS from 4 to 9. Conclusion: Age and frailty are independently associated with adverse outcomes in COVID-19. Risk of increased care needs was also increased in survivors of COVID-19 with frailty or older age.

引用

页码：617 / 630

页数：14

共 57 条

[1]

[Anonymous], 2018, JMIR RES PROTOC, DOI DOI 10.2196/resprot.9304

[2] Preexisting Comorbidities Predicting COVID-19 and Mortality in the UK Biobank Community Cohort [J].