Theodore D Cosco1, John Best2, Daniel Davis3, Daniele Bryden4, Suzanne Arkill5, James van Oppen6, Indira Riadi7, Kevin R Wagner8, Simon Conroy9. 1. Assistant Professor, Department of Gerontology, Simon Fraser University, Vancouver, Canada. 2. University Research Associate, Department of Gerontology, Simon Fraser University, Vancouver, Canada. 3. Senior Research Fellow, University College London, UK. 4. Sheffield Teaching Hospitals, UK. 5. University Hospitals of Leicester, UK. 6. Academic Clinical Fellow, University of Leicester. 7. Graduate Student, Department of Gerontology, Simon Fraser University. 8. Simon Fraser University, Vancouver, Canada. 9. Department of Health Sciences, University of Leicester, University Road, Leicester, LE1 7RH, UK.
Abstract
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.
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.
Authors: Ruth E Hubbard; Nancye M Peel; Mayukh Samanta; Leonard C Gray; Arnold Mitnitski; Kenneth Rockwood Journal: Age Ageing Date: 2017-09-01 Impact factor: 10.668
Authors: Simon E Brill; Hannah C Jarvis; Ezgi Ozcan; Thomas L P Burns; Rabia A Warraich; Lisa J Amani; Amina Jaffer; Stephanie Paget; Anand Sivaramakrishnan; Dean D Creer Journal: BMC Med Date: 2020-06-25 Impact factor: 8.775
Authors: Aline Mendes; Christine Serratrice; François R Herrmann; Laurence Genton; Samuel Périvier; Max Scheffler; Thomas Fassier; Philippe Huber; Marie-Claire Jacques; Virginie Prendki; Xavier Roux; Katharine Di Silvestro; Véronique Trombert; Stephan Harbarth; Gabriel Gold; Christophe E Graf; Dina Zekry Journal: J Am Med Dir Assoc Date: 2020-09-15 Impact factor: 4.669
Authors: Asangaedem Akpan; Charlotte Roberts; Karen Bandeen-Roche; Barbara Batty; Claudia Bausewein; Diane Bell; David Bramley; Julie Bynum; Ian D Cameron; Liang-Kung Chen; Anne Ekdahl; Arnold Fertig; Tom Gentry; Marleen Harkes; Donna Haslehurst; Jonathon Hope; Diana Rodriguez Hurtado; Helen Lyndon; Joanne Lynn; Mike Martin; Ruthe Isden; Francesco Mattace Raso; Sheila Shaibu; Jenny Shand; Cathie Sherrington; Samir Sinha; Gill Turner; Nienke De Vries; George Jia-Chyi Yi; John Young; Jay Banerjee Journal: BMC Geriatr Date: 2018-02-02 Impact factor: 3.921
Authors: Marta Cobos-Siles; Pablo Cubero-Morais; Irene Arroyo-Jiménez; María Rey-Hernández; Laura Hernández-Gómez; Derly Judith Vargas-Parra; María González-Fernández; Marina Cazorla-González; Miriam Gabella-Martín; Tomás Ruíz-Albi; José Angel Berezo-García; Jesús Fernando García-Cruces-Méndez; José Pablo Miramontes-González; Luis Corral-Gudino Journal: Intern Emerg Med Date: 2020-09-10 Impact factor: 3.397
Authors: Sara Hägg; Juulia Jylhävä; Yunzhang Wang; Hong Xu; Carina Metzner; Martin Annetorp; Sara Garcia-Ptacek; Masih Khedri; Anne-Marie Boström; Ahmadul Kadir; Anna Johansson; Miia Kivipelto; Maria Eriksdotter; Tommy Cederholm; Dorota Religa Journal: J Am Med Dir Assoc Date: 2020-08-14 Impact factor: 7.802