Objectives: To determine the association between frailty and short-term mortality in older adults hospitalized for coronavirus disease 2019 . Design: Retrospective single-center observational study. Setting and participants: Eighty-one patients with COVID-19 confirmed by reverse-transcriptase polymerase chain reaction (RT-PCR), at the Geriatrics department of a general hospital in Belgium. Measurements: Frailty was graded according to the Rockwood Clinical Frailty Scale (CFS). Demographic, biochemical, and radiologic variables, comorbidities, symptoms, and treatment were extracted from electronic medical records. Results: Participants (N ¼ 48 women, 59%) had a median age of 85 years (range 65-97 years) and a median CFS score of 7 (range 2-9); 42 (52%) were long-term care residents. Within 6 weeks, 19 patients died. Mortality was significantly but weakly associated with age (Spearman r ¼ 0.241, P ¼ .03) and CFS score (r ¼ 0.282, P ¼ .011), baseline lactate dehydrogenase (LDH; r ¼ 0.301, P ¼ .009), lymphocyte count (r ¼ À0.262, P ¼ .02), and RT-PCR cycle threshold (Ct, r ¼ À0.285, P ¼ .015). Mortality was not associated with long-term care residence, dementia, delirium, or polypharmacy. In multivariable logistic regression analyses, CFS, LDH, and RT-PCR Ct (but not age) remained independently associated with mortality. Both age and frailty had poor specificity to predict survival. A multivariable model combining age, CFS, LDH, and viral load significantly predicted survival. Conclusions and Implications: Although their prognosis is worse, even the oldest and most severely frail patients may benefit from hospitalization for COVID-19, if sufficient resources are available.

Objective• To evaluate the impact of baseline serum C-reactive protein (CRP) level on outcome in patients with metastatic renal cell carcinoma (mRCC) treated with sunitinib. Patients and Methods• We reviewed the charts of patients with mRCC who started sunitinib as a first targeted treatment between 2005 and 2012 in three hospitals in Belgium and France.• Collected data included known prognostic factors for mRCC, anatomical location of metastatic sites, response rate (RR), progression-free survival (PFS) and overall survival (OS). Results• A total of 200 eligible patients were identified by retrospective chart review. The median PFS and OS were 12 and 20 months, respectively. • Patients with elevated baseline CRP levels had a poor prognosis independent of the IMDC risk group, whereas patients with a low baseline CRP in the IMDC favourable risk group had a very good outcome. Conclusion• Baseline serum CRP level is a strong independent variable linked with RR, PFS and OS in patients with mRCC treated with sunitinib.

Background: Older adults with coronavirus disease 2019 (COVID−19) face an increased risk of adverse health outcomes including mortality. Ethical guidelines consider allocation of limited resources based on likelihood of survival, frailty, co−morbidities and age. However, the association of frailty with clinical outcomes in older COVID−19 patients remains unclear. Objectives: To determine the association between frailty and short-term mortality in older adults hospitalized for COVID−19. Design: Retrospective single-center observational study. Setting and participants: N = 81 patients with COVID−19 confirmed by reverse-transcriptase polymerase chain reaction (RT−PCR), at the Geriatrics department of Imelda general hospital, Belgium. Measurements: Frailty was graded according to the Rockwood Clinical Frailty Scale (CFS). Demographic, biochemical and radiological variables, co−morbidities, symptoms and treatment were extracted from electronic medical records. Results: Participants (N = 48 women, 59%) had a median age of 85 years (range 65 − 97 years), median CFS score of 7 (range 2 − 9), and 42 (52%) were long−term care residents. Within six weeks, eighteen patients died. Mortality was significantly but weakly associated with age (Spearman r = 0.241, P = 0.03) and CFS score (r = 0.282, P = 0.011), baseline lactate dehydrogenase (LDH) (r = 0.301, P = 0.009), lymphocyte count (r = −0.262, P = 0.02) and RT-PCR Ct value (r = −0.285, P = 0.015). Mortality was not associated with long-term care residence, dementia, delirium or polypharmacy. In multivariable logistic regression analyses, CFS, LDH and RT-PCR Ct values (but not age) remained independently associated with mortality. Both age and frailty had poor specificity to predict survival. A multivariable model combining age, CFS, LDH and viral load significantly predicted survival. Conclusions and implications: Although their prognosis is worse, even the oldest and most severely frail patients may benefit from hospitalization for COVID−19, if sufficient resources are available.