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

作者：Mustafa Alsahab, Lucy Beishon, Bryony Brown, Elinor Burn, Jennifer Kirsty Burton, Natalie J. Cox, Melanie Dani, Muhammed Elhadi, Sarah L Freshwater, Victoria Gaunt, Adam Lee Gordon, Marie Goujon, Matthew David Hale, Terry Lynn Hughes, Thomas Jackson, Benjamin Jelley, Asma Afzal Khan, Heena Khiroya, Rajni Lal, Katy Madden, Laura Magill, Jane A. H. Masoli, Tahir Masud, Lauren McCluskey, Natalie McNeela, Awolkhier Mohammedseid-Nurhussien, Hannah C. Moorey, Mary Ní Lochlainn, Krishnarajah Nirantharakumar, Kelvin Okoth, Christopher Nnaemeka Osuafor, Katherine Patterson, Grace M E Pearson, Rita J. Perry, Michala E. Pettitt, Jennifer Pigott, Thomas D Pinkney, Terence J. Quinn, Abigail Reynolds, Sarah Joanna Richardson, Nik Sanyal, Adam Seed, Isobel J. Sleeman, C. R. de Soó, Claire J. Steves, William David Strain, Joanne Taylor, Kelli Torsney, Carly Welch, Daisy V. Wilson, Miles D. Witham, Covid Collaborative, Hossam Aldein S Abd Elazeem, Mohammed Abdelhafez, Amir Abdelmalak, Omar Ahmed Abdelwahab, Osama Mohamed Ali Senussi Abdulhadi, Olubayode Adewole, Mohammed Ahmad, Eltayeb A Ahmed, Hazem A. Sayed Ahmed, Islam Ahmed, Mertcan Akçay, Yeşim Akdeniz, Emrah Akın, Carolyn Akladious, Francesco Alessandri, Ali Ali, Abdulmalek Aljafari, Abdulmoiz Aljafari, Mohammed Al‐Sadawi, Lobna Al-Sodani, Fatih Altıntoprak, Gitanjali Amaratungaz, Jocelyn Amer, Sylvia Amini, Taha Amir, Cheran Anandarajah, Rachael Anders, Muhammed H Ansari, Kingsley Opoku Appiah, Jolene Atia, Catherine Atkin, Avinash Aujayeb, Elsayed M Awad, Mohammed Atef Azab, Mohammad T. Azam, Sally Aziz, Ahmed Y. Azzam, Laxmi Babar, Laura Babb, Manpreet Badh, C L Baguneid, Emily J Bailey, Efstratia Baili, Sarah Baldwin, Ioannis Baloyiannis, Moulinath Bannerjee, Anna Nicole Barnard, Fabio Barra, Hannah Bashir, Monica Bawor, Zülfü Bayhan, Dr Lucy Beishon, James Belcher, Ravindra B Belgamwar, Corrina Bentley, Amy Birchenough, Yen Nee Jenny Bo, Hayley Boden, Ahmad Elmabri Mohammad Bouhuwaish, Gioia Brachini, Laura Bremner, Hannah Bridgwater, Catherine Bryant, Gabrielle Budd, Sharon Budd, Adam Budzikoski, Reem Bulla, Antonio Buondonno, Antonio Buondonno, Nicole Burden, Elinor Burn, Hejab Butt, Recayi Çapoğlu, Andra Caracostea, Rifa Cardoso, Alexis Carr, Milagros Carrasco-Prats, Caterina Cattel, Giancarlo Ceccarelli, Giuseppe Cecere, Alexandros Charalabopoulos, Evelyn Charsley, Hannah Cheney-Lowe, Theodore Chevallier, Asad J. Choudhry, Flavia Ciccarone, Pierfranco Maria Cicerchia, Bruno Cirillo, Fatma D Collins, Victoria Comerford, Ahmed Cordie, Siobhan Coulter, Nick Coulthard, Catrin Cox, Victoria A. Cox, Andrew P Crowe, Jack Cullen, Jean Cummings, Niamh Cunningham, Daniel Curley, Hannah Currie, Madeleine Daly, Jay Darley, Nikhita Dattani, Spyridon Davakis, Rowan Davies, Gilda De Paola, Giorgio De Toma, Sergio Del Valle-Ruiz, Benyamin Deldar, Hakan Demir, Arjun Desai, Nirali Desai, Alice Devaney, Lindsey Dew, Jugdeep K. Dhesi, Margarida Figueiredo-Dias, Gordon Dick, Parveen Doddamani, Gurinder Dogra, Tina Doll, Hannah C. Dooley, Samiullah Dost, Catherine Louise Dotchin, Hannah C. Dowell, Ioan M Draghita, James Dundas, Giulia Duranti, Hiren Dusara, Rajesh Dwivedi, Adam H. Dyer, Alison Eastaugh, Elinor Edwards, S M.elghazaly, Ahmed Osama Elmehrath, Hope Elrick, Mostafa I. Elshazly, Alexander Wayne Emery, Eric Wayne Etchill, Sarah B Evans, Felicity Evison, Cassandra Fairhead, Margherita Faulkner, Agnieszka Felska, Antia Fernandez, Pedro Vicente Fernández-Fernández, Antonella Ferraiolo, Simone Ferrero, Enrico Fiori, Necattin Fırat, Gracie Fisk, Anna Fleck, Giovanni Battista Fonsi, Alodia Gabre‐Kidan, Gaetano Gallo, Ratnam Gandhi, Madeleine Garner, Nikolaos Georgiou, Hannah Gerretsen, Nourhan A A Ghannam, Andrew Ghobrial, Hedra Ghobrial, Zaynub Ghufoor, Jake Ryan Gibbon, Georgia F Gilbert, Marie Giles, Clara Giménez-Francés, Emre Gönüllü, Amy Zigrida Gray, Joshua H Gray, Deirdre Green, Charlotte Greene, Ellanna Griffin, Karla Griffith, Anthony Grubb, Yue Guan, Daniel N Guerero, Ayushi Gupta, Claudio Gustavino, Laurenny Guzman, Ahmed Khalifa Hadreiez, Jiannis K. Hajiioannou, Deevia Hanji, Deepthy Hari Madhavan, Ahmet Tarık Harmantepe, Patrick T. Harrison, Barbara J. Hart, Aidan Haslam, Victoria Joanna Haunton, Elliott Richard Haut, Torben Heinsohn, Lindsay Hennah, ‏Helal F. Hetta, Alexander Hickman, Abigail Hobill, Patrick Hogan, Vesna Hogan, Elizabeth A. Holmes, Katie Honney, Katharine Hood, Katherine Hopkinson, Lara Howells, Nicole Hrouda, Danielle Hunsley, W. Jeffrey Hurst, Rand A Hussein, Mohamed Ibrahim, Ishmam Ibtida, Aina Ibukunoluwakitan, Irem Ishlek, Rishi Iyer, Karl A. Jackson, Rosie Jackson, Ellen James, Hayley Jarvis, Sophie Jeffs, Nathan Jenko, Sasha Jeyakumar, Shahriar Kabir, Harjinder Kainth, Jason Kalloo, Akhil Kanzaria, Αmalia Karapanou, Nuha Kardaman, Sandeep Karthikeyan, Anne Karunatilleke, Mairead Kelly, Nicola Kelly, Khalid Hesham, Haris Khan, Muhammad Shoaib Khan, Matthew King, Thomas Kneen, Li Teng Kok, Chiara Kratochwila, Aneliya Kuzeva, Pierfrancesco Lapolla, Rebecca K Lau, Kar Yee Law, A. J. Leadbetter, Gabriel Lee, Helena Lee, Helena Lee, Gavriella Levinson, Grace Lewis, Theodore Liakakos, Stephen E R Lim, Danielle Lis, Emma Livesey, Pedro López-Morales, Lily Lowes, Eleanor Lunt, Emily Lyon, Suvira Madan, Zeinab Majid, Harsha Malapati, Jade Man, Baguiasri Mandane, S Manning, Barış Mantoğlu, Nuria Martínez-Sanz, William H. Marx, Almontacer E B Masood, Tom Maughan, Jamie A Mawhinney, Dominic Maxfield, Jordan Mayer, Henry Maynard, Claire McDonald, Aine McGovern, Sophie Mclachlan, Esther Medina-Manuel, Simona Meneghini, Michelle Metcalf, John Millwood-Hargrave, Andrea Mingoli, Kelvin Miu, Fawsiya Mohamed, Soha Moussa Mohamed, Aliae A. R. Mohamed Hussein, Abdulkader Mohammad, Aaliya Mohammed, Ahmed Abdulhakim Momen, Farhana Moomo, Ismael Mora Guzmán, Lizzie Moriarty, Hamilton Morrin, Claire Morris, Nicholas Moss, Mohamed M Moustafa, Maria Mpoura, Mohammed Mubin, Ali Muhtaroğlu, Georgina Muir, Stephanie T. Mulhern, Daniel Muller, Declan C. Murphy, Bushra Muzammil, Varun Nadkarni, Mariam Albatoul Nageh, Yasmin K. Nasr‐Eldin, Wasim Nawaz, Hanna Nguyen, Clíona Ní Cheallaigh, Alexander P. Noar, Samuel North, Favour Nwolu, Alice O'Docherty, Omoteniola Similoluwa Odutola, Sinead O’Dwyer, Olebu Ogochukwu, Catherine O’Mahony, Lia Orlando, Marc F. Österdahl, Christina Page, Ismini Panayotidis, Shivam Pancholi, Jessica Parkin, Lauren Passby, Patricia Pastor-Pérez, Harnish P. Patel, Shefali S. Patel, Rose Penfold, Rupini Perinpanathan, Konstantinos Perivoliotis, Teresa Perra, Martha Pinkney, Enrico Pinotti, Alberto Porcu, Angeline Price, Francesco Rocco Pugliese, Prabhleen Puri, Sylvia Pytraczyk, Yusra Qaiser, Maria Qurashi, Dina Radenković, Thurkka Rajeswaran, Sarah F. Rapaport, Tahmina Razzak, Lara Reilly, Paul N. Reynolds, Alexandra Richardson, Amelia M. Roberts, Amelia M. Roberts, Charlotte Roberts-Rhodes, Tanya O. Robinson, Aldo Rocca, Emily Ross-Skinner, Miguel Ruiz‐Marín, Rebecca Ryall, Alshaimaa M. Saad, Mahmoud M. Saad, Ambreen Sadiq, Giuseppe Sammarco, Michail A Sampanis, Hazel Sanghvi, Paolo Sapienza, R. R. Sayers, Luca Scott, Michael Sen, Mosab Abdelrazak A. Shaban, Kathleen T Shakespeare, Ellie Shaw, Hannah Shaw, Jonathan Sheldrake, Sing Yang Sim, Luigi Simonelli, Nikolaos V. Sipsas, Jarita Sivam, Sri G Sivarajan, Jennifer J. Smith, Fabio Speranza, Claire Spice, Amanda Stafford, Katharine Stambollouian, Kent Allen Stevens, Jack M. Stewart, Emma Stratton, Hannah Street, Michael Surtees, Emma Swinnerton, Ahmed Sa Taher, Caroline Tait, Amybel Taylor, Miriam Thake, Katie Thin, Hannah Thould, Thyn Thyn, Benjaman To, Hannah Tobiss, Kathryn Toppley, Liam Townsend, Ellen Tullo, George A. Tzovaras, Anthony Umeadi, Hrisheekesh Jayant Vaidya, María Valero-Soriano, Rosanna Varden, Vittoria Vergani, Dominique Vervoort, Giuseppina Vescio, Mark Vettasseri, Madiha Virk, Vaishali Vyas, Joanne Wagland, Stephanie Wallis, Chloe Warner, Eleanor Watkins, Hannah Watson, Rachael Webb, Sarah Welsh, Ruth West, Elisha Whelan, Julie C. Whitney, Mark Whitsey, Catherine Wilcock, Iain David Wilkinson, David James Williams, Megan L. Williamson, Ruth H. Willott, Mettha Wimalasundera, Yu Lelt Win, Laura Winter, Stephanie Worrall, Rebecca Wright, Natalie Yeo, Eirene Yeung, Merve Yiğit, Yasin Alper Yıldız, Humza Yusuf, Martina Zambon, Hein Khant Zaw, Omar Zein Elabedeen, Carly Welch · 发表于：Age and Ageing · 年份：2021 · DOI：10.1093/ageing/afab026 · 被引用次数：171 · 研究领域：Frailty in Older Adults、Intensive Care Unit Cognitive Disorders、Long-Term Effects of COVID-19

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 w...