4.7 Article

Risk factors for death in adult COVID-19 patients: Frailty predicts fatal outcome in older patients

Journal

INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES
Volume 102, Issue -, Pages 415-421

Publisher

ELSEVIER SCI LTD
DOI: 10.1016/j.ijid.2020.10.071

Keywords

COVID-19; SARS-CoV-2; Risk factors; Mortality; Clinical Frailty Scale; Frailty

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This study investigated demographics, comorbidities, and death rate in hospitalized COVID-19 patients and found that functional status may be a better predictor of poor outcomes. Increasing age, chronic kidney disease, and previous stroke were identified as risk factors for death in hospitalized patients with COVID-19.
Objectives: 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 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. (C) 2020 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.

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