The impact of frailty on survival in elderly intensive care patients with COVID-19: the COVIP study.

Jung, Christian; Flaatten, Hans; Fjølner, Jesper; Bruno, Raphael Romano; Wernly, Bernhard; Artigas, Antonio; Bollen Pinto, Bernardo; Schefold, Joerg C; Wolff, Georg; Kelm, Malte; Beil, Michael; Sviri, Sigal; van Heerden, Peter Vernon; Szczeklik, Wojciech; Czuczwar, Miroslaw; Elhadi, Muhammed; Joannidis, Michael; Oeyen, Sandra; Zafeiridis, Tilemachos; Marsh, Brian; ... (2021). The impact of frailty on survival in elderly intensive care patients with COVID-19: the COVIP study. Critical care, 25(1), p. 149. BioMed Central 10.1186/s13054-021-03551-3

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BACKGROUND

The COVID-19 pandemic has led highly developed healthcare systems to the brink of collapse due to the large numbers of patients being admitted into hospitals. One of the potential prognostic indicators in patients with COVID-19 is frailty. The degree of frailty could be used to assist both the triage into intensive care, and decisions regarding treatment limitations. Our study sought to determine the interaction of frailty and age in elderly COVID-19 ICU patients.

METHODS

A prospective multicentre study of COVID-19 patients ≥ 70 years admitted to intensive care in 138 ICUs from 28 countries was conducted. The primary endpoint was 30-day mortality. Frailty was assessed using the clinical frailty scale. Additionally, comorbidities, management strategies and treatment limitations were recorded.

RESULTS

The study included 1346 patients (28% female) with a median age of 75 years (IQR 72-78, range 70-96), 16.3% were older than 80 years, and 21% of the patients were frail. The overall survival at 30 days was 59% (95% CI 56-62), with 66% (63-69) in fit, 53% (47-61) in vulnerable and 41% (35-47) in frail patients (p < 0.001). In frail patients, there was no difference in 30-day survival between different age categories. Frailty was linked to an increased use of treatment limitations and less use of mechanical ventilation. In a model controlling for age, disease severity, sex, treatment limitations and comorbidities, frailty was independently associated with lower survival.

CONCLUSION

Frailty provides relevant prognostic information in elderly COVID-19 patients in addition to age and comorbidities. Trial registration Clinicaltrials.gov: NCT04321265 , registered 19 March 2020.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic of Intensive Care

UniBE Contributor:

Schefold, Jörg Christian

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1364-8535

Publisher:

BioMed Central

Language:

English

Submitter:

Jsabelle Arni

Date Deposited:

25 May 2021 15:30

Last Modified:

30 May 2021 03:06

Publisher DOI:

10.1186/s13054-021-03551-3

PubMed ID:

33874987

Uncontrolled Keywords:

COVID-19 Elderly Frailty Outcome Pandemia

BORIS DOI:

10.48350/155968

URI:

https://boris.unibe.ch/id/eprint/155968

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