A Prospective Cohort Analysis of COVID-19 Positive and Negative Patients Admitted to a Single Centre in the North-East of England During the Peak of a Pandemic

Dhar, Anjan; Newman, Alexander; Hall, Keryn; Pexton, Christopher; Ramful, Satyasheel; Carter, Alison; Lee, Whajong; Bethapud, Sarath; Allan, Anthony; Akram, Muhammad Safwan; Rand, Vikki

doi:10.2139/ssrn.3672325

Cited by 1 publication

(5 citation statements)

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“…Study characteristics of included articles are shown in Table S1. The majority of articles (44; 84.6%) 8,19–61 originated from Europe, while two originated from North America, 62,63 two from South America, 64,65 two from Asia, 66,67 and two articles were international 68,69 . Most studies (50; 96.2%) took place in a hospital setting, 8,19–21,23–26,28–62,64–69 while three were community‐based (5.8%), 22,58,68 and two took place in a long‐term care facility (3.8%) 36,63 .…”

Section: Resultsmentioning

confidence: 99%

“…The majority of articles (44; 84.6%) 8,19–61 originated from Europe, while two originated from North America, 62,63 two from South America, 64,65 two from Asia, 66,67 and two articles were international 68,69 . Most studies (50; 96.2%) took place in a hospital setting, 8,19–21,23–26,28–62,64–69 while three were community‐based (5.8%), 22,58,68 and two took place in a long‐term care facility (3.8%) 36,63 . Study population sizes were variable (16 to 91,541 participants) and included a total of 118,373 participants across the 50 studies that reported their sample size.…”

Section: Resultsmentioning

confidence: 99%

“…Average age ranged from 56–87 years and the percentage of female participants ranged from 21.7% to 66.7%. Five studies (9.4%) were only available in preprint 22,47,49,50,65 …”

Section: Resultsmentioning

confidence: 99%

“…The most common health outcome reported was mortality (37 studies; 71.2%) 8,19,23,24,26,27,29,31–37,40–45,47–52,54–57,59,62–65,68,69 . The pooled odds ratio (OR) for unadjusted data associating frailty based on the CFS with mortality was 2.02 (95% confidence interval [CI] 1.62–2.51; I 2 83%; Figure S1).…”

Section: Resultsmentioning

confidence: 99%

“…The most common health outcome reported was mortality (37 studies; 71.2%). 8,19,23,24,26,27,29,[31][32][33][34][35][36][37][40][41][42][43][44][45][47][48][49][50][51][52][54][55][56][57]59,[62][63][64][65]68,69 The pooled odds ratio (OR) for unadjusted data associating frailty based on the CFS with mortality was 2.02 (95% confidence interval [CI] 1.62-2.51; I 2 83%; Figure S1). All studies adjusted for age, a majority controlled for comorbidity and sex, while other factors like COVID severity, laboratory values, and socioeconomic indicators were variably adjusted for.…”

Section: Health Outcomesmentioning

confidence: 99%

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Association of frailty with outcomes in individuals with COVID‐19: A living review and meta‐analysis

Dumitrascu

Branje

Hladkowicz

et al. 2021

J American Geriatrics Society

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Background and Objectives: Frailty leaves older adults vulnerable to adverse health outcomes. Frailty assessment is recommended by multiple COVID-19 guidelines to inform care and resource allocation. We aimed to identify, describe, and synthesize studies reporting the association of frailty with outcomes (informed by the Institute for Healthcare Improvement's Triple Aim [health, resource use, and experience]) in individuals with COVID-19.Design: Systematic review and meta-analysis. Setting: Studies reporting associations between frailty and outcomes in the setting of COVID-19 diagnosis. Participants: Adults with COVID-19.Measurements: Following review of titles, abstracts and full text, we included 52 studies that contained 118,373 participants with COVID-19. Risk of bias was assessed using the Quality in Prognostic studies tool. Our primary outcome was mortality, secondary outcomes included delirium, intensive care unit admission, need for ventilation and discharge location. Where appropriate, random-effects meta-analysis was used to pool adjusted and unadjusted effect measures by frailty instrument.Results: The Clinical Frailty Scale (CFS) was the most used frailty instrument. Mortality was reported in 37 studies. After confounder adjustment, frailty identified using the CFS was significantly associated with mortality in COVID-19 positive patients (odds ratio 1.79, 95% confidence interval [CI] 1.49-2.14; hazard ratio 1.87, 95% CI 1.33-2.61). On an unadjusted basis, frailty identified using the CFS was significantly associated with increased odds of delirium and reduced odds of intensive care unit admission. Results were generally consistent using other frailty instruments. Patient-reported, cost and experience outcomes were rarely reported. Conclusion:Frailty is associated with a substantial increase in mortality risk in COVID-19 patients, even after adjustment. Delirium risk is also increased. Frailty assessment may help to guide prognosis and individualized care

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…Average age ranged from 56–87 years and the percentage of female participants ranged from 21.7% to 66.7%. Five studies (9.4%) were only available in preprint 22,47,49,50,65 …”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%