Quality of life and intrinsic capacity in patients with post-acute COVID-19 syndrome is in relation to frailty and resilience phenotypes

The objective of this study was to characterize frailty and resilience in people evaluated for Post-Acute COVID-19 Syndrome (PACS), in relation to quality of life (QoL) and Intrinsic Capacity (IC). This cross-sectional, observational, study included consecutive people previously hospitalized for severe COVID-19 pneumonia attending Modena (Italy) PACS Clinic from July 2020 to April 2021. Four frailty-resilience phenotypes were built: fit/resilient, fit/non-resilient, frail/resilient and frail/non-resilient. Frailty and resilience were defined according to frailty phenotype and Connor Davidson resilience scale (CD-RISC-25) respectively. Study outcomes were: QoL assessed by means of Symptoms Short form health survey (SF-36) and health-related quality of life (EQ-5D-5L) and IC by means of a dedicated questionnaire. Their predictors including frailty-resilience phenotypes were explored in logistic regressions. 232 patients were evaluated, median age was 58.0 years. PACS was diagnosed in 173 (74.6%) patients. Scarce resilience was documented in 114 (49.1%) and frailty in 72 (31.0%) individuals. Predictors for SF-36 score < 61.60 were the phenotypes frail/non-resilient (OR = 4.69, CI 2.08-10.55), fit/non-resilient (OR = 2.79, CI 1.00-7.73). Predictors for EQ-5D-5L < 89.7% were the phenotypes frail/non-resilient (OR = 5.93, CI 2.64-13.33) and frail/resilient (OR = 5.66, CI 1.93-16.54). Predictors of impaired IC (below the mean score value) were frail/non-resilient (OR = 7.39, CI 3.20-17.07), and fit/non-resilient (OR = 4.34, CI 2.16-8.71) phenotypes. Resilience and frailty phenotypes may have a different impact on wellness and QoL and may be evaluated in people with PACS to identify vulnerable individuals that require suitable interventions.

Automated summary

This study aims to characterize frailty and resilience in people with Post-Acute COVID-19 Syndrome (PACS) and explore their relationship with quality of life (QoL) and Intrinsic Capacity (IC). The study identified four frailty-resilience phenotypes and found that frailty and resilience are associated with QoL and IC. Evaluating frailty and resilience in individuals with PACS can help identify vulnerable individuals who may require interventions.