Predictive value of frailty in the mortality of hospitalized patients with COVID-19: a systematic review and meta-analysis

Zou, Yuan; Han, Maonan; Wang, Jiarong; Zhao, Jichun; Gan, Hui-Li; Yang, Yi

doi:10.21037/atm-22-274

Cited by 19 publications

(18 citation statements)

References 43 publications

(40 reference statements)

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“…Of all, the study by Saragih et al ( 53) was the only one that exclusively included older adults, while Zou et al (15) and Subramaniam et al (51) carried out an subgroup FIGURE Frail vs. Non-frail Short-term Mortality. Sample, number of participants (number of studies in the meta-analysis), and likelihood of event ( % confidence interval, CI).…”

Section: Frailty In Covid-pandemic Settingmentioning

confidence: 99%

“…As part of the scope of the present review, a search was performed from PubMed database searching for meta-analyses studies reporting associations between frailty and COVID-19 related outcomes in community-dwelling older adults using the terms “frailty or frail” and “SARS-CoV-2 or COVID-19” by June 6, 2022. To date, seven studies have performed meta-analyses to assess the impact of frailty on short-term mortality risk from COVID-19 ( 15 , 16 , 24 , 51 – 54 ), although Pranata et al ( 54 ) aimed to quantify the dose-response relationship between clusters of clinical frailty scale (CFS) and mortality in COVID-19 patients. The authors ( 54 ) presented a similar distribution in the pooled prevalence for the clustered CFS 1–3 (34%), CFS 4–6 (42%), and CFS 7–9 (23%), and a significant 12% increase in mortality for each 1-point increment in CFS [OR 1.12 (95% Confidence Interval, CI, 1.04–1.20), p = 0.003].…”

Section: Frailty In Covid-19 Pandemic Settingmentioning

confidence: 99%

“…Sample, number of participants (number of studies in the meta-analysis), and likelihood of event (95% confidence interval, CI). Summary of the mortality risk outcome from meta-analyses ( 15 , 16 , 24 , 51 – 53 ). Dashed line represents absence of statistical significance.…”

Section: Frailty In Covid-19 Pandemic Settingmentioning

confidence: 99%

“…Of all, the study by Saragih et al ( 53 ) was the only one that exclusively included older adults, while Zou et al ( 15 ) and Subramaniam et al ( 51 ) carried out an subgroup analysis in this population. The primary outcome of all studies was short-term mortality, defined as in-hospital death or within 30 days, although three of them ( 24 , 51 , 52 ) also reported additional outcomes such as delirium, risk of COVID-19 severity, admission to intensive care unit, application of invasive mechanical ventilation, and long hospital length of stay.…”

Section: Frailty In Covid-19 Pandemic Settingmentioning

confidence: 99%

“…Frailty per se makes older adults vulnerable to unfavorable health outcomes. In the context of a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, the etiological agent of coronavirus disease 2019 (COVID-19), 51.4% of patients hospitalized with positive COVID-19 were frail and had a significantly higher risk of short-term mortality compared with non-frail older adults ( 15 ). These findings corroborate previous evidence indicating frailty as an independent predictor of mortality among patients with COVID-19 ( 16 ), even in hospitalized patients younger than 65 years ( 17 ).…”

Section: Introductionmentioning

confidence: 99%

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Frailty in the context of COVID-19 pandemic: A life-threatening condition

Fernandes

Pereira

2022

Front. Med.

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The pandemic outbreak of coronavirus disease 2019 (COVID-19) has caused emerging challenges for healthcare systems regarding the assistance to the older adult population which, added to the increased life expectancy, may be exposing frail older adults to an increased risk of unfavorable health outcomes. Frailty has a pathogenesis of multifactorial etiology and is defined as a condition characterized by progressive decline in physiological function, weakness, decreased strength, and reduced resilience to stressors, leading to vulnerability and an increased risk of fractures, falls, institutionalization, and death. In the context of COVID-19, frail older adults accounted for approximately 51% of hospitalized patients with confirmed cases and elevated risk of mortality in-hospital. In addition, frailty may be associated with recent “excess mortality” reported by the World Health Organization (WHO) in terms of the full death toll associated directly (due to the disease) or indirectly (due to the pandemic's impact on health systems and society) to COVID-19. Therefore, this mini review aimed to provide a summarized discussion from meta-analyses data regarding the impact of frailty in community-dwelling older adults hospitalized with COVID-19 on short-term mortality risk.

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Section: Frailty In Covid-pandemic Settingmentioning

confidence: 99%

Section: Frailty In Covid-19 Pandemic Settingmentioning

confidence: 99%

Section: Frailty In Covid-19 Pandemic Settingmentioning

confidence: 99%

Section: Frailty In Covid-19 Pandemic Settingmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Frailty in the context of COVID-19 pandemic: A life-threatening condition

Fernandes

Pereira

2022

Front. Med.

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Prognostic Factors of COVID‐19: An Umbrella Review Endorsed by the International Society for Pharmacoepidemiology

Sarri¹,

Liu

Zabotka

et al. 2023

Clin Pharma and Therapeutics

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During the coronavirus disease 2019 (COVID‐19) pandemic, the urgency for updated evidence to inform public health and clinical care placed systematic literature reviews (SLRs) at the cornerstone of research. We aimed to summarize evidence on prognostic factors for COVID‐19 outcomes through published SLRs and to critically assess quality elements in the findings' interpretation. An umbrella review was conducted via electronic databases from January 2020 to April 2022. All SLRs (and meta‐analyses) in English were considered. Data screening and extraction were conducted by two independent reviewers. AMSTAR 2 tool was used to assess SLR quality. The study was registered with PROSPERO (CRD4202232576). Out of 4,564 publications, 171 SLRs were included of which 3 were umbrella reviews. Our primary analysis included 35 SLRs published in 2022, which incorporated studies since the beginning of the pandemic. Consistent findings showed that, for adults, older age, obesity, heart disease, diabetes, and cancer were more strongly predictive of risk of hospitalization, intensive care unit admission, and mortality due to COVID‐19. Male sex was associated with higher risk of short‐term adverse outcomes, but female sex was associated with higher risk of long COVID. For children, socioeconomic determinants that may unravel COVID‐19 disparities were rarely reported. This review highlights key prognostic factors of COVID‐19, which can help clinicians and health officers identify high‐risk groups for optimal care. Findings can also help optimize confounding adjustment and patient phenotyping in comparative effectiveness research. A living SLR approach may facilitate dissemination of new findings. This paper is endorsed by the International Society for Pharmacoepidemiology.

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Comment on Tsai et al.'s “clinical effectiveness of oral antiviral agents in older patients with COVID‐19 based on real‐world data”

Chu,

Hsieh,

Wei

2023

Journal of Medical Virology

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We read with great interest the article by Tsai et al., 1 which reports the association of oral antiviral agents with a decreased risk of allcause hospitalization and mortality in older patients infected with COVID-19. However, we would like to highlight some key concerns. First, in 2022, many older adults already had past COVID-19 infection. Previous studies demonstrated that past severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection had a high protective effect against reinfection with severe disease course. 2 Such protection could also possess alteration to the outcome of patients with past COVID-19 infection in the current study. However, this was not considered in the current study. We suggested that individuals who have previously been infected with COVID-19, or individuals who have been infected with COVID-19 within the past 3 months should be excluded of the study to minimize the bias.Second, for older adults, the prognosis of being infected with COVID-19 are greatly affected by the functional status, psychiatric conditions, and frailty. 3-5 Also, physical activity increased the risk of having a severe disease course after COVID-19 infection. 6 However,

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Predictive value of frailty in the mortality of hospitalized patients with COVID-19: a systematic review and meta-analysis

Cited by 19 publications

References 43 publications

Frailty in the context of COVID-19 pandemic: A life-threatening condition

Frailty in the context of COVID-19 pandemic: A life-threatening condition

Prognostic Factors of COVID‐19: An Umbrella Review Endorsed by the International Society for Pharmacoepidemiology

Comment on Tsai et al.'s “clinical effectiveness of oral antiviral agents in older patients with COVID‐19 based on real‐world data”

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