Clinical Features, Inpatient Trajectories and Frailty in Older Inpatients with COVID-19: A Retrospective Observational Study.
Geriatrics (Basel)
; 6(1)2021 Feb 01.
Article
in English
| MEDLINE | ID: covidwho-1060010
ABSTRACT
INTRODUCTION:
We describe the clinical features and inpatient trajectories of older adults hospitalized with COVID-19 and explore relationships with frailty.METHODS:
This retrospective observational study included older adults admitted as an emergency to a University Hospital who were diagnosed with COVID-19. Patient characteristics and hospital outcomes, primarily inpatient death or death within 14 days of discharge, were described for the whole cohort and by frailty status. Associations with mortality were further evaluated using Cox Proportional Hazards Regression (Hazard Ratio (HR), 95% Confidence Interval).RESULTS:
214 patients (94 women) were included of whom 142 (66.4%) were frail with a median Clinical Frailty Scale (CFS) score of 6. Frail compared to nonfrail patients were more likely to present with atypical symptoms including new or worsening confusion (45.1% vs. 20.8%, p < 0.001) and were more likely to die (66% vs. 16%, p = 0.001). Older age, being male, presenting with high illness acuity and high frailty were independent predictors of death and a dose-response association between frailty and mortality was observed (CFS 1-4 reference; CFS 5-6 HR 1.78, 95% CI 0.90, 3.53; CFS 7-8 HR 2.57, 95% CI 1.26, 5.24).CONCLUSIONS:
Clinicians should have a low threshold for testing for COVID-19 in older and frail patients during periods of community viral transmission, and diagnosis should prompt early advanced care planning.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Type of study:
Cohort study
/
Experimental Studies
/
Observational study
/
Prognostic study
Language:
English
Year:
2021
Document Type:
Article
Affiliation country:
Geriatrics6010011
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