Introduction Increased mortality has been demonstrated in older adults with COVID-19, but the effect of frailty has been unclear. Methods This multi-centre cohort study involved patients aged 18 years and older hospitalised with COVID-19, using routinely collected data. We used Cox regression analysis to assess the impact of age, frailty, and delirium on the risk of inpatient mortality, adjusting for sex, illness severity, inflammation, and co-morbidities. We used ordinal logistic regression analysis to assess the impact of age, Clinical Frailty Scale (CFS), and delirium on risk of increased care requirements on discharge, adjusting for the same variables. Results Data from 5,711 patients from 55 hospitals in 12 countries were included (median age 74, IQR 54–83; 55.2% male). The risk of death increased independently with increasing age (>80 vs 18–49: HR 3.57, CI 2.54–5.02), frailty (CFS 8 vs 1–3: HR 3.03, CI 2.29–4.00) inflammation, renal disease, cardiovascular disease, and cancer, but not delirium. Age, frailty (CFS 7 vs 1–3: OR 7.00, CI 5.27–9.32), delirium, dementia, and mental health diagnoses were all associated with increased risk of higher care needs on discharge. The likelihood of adverse outcomes increased across all grades of CFS from 4 to 9. Conclusions Age and frailty are independently associated with adverse outcomes in COVID-19. Risk of increased care needs was also increased in survivors of COVID-19 with frailty or older age.

Tubal factor infertility may be reversed using porcine small-intestinal submucosa (SIS). The method uses as a model the New Zealand White rabbit uerine horn. In surgery, SIS grafts were prepared from porcine jejunum; the uterine horn segment was resected and a graft was placed; then the contralateral adnexa was resected. Fecundability was tested with natural mating. Three out of six rabbits became pregnant. Gross and microscopic examination confirmed regeneration of all tissue layers. Thus, this study determined that SIS facilitates successful regeneration of uterine horn morphology in a manner similar to that observed in other tissues and species.

The goal of peripheral nerve repair is to successfully direct the regenerating fibers into the environment of the distal terminus with minimal loss of fibers at the suture line. Successful nerve repair is dependent on sensory, motor, and autonomic axons making appropriate connection with their distal terminus. The subsequent results are dependent on parameters such as the location and extent of the injury, appropriateness of realignment of the injured nerve, and the surgical technique. Peripheral nerve repair using autograft material has several shortcomings, including donor site morbidity, inadequate return of function, and aberrant regeneration. Recent peripheral nerve research has focused on the generation of synthetic conduits for nerve guidance. Small intestine submucosa (SIS) is a biological material that might better address those outcomes and improve regeneration. Its unique properties appear to offer several advantages. The SIS graft acts as a natural conduit between the proximal and distal nerves, provides a favorable growth environment, and appears to lack antigenicity. This preliminary study to evaluate the integrity of sciatic nerve repair was conducted over a period of 90 d. Distally directed growth of the proximal nerve was demonstrated histologically. Further investigations to demonstrate the extent and integrity of this regeneration are underway.

A certain degree of age-related cognitive decline is normal; however, some people retain more cognitive function than others. Cognitive impairment is associated with an increased risk of dementia. Thus, understanding the factors that contribute to cognitive reserve is crucial, so effective strategies for the prevention of dementia can be developed. Engaging in physical activity can delay cognitive decline and reduce the risk of dementia and a number of early life conditions have been shown to have long-lasting effects on cognition. This mini-review combines these two observations to evaluate the evidence from both animal models and epidemiological studies for physical activity in early life (≤30 years) delaying cognitive decline in later life (cognition tested ≥60 years). Three epidemiological studies were found; two showed a positive association and one found none. The latter was deemed to have an unreliable method. A review of animal studies found none that analyzed the effect of physical activity in early life on cognition in later life. However, in rodent models that analyzed mid-life cognition, runners showed improved cognition and enhanced adult hippocampal neurogenesis, changes which were preserved across the life span. Currently, there is insufficient evidence to conclude whether physical activity in early life may delay cognitive decline in later life, but these results indicate that further studies are warranted. Future human research should be in the form of longitudinal studies that begin below ≤15 years and assess sex differences. Crucially, the physical activity data must define type, quantity and intensity of exercise.