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

Abstract:
INTRODUCTION: Increased mortality has been demonstrated in older adults with COVID-19, but the effect of frailty has been unclear.METHODS: This multi-centre cohort study involved patients aged 18years 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, IQR 54-83; 55.2% male). The risk of death increased independently with increasing age (>80 vs 18-49: HR 3.57, CI 2.54-5.02), frailty (CFS 8 vs 1-3: HR 3.03, CI 2.29-4.00) inflammation, renal disease, cardiovascular disease, and cancer, but not delirium. Age, frailty (CFS 7 vs 1-3: OR 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.CONCLUSIONS: 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
Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1093/ageing/afab026
Publication website:
https://pure.beds.ac.uk/ws/files/20629895/afab026.pdf

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Role:
Author
ORCID:
0000-0002-3140-8688
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Role:
Author
ORCID:
0000-0002-4752-6988


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Funder identifier:
10.13039/501100000550


Publisher:
Oxford University Press
Journal:
Age and Ageing More from this journal
Volume:
50
Issue:
3
Pages:
617-630
Publication date:
2021-02-05
DOI:
EISSN:
1468-2834
ISSN:
0002-0729


Language:
English
Keywords:
Pubs id:
1231456
Local pid:
pubs:1231456
Source identifiers:
W3126379194
Deposit date:
2026-04-09
ARK identifier:
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