Abstract
Background: The aim of this study was to describe outcomes in hospitalised older people with different levels of frailty and COVID-19 infection.
Methods: We undertook a single-centre, retrospective cohort study examining COVID-19-related mortality using electronic health records, for older people (65 and over) with frailty, hospitalised with or without COVID-19 infection. Baseline covariates included demographics, early warning scores, Charlson Comorbidity Indices and frailty (Clinical Frailty Scale, CFS), linked to COVID-19 status.
Findings: We analysed outcomes on 1,071 patients with COVID-19 test results (285 (27%) were positive for COVID-19). The mean age at ED arrival was 79.7 and 49.4% were female. All-cause mortality (by 30 days) rose from 9 (not frail) to 33% (severely frail) in the COVID-negative cohort but was around 60% for all frailty categories in the COVID-positive cohort. In adjusted analyses, the hazard ratio for death in those with COVID-19 compared to those without COVID-19 was 7.3 (95% CI: 3.00, 18.0) with age, comorbidities and illness severity making small additional contributions.
Interpretation: In this study, frailty measured using the CFS appeared to make little incremental contribution to the hazard of dying in older people hospitalised with COVID-19 infection; illness severity and comorbidity had a modest association with the overall adjusted hazard of death, whereas confirmed COVID-19 infection dominated, with a sevenfold hazard for death.
Keywords: COVID-19; cohort study; frailty; older people.
【저자키워드】 COVID-19, frailty, older people, cohort study, 【초록키워드】 Mortality, Comorbidity, outcome, Cohort, COVID-19 infection, clinical, female, death, age, scale, association, Electronic health records, Illness severity, demographics, retrospective cohort study, Older, hazard ratio, Confirmed COVID-19 infection, covariate, positive, adjusted analyses, CFS, hospitalised, analysed, adjusted, category, patients with COVID-19, with COVID-19, 【제목키워드】 Mortality, Electronic health record, association, retrospective, Older, hospitalised,