Older adults with SARS-CoV-2 infection: Utility of the clinical frailty scale to predict mortality.

The objective of this study was to identify predictive factors of mortality in older adults with coronavirus disease 2019 (COVID-19), including the level of clinical frailty by using the clinical frailty scale (CFS). We analyzed medical records of all patients aged of 75 and older with a confirmed diagnosis of COVID-19 hospitalized in our Hospital between March 3 and April 25, 2020. Standardized variables were prospectively collected, and standardized care were provided to all patients. One hundred and eighty-six patients were included (mean 85.3 ± 5.78 year). The all cause 30-day mortality was 30% (56/186). At admission, dead patients were more dyspneic (57% vs. 38%, p = .014), had more often an oxygen saturation less than 94% (70% vs. 47%, p < .01) and had more often a heart rate faster than 90/min (70% vs. 42%, p < .001). Mortality increased in parallel with CFS score (p = .051) (20 deaths (36%) in 7-9 category). In multivariate analysis, CFS score (odds ratio [OR] = 1.49; confidence interval [CI] 95%, 1.01-2.19; p = .046), age (OR = 1.15; CI 95%, 1.01-1.31; p = .034), and dyspnea (OR = 5.37; CI 95%, 1.33-21.68; p = .018) were associated with all-cause 30-day mortality. It is necessary to integrate the assessment of frailty to determine care management plan of older patients with COVID-19, rather than the only restrictive criterion of age.