Risk factors for death in adult COVID-19 patients: Frailty predicts fatal outcome in older patients
Sara Tehrani, Anna Killander, Per Åstrand, Jan Jakobsson, Patrik Gille-Johnson
International Journal of Infectious Diseases, doi:10.1016/j.ijid.2020.10.071
This study investigated demographics, comorbidities, and death rate in hospitalized patients with confirmed COVID-19. In addition, we hypothesized that functional status, according to the Clinical Frailty Scale (CFS), in patients aged 65 years or older is a better predictor of poor outcome than age and comorbidities. Methods: A total of 255 randomly selected COVID-19 patients admitted to a university hospital were included and followed up for 60 days. Patient data were extracted manually from the electronic health records with use of a standardized protocol. Results: The age of the study population ranged between 20 and 103 years (mean age 66 years AE 17 years). Hypertension, diabetes mellitus, and obesity were the three most prevalent comorbidities. At the 60-day follow-up, 70 patients (27%) had died. In multivariate analyses, age, chronic kidney disease, and previous stroke were associated with death. Most fatal cases (90%) occurred in patients aged 65 years or older. Among such patients, CFS level was the only predictor of death in multivariate analyses. Conclusions: This study shows that increasing age, chronic kidney disease, and previous stroke significantly contribute to a fatal outcome in hospitalized patients with COVID-19. In patients aged 65 years or older, CFS level was the strongest prognostic factor for death.
Conflict of interest The authors have no conflict of interest to report for this study. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. The protocol of this trial was approved by the Swedish Ethical Review Authority (record number 2020-0177).
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