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What is the relationship between validated frailty scores and mortality for adults with COVID version 3.1 no TC.docx (158.2 kB)

What is the relationship between validated frailty scores and mortality for adults with COVID-19 in acute hospital care? A systematic review.

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journal contribution
posted on 2021-02-08, 15:59 authored by Theodore D Cosco, John Best, Daniel Davis, Daniele Bryden, Suzanne Arkill, James van Oppen, Indira Riadi, Kevin R Wagner, Simon Conroy

Background & aim

The aim of this systematic review was to quantify the association between frailty and COVID-19 in relation to mortality in hospitalised patients.

Methods

Medline, Embase, Web of Science and the grey literature were searched for papers from inception to 10th September 2020; the search was re-run in Medline up until the 9th December 2020. Screening, data extraction and quality grading were undertaken by two reviewers. Results were summarised using descriptive statistics, including a meta-analysis of overall mortality; the relationships between frailty and COVID-19 mortality were summarised narratively.

Results

2,286 papers were screened resulting in 26 being included in the review. Most studies were from Europe, half from the UK, and one from Brazil; the median sample size was 242.5, median age 73.1 and 43.5% were female. 22/26 used the Clinical Frailty Scale; reported mortality ranged from 14 to 65%. Most, but not all studies showed an association between increasing frailty and a greater risk of dying. Two studies indicated a sub-additive relationship between frailty, COVID-19 and death, and two studies showed no association.

Conclusions

Whilst the majority of studies have shown a positive association between COVID-19 related death and increasing frailty, some studies suggested a more nuanced understanding of frailty and outcomes in COVID-19 is needed. Clinicians should exert caution in placing too much emphasis on the influence of frailty alone when discussing likely prognosis in older people with COVID-19 illness.

History

Citation

Age and Ageing, afab008, https://doi.org/10.1093/ageing/afab008

Author affiliation

Department of Health Sciences, University of Leicester

Version

  • AM (Accepted Manuscript)

Published in

Age and ageing

Publisher

Oxford University Press (OUP)

issn

0002-0729

eissn

1468-2834

Copyright date

2021

Available date

2022-01-14

Spatial coverage

England

Language

eng

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