Frailty assessment for COVID-19 follow-up: a prospective cohort study.

Müller, Ilena; Mancinetti, Marco; Renner, Anja; Bridevaux, Pierre-Olivier; Brutsche, Martin H; Clarenbach, Christian; Garzoni, Christian; Lenoir, Alexandra; Naccini, Bruno; Ott, Sebastian; Piquilloud, Lise; Prella, Maura; Que, Yok-Ai; Soccal, Paola Marina; von Garnier, Christophe; Geiser, Thomas K; Funke-Chambour, Manuela; Guler, Sabina (2022). Frailty assessment for COVID-19 follow-up: a prospective cohort study. BMJ Open Respiratory Research, 9(1) BMJ Publishing Group: Open Access 10.1136/bmjresp-2022-001227

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The Clinical Frailty Scale (CFS) is increasingly used for clinical decision making in acute care but little is known about frailty after COVID-19.


To investigate frailty and the CFS for post-COVID-19 follow-up.


This prospective multicentre cohort study included COVID-19 survivors aged ≥50 years presenting for a follow-up visit ≥3 months after the acute illness. Nine centres retrospectively collected pre-COVID-19 CFS and prospectively CFS at follow-up. Three centres completed the Frailty Index (FI), the short physical performance battery (SPPB), 30 s sit-to-stand test and handgrip strength measurements. Mixed effect logistic regression models accounting for repeated measurements and potential confounders were used to investigate factors associated with post-COVID-19 CFS. Criterion and construct validity were determined by correlating the CFS to other concurrently assessed frailty measurements and measures of respiratory impairment, respectively.


Of the 288 participants 65% were men, mean (SD) age was 65.1 (9) years. Median (IQR) CFS at follow-up was 3 (2-3), 21% were vulnerable or frail (CFS ≥4). The CFS was responsive to change, correlated with the FI (r=0.69, p<0.001), the SPPB score (r=-0.48, p<0.001) (criterion validity) and with the St George's Respiratory Questionnaire score (r=0.59, p<0.001), forced vital capacity %-predicted (r=-0.25, p<0.001), 6 min walk distance (r=-0.39, p<0.001) and modified Medical Research Council (mMRC) (r=0.59, p<0.001). Dyspnoea was significantly associated with a higher odds for vulnerability/frailty (per one mMRC adjusted OR 2.01 (95% CI 1.13 to 3.58), p=0.02).


The CFS significantly increases with COVID-19, and dyspnoea is an important risk factor for post-COVID-19 frailty and should be addressed thoroughly.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Pneumology
04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Rheumatology, Clinical Immunology and Allergology
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > Forschungsbereich Mu50 > Forschungsgruppe Pneumologie (Erwachsene)
04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic of Intensive Care
04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Infectiology

UniBE Contributor:

Garzoni, Christian, Que, Yok-Ai, Geiser, Thomas (A), Funke-Chambour, Manuela, Guler, Sabina Anna


600 Technology > 610 Medicine & health




BMJ Publishing Group: Open Access




Pubmed Import

Date Deposited:

26 Apr 2022 15:19

Last Modified:

12 May 2023 11:59

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

COVID-19 respiratory infection




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