Abstract
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.
| Original language | English |
|---|---|
| Pages (from-to) | 617-630 |
| Number of pages | 14 |
| Journal | Age and Ageing |
| Volume | 50 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - 5 Feb 2021 |
UN SDGs
This output contributes to the following UN Sustainable Development Goals (SDGs)
-
SDG 3 Good Health and Well-being
Keywords
- delirium
- frailty,COVID-19
- mortality
- transitions of care
- Humans
- Survivors
- Male
- Frail Elderly
- Frailty/diagnosis
- COVID-19
- SARS-CoV-2
- Female
- Aged
- Cohort Studies
ASJC Scopus subject areas
- Aging
- Geriatrics and Gerontology
Access to Document
Handle.net
Other files and links
Fingerprint
Dive into the research topics of 'Age and frailty are independently associated with increased COVID-19 mortality and increased care needs in survivors: results of an international multi-centre study'. Together they form a unique fingerprint.Cite this
- APA
- Author
- BIBTEX
- Harvard
- Standard
- RIS
- Vancouver
}
In: Age and Ageing, Vol. 50, No. 3, 05.02.2021, p. 617-630.
Research output: Contribution to journal › Article › peer-review
TY - JOUR
T1 - Age and frailty are independently associated with increased COVID-19 mortality and increased care needs in survivors
T2 - results of an international multi-centre study
AU - Welch, Carly
AU - Alsahab, Mustafa
AU - Beishon, Lucy
AU - Brown, Bryony
AU - Burn, Elinor
AU - Burton, Jenni K.
AU - Cox, Natalie
AU - Dani, Melanie
AU - Elhadi, Muhammed
AU - Freshwater, Sarah
AU - Gaunt, Victoria
AU - Gordon, Adam
AU - Goujon, Marie
AU - Hale, Matthew
AU - Hughes, Terry
AU - Jackson, Thomas A.
AU - Jelley, Benjamin
AU - Khan, Asma
AU - Khiroya, Heena
AU - Lal, Rajni
AU - Madden, Katy
AU - Magill, Laura
AU - Masoli, Jane
AU - Masud, Tahir
AU - McCluskey, Lauren
AU - McNeela, Natalie
AU - Mohammedseid-Nurhussien, Awolkhier
AU - Moorey, Hannah
AU - Lochlainn, Mary Ni
AU - Nirantharakumar, Krishnarajah
AU - Okoth, Kelvin
AU - Osuafor, Christopher N.
AU - Patterson, Katherine
AU - Pearson, Grace M.E.
AU - Perry, Rita
AU - Pettitt, Michala
AU - Pigott, Jennifer
AU - Pinkney, Thomas
AU - Quinn, Terence
AU - Reynolds, Abigail
AU - Richardson, Sarah
AU - Sanyal, Nik
AU - Seed, Adam
AU - Sleeman, Isobel
AU - Soo, Chee
AU - Steves, Claire
AU - Strain, W. David
AU - Taylor, Joanne
AU - Torsney, Kelli
AU - Wilson, Daisy
AU - Witham, Miles
AU - Abd Elazeem, Hossam Aldein S.
AU - Abdelhafez, Mohammed H.
AU - Abdelmalak, Amir
AU - Abdelwahab, Omar A.
AU - Abdulhadi, Osama M.A.S.
AU - Adewole, Olubayode
AU - Eltayeb, Mohammed Ahmad
AU - Hazem, A. Ahmed
AU - Islam, Ahmed
AU - Ahmed, A.
AU - Yesim, Mertcan Akcay
AU - Emrah, Akdeniz
AU - Carolyn, Akın
AU - Francesco, Akladious
AU - Ali, Alessandri
AU - Abdulmalek, Ali
AU - Abdulmoiz, Aljafari
AU - Mohammed, Aljafari
AU - Lobna, Al Sadawi
AU - Fatih, Al Sodani
AU - Gitanjali, Altintoprak
AU - Jocelyn, Amaratungaz
AU - Sylvia, Amer
AU - Taha, Amini
AU - Cheran, Amir
AU - Rachael, Anandarajah
AU - Muhammed, Anders
AU - Kingsley, H. Ansari
AU - Jolene, Appiah
AU - Catherine, Atia
AU - Avinash, Atkin
AU - Elsayed, Aujayeb
AU - Mohammed, M. Awad
AU - Mohammad, A. Azab
AU - Sally, T. Azam
AU - Ahmed, Aziz
AU - Azzam, Y.
AU - Babar, Laxmi
AU - Babb, Laura
AU - Badh, Manpreet
AU - Baguneid, Clare
AU - Bailey, Emily
AU - Baili, Efstratia
AU - Baldwin, Sarah
AU - Baloyiannis, Ioannis
AU - Bannerjee, Moulinath
AU - Barnard, Anna
AU - Barra, Fabio
AU - Bashir, Hannah
AU - Bawor, Monica
AU - Bayhan, Zülfü
AU - Belcher, James
AU - Belgamwar, Ravindra
AU - Bentley, Corrina
AU - Birchenough, Amy
AU - Nee, Yen
AU - Hayley, J. Bo
AU - Boden, R.
AU - Bouhuwaish, Ahmad
AU - Brachini, Gioia
AU - Bremner, Laura
AU - Bridgwater, Hannah
AU - Bryant, Catherine
AU - Budd, Gabrielle
AU - Budd, Sharon
AU - Budzikoski, Adam
AU - Bulla, Reem
AU - Buondonno, Antonio
AU - Burden, Nicole
AU - Butt, Hejab
AU - Capoglu, Recayi
AU - Caracostea, Andra
AU - Cardoso, Rifa
AU - Carr, Alexis
AU - Carrasco-Prats, Milagros
AU - Cattel, Caterina
AU - Ceccarelli, Giancarlo
AU - Cecere, Giuseppe
AU - Charalabopoulos, Alexandros
AU - Charsley, Evelyn
AU - Cheney-Lowe, Hannah
AU - Chevallier, Theodore
AU - Choudhry, Asad J.
AU - Ciccarone, Flavia
AU - Cicerchia, Pierfranco M.
AU - Cirillo, Bruno
AU - Collins, Fatma D.
AU - Comerford, Victoria
AU - Cordie, Ahmed
AU - Coulter, Siobhan
AU - Coulthard, Nick
AU - Cox, Catrin
AU - Cox, Victoria
AU - Crowe, Andrew
AU - Cullen, Jack
AU - Cummings, Jean
AU - Cunningham, Niamh
AU - Curley, Daniel
AU - Currie, Hannah
AU - Daly, Madeleine
AU - Darley, Jay
AU - Dattani, Nikhita
AU - Davakis, Spyridon
AU - Davies, Rowan
AU - De Paola, Gilda
AU - De Toma, Giorgio
AU - Del Valle-Ruiz, Sergio
AU - Deldar, Benyamin
AU - Demir, Hakan
AU - Desai, Arjun
AU - Desai, Nirali
AU - Devaney, Alice
AU - Dew, Lindsey
AU - Dhesi, Jugdeep
AU - Dias, Maria
AU - Dick, Gordon
AU - Doddamani, Parveen
AU - Dogra, Gurinder
AU - Doll, Tina
AU - Dooley, Hannah C.
AU - Dost, Samiullah
AU - Dotchin, Catherine
AU - Dowell, Hannah
AU - Drghita, Ioan M.
AU - Dundas, James M.
AU - Duranti, Giulia
AU - Dusara, Hiren
AU - Dwivedi, Rajesh
AU - Dyer, Adam H.
AU - Eastaugh, Alison
AU - Edwards, Elinor
AU - Elghazaly, Shrouk M.
AU - Elmehrath, Ahmed O.
AU - Elrick, Hope
AU - El-Shazly, Mostafa
AU - Emery, Alexander
AU - Etchill, Eric W.
AU - Evans, Sarah
AU - Evison, Felicity
AU - Fairhead, Cassandra
AU - Faulkner, Margherita
AU - Felska, Agnieszka
AU - Fernandez, Antia
AU - Fernández-Fernández, Pedro V.
AU - Ferraiolo, Antonella
AU - Ferrero, Simone
AU - Fiori, Enrico
AU - First, Necattin
AU - Fisk, Gracie
AU - Fleck, Anna
AU - Giovanni, B.
AU - Gabre-Kidan, Fonsi Alodia
AU - Gallo, Gaetano
AU - Gandhi, Ratnam
AU - Garner, Madeleine
AU - Georgiou, Nikolaos
AU - Gerretsen, Hannah
AU - Ghannam, Nourhan A.A.
AU - Ghobrial, Andrew
AU - Ghobrial, Hedra
AU - Ghufoor, Zaynub
AU - Gibbon, Jake
AU - Gilbert, Georgia F.
AU - Giles, Marie
AU - Giménez-Francés, Clara
AU - Gonullu, Emre
AU - Gray, Amy
AU - Gray, Joshua H.
AU - Green, Deirdre
AU - Greene, Charlotte
AU - Griffin, Ellanna
AU - Griffith, Karla
AU - Grubb, Anthony
AU - Guan, Yue
AU - Guerero, Daniel N.
AU - Gupta, Ayushi
AU - Gustavino, Claudio
AU - Guzman, Laurenny
AU - Hadreiez, Ahmed K.M.
AU - Hajiioannou, Jiannis
AU - Hanji, Deevia
AU - Madhavan, Deepthy Hari
AU - Harmantepe, Tarık
AU - Harrison, Patrick
AU - Hart, Barbara
AU - Haslam, Aidan
AU - Haunton, Victoria
AU - Haut, Elliott R.
AU - Heinsohn, Torben
AU - Hennah, Lindsay
AU - Hetta, Helal F.
AU - Hickman, Alexander
AU - Hobill, Abigail
AU - Hogan, Patrick C.P.
AU - Hogan, Vesna
AU - Holmes, Elizabeth
AU - Honney, Katie
AU - Hood, Katharine
AU - Hopkinson, Katherine
AU - Howells, Lara
AU - Hrouda, Nicole
AU - Hunsley, Danielle
AU - Hurst, William
AU - Rand, A.
AU - Mohamed, Hussein
AU - Ibrahim, Eltaher A.A.
AU - Ibtida, Ishmam
AU - Ibukunoluwakitan, Aina
AU - Ishlek, Irem
AU - Iyer, Rishi
AU - Jackson, Karl
AU - Jackson, Rosie
AU - James, Ellen
AU - Jarvis, Hayley
AU - Jeffs, Sophie
AU - Jenko, Nathan
AU - Jeyakumar, Sasha
AU - Kabir, Shahriar
AU - Kainth, Harjinder
AU - Kalloo, Jason
AU - Kanzaria, Akhil
AU - Karapanou, Amalia
AU - Kardaman, Nuha
AU - Karthikeyan, Sandeep
AU - Karunatilleke, Anne
AU - Kelly, Mairead
AU - Kelly, Nicola I.
AU - Khalid, Hesham
AU - Khan, Haris
AU - Khan, Muhammad S.
AU - King, Matthew
AU - Kneen, Thomas
AU - Kok, Li
AU - Kratochwila, Chiara
AU - Kuzeva, Aneliya
AU - Lapolla, Pierfrancesco
AU - Lau, Rebecca
AU - Yee, Kar
AU - Aimee, Law
AU - Gabriel, Leadbetter
AU - Helena, Lee
AU - Gavriella, Lee
AU - Grace, Levinson
AU - Theodore, Lewis
AU - Stephen, Liakakos
AU - Danielle, Lim
AU - Emma, Lis
AU - Pedro, Livesey
AU - Lily, López Morales
AU - Eleanor, Lowes
AU - Emily, Lunt
AU - Suvira, Lyon
AU - Zeinab, Madan
AU - Harsha, Majid
AU - Jade, Malapati
AU - Baguiasri, Man
AU - Sarah, Mandane
AU - Manning, H.
AU - Mantoglu, Baris
AU - Martínez-Sanz, Nuria
AU - Marx, William
AU - Masood, Almontacer E.B.
AU - Maughan, Tom
AU - Mawhinney, Jamie
AU - Maxfield, Dominic
AU - Mayer, Jordan
AU - Maynard, Henry
AU - McDonald, Claire
AU - McGovern, Aine
AU - Mclachlan, Sophie
AU - Medina-Manuel, Esther
AU - Meneghini, Simona
AU - Metcalf, Michelle
AU - Millwood-Hargrave, John
AU - Mingoli, Andrea
AU - Miu, Kelvin
AU - Mohamed, Fawsiya
AU - Mohamed Aliae, Soha M.
AU - Hussein, A. R.Mohamed
AU - Aaliya, Abdulkader Mohammad
AU - Momen, Mohammed Ahmed A.
AU - Moomo, Farhana
AU - Mora-Guzmán, Ismael
AU - Moriarty, Lizzie
AU - Morrin, Hamilton
AU - Morris, Claire
AU - Moss, Nicholas
AU - Moustafa, Mohamed M.
AU - Mpoura, Maria
AU - Mubin, Mohammed
AU - Muhtaroglu, Ali
AU - Muir, Georgina
AU - Mulhern, Stephanie
AU - Muller, Daniel
AU - Murphy, Declan C.
AU - Muzammil, Bushra
AU - Nadkarni, Varun
AU - Albatoul, Mariam
AU - Yasmin, Nageh
AU - NasrEldin, K.
AU - Nawaz, Wasim
AU - Nguyen, Hanna
AU - Ni, Cliona
AU - Alexander, Cheallaigh
AU - Samuel, Noar
AU - Favour, North
AU - Alice, Nwolu
AU - Omoteniola, O'Docherty
AU - Sinead, Odutola
AU - Olebu, O'Dwyer
AU - Catherine, Ogochukwu
AU - Lia, O'Mahony
AU - Marc, Orlando
AU - Christina, Osterdahl
AU - Ismini, Page
AU - Shivam, Panayotidis
AU - Jessica, Pancholi
AU - Lauren, Parkin
AU - Passby, C.
AU - Pastor-Pérez, Patricia
AU - Patel, Harnish
AU - Patel, Shefali
AU - Penfold, Rose
AU - Perinpanathan, Rupini
AU - Perivoliotis, Konstantinos
AU - Perra, Teresa
AU - Pinkney, Martha
AU - Pinotti, Enrico
AU - Porcu, Alberto
AU - Price, Angeline
AU - Pugliese, Francesco
AU - Puri, Prabhleen
AU - Pytraczy, Sylvia
AU - Qaiser, Yusra
AU - Qurashi, Maria
AU - Radenkovic, Dina
AU - Rajeswaran, Thurkka
AU - Rapaport, Sarah F.
AU - Razzak, Tahmina
AU - Reilly, Lara
AU - Reynolds, Paul
AU - Richardson, Alexandra
AU - Roberts, Amelia
AU - Roberts-Rhodes, Charlotte
AU - Robinson, Tanya
AU - Rocca, Aldo
AU - Ross-Skinner, Emily
AU - Ruiz-Marín, Miguel
AU - Ryall, Rebecca
AU - Saad, Alshaimaa M.
AU - Saad, Mahmoud M.
AU - Sadiq, Ambreen
AU - Sammarco, Giuseppe
AU - Sampanis, Michail A.
AU - Sanghvi, Hazel
AU - Sapienza, Paolo
AU - Sayers, Ross
AU - Scott, Luca
AU - Sen, Michael
AU - Shaban, Mosab A.A.
AU - Shakespeare, Kathleen T.
AU - Shaw, Ellie
AU - Shaw, Hannah
AU - Sheldrake, Jonathan
AU - Yang, Sing
AU - Luigi, Sim
AU - Nikolaos, Simonelli
AU - Jarita, V. Sipsas
AU - Sivarajan, Sivam Sri
AU - Smith, Jennifer
AU - Speranza, Fabio
AU - Spice, Claire
AU - Stafford, Amanda
AU - Stambollouian, Katharine
AU - Stevens, Kent A.
AU - Stewart, Jack
AU - Stratton, Emma
AU - Street, Hannah
AU - Surtees, Michael
AU - Swinnerton, Emma
AU - Taher, Ahmed S.A.
AU - Tait, Caroline
AU - Taylor, Amybel
AU - Thake, Miriam
AU - Thin, Katie
AU - Thould, Hannah
AU - Thyn, Thyn
AU - To, Benjaman
AU - Tobiss, Hannah
AU - Toppley, Kathryn
AU - Townsend, Liam
AU - Tullo, Ellen
AU - Tzovaras, George
AU - Umeadi, Anthony
AU - Vaidya, Hrisheekesh
AU - Valero-Soriano, María
AU - Varden, Rosanna
AU - Vergani, Vittoria
AU - Vervoort, Dominique
AU - Vescio, Giuseppina
AU - Vettasseri, Mark
AU - Virk, Madiha
AU - Vyas, Vaishali
AU - Wagland, Joanne
AU - Wallis, Stephanie
AU - Warner, Chloe
AU - Watkins, Eleanor
AU - Watson, Hannah
AU - Webb, Rachael
AU - Welsh, Sarah H.
AU - West, Ruth
AU - Whelan, Elisha
AU - Whitney, Julie
AU - Whitsey, Mark
AU - Wilcock, Catherine
AU - Wilkinson, Iain
AU - Williams, David
AU - Williamson, Megan
AU - Willott, Ruth H.
AU - Wimalasundera, Mettha
AU - Lelt, Yu
AU - Laura, Win
AU - Winter, Stephanie
AU - Worrall, Rebecca
AU - Wright, Natalie
AU - Yeo, Eirene
AU - Yeung, Merve
AU - Yasin, Yigit
AU - Yildiz, A.
AU - Yusuf, Humza
AU - Zambon, Martina
AU - Zaw, Hein
AU - Elabedeen, Omar Zein
N1 - © 2021. Published by Oxford University Press on behalf of the British Geriatrics Society.
PY - 2021/2/5
Y1 - 2021/2/5
N2 - 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.
AB - 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.
KW - delirium
KW - frailty,COVID-19
KW - mortality
KW - transitions of care
KW - Humans
KW - Survivors
KW - Male
KW - Frail Elderly
KW - Frailty/diagnosis
KW - COVID-19
KW - SARS-CoV-2
KW - Female
KW - Aged
KW - Cohort Studies
UR - https://www.scopus.com/pages/publications/85109893369
U2 - 10.1093/ageing/afab026
DO - 10.1093/ageing/afab026
M3 - Article
C2 - 33543243
AN - SCOPUS:85109893369
SN - 0002-0729
VL - 50
SP - 617
EP - 630
JO - Age and Ageing
JF - Age and Ageing
IS - 3
ER -