The unavoidable costs of frailty: a geriatric perspective in the time of COVID-19

Polidori, Maria Cristina; Maggi, Stefania; Mattace‐Raso, Francesco

doi:10.4081/gc.2020.8989

Cited by 20 publications

(20 citation statements)

References 10 publications

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“…The reason behind these trends might be due to the fact that Italy has one of the oldest populations in the world. According to the latest data, Italy has 14 million residents over the age of 65 (22%) with an average age of 45.7 years, while in Ecuador the average population is 26.6 years old [7,23,24].…”

Section: Discussionmentioning

confidence: 99%

Epidemiological, socio-demographic and clinical features of the early phase of the COVID-19 epidemic in Ecuador

et al. 2021

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The SARS-CoV-2 virus has spread rapidly around the globe. Nevertheless, there is limited information describing the characteristics and outcomes of COVID-19 patients in Latin America. We conducted a cross-sectional analysis of 9,468 confirmed COVID-19 cases reported in Ecuador. We calculated overall incidence, mortality, case fatality rates, disability adjusted life years, attack and crude mortality rates, as well as relative risk and relative odds of death, adjusted for age, sex and presence of comorbidities. A total of 9,468 positive COVID-19 cases and 474 deaths were included in the analysis. Men accounted for 55.4% (n = 5, 247) of cases and women for 44.6% (n = 4, 221). We found the presence of comorbidities, being male and older than 65 years were important determinants of mortality. Coastal regions were most affected by COVID-19, with higher mortality rates than the highlands. Fatigue was reported in 53.2% of the patients, followed by headache (43%), dry cough (41.7%), ageusia (37.1%) and anosmia (36.1%). We present an analysis of the burden of COVID-19 in Ecuador. Our findings show that men are at higher risk of dying from COVID-19 than women, and risk increases with age and the presence of comorbidities. We also found that blue-collar workers and the unemployed are at greater risk of dying. These early observations offer clinical insights for the medical community to help improve patient care and for public health officials to strengthen Ecuador’s response to the outbreak.

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Section: Discussionmentioning

confidence: 99%

Epidemiological, socio-demographic and clinical features of the early phase of the COVID-19 epidemic in Ecuador

et al. 2021

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Section: Discussionmentioning

confidence: 99%

Epidemiological, socio-demographic and clinical features of the early phase of the COVID-19 epidemic in Ecuador

Ortíz-Prado

Simbaña-Rivera

Diaz

et al. 2020

Preprint

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Background:The SARS-CoV-2 virus has spread rapidly around the globe. Nevertheless, there is limited information describing the characteristics and outcomes of COVID-19 patients in Latin America. Methods:We conducted a cross-sectional analysis of 9,468 confirmed COVID-19 cases reported in Ecuador. We calculated overall incidence, mortality, case fatality rates, disability adjusted life years, attack and crude mortality rates, as well as relative risk and relative odds of death, adjusted for age, sex and presence of comorbidities.Results: A total of 9,468 positive COVID-19 cases and 474 deaths were included in the analysis. Men accounted for 55.4% (n = 5, 247) of cases and women for 44.6% (n = 4, 221).We found the presence of comorbidities, being male and older than 65 years were important determinants of mortality. Coastal regions were most affected by COVID-19, with higher mortality rates than the highlands. Fatigue was reported in 53.2% of the patients, followed by headache (43%), dry cough (41.7%), ageusia (37.1%) and anosmia (36.1%). Conclusion:We present the first analysis of the burden of COVID-19 in Ecuador. Our findings show that men are at higher risk of dying from COVID-19 than women, and risk increases with age and the presence of comorbidities. We also found that blue-collar workers and the unemployed are at greater risk of dying. These early observations offer clinical insights for the medical community to help improve patient care and for public health officials to strengthen Ecuador's response to the outbreak.

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“…Among all the National Health Systems, a source of great concern is the number of hospital and intensive care unit (ICU) beds available during the different pandemic phases to face with the great number of older patients needing hospitalization for COVID-19 ( Haas, de Lange, van Dijk, & van Delden, 2020 ). This indicates the need of a precise stratification of older people by prognostic factors other than age and disease-specific determinants, including also functional, physical and psycho-social factors that can be best addressed by a geriatric multidimensional assessment ( Polidori, Maggi, Mattace-Raso, & Pilotto, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

The multidimensional prognostic index (MPI) for the prognostic stratification of older inpatients with COVID-19: A multicenter prospective observational cohort study

Azzini¹,

Cella

Cenderello

et al. 2021

Archives of Gerontology and Geriatrics

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Background The topic of prognosis in COVID-19 research may be important in adopting appropriate clinical decisions. Multidimensional prognostic index (MPI) is a frailty assessment tool widely used for stratifying prognosis in older people, but data regarding inpatients, affected by COVID-19, are not available. Objectives To evaluate whether MPI can predict in-hospital mortality and the admission to intensive care unit (ICU) in older inpatients hospitalized for COVID-19 infection. Methods In this longitudinal, Italian, multi-center study, older patients with COVID-19 were included. MPI was calculated using eight different domains typical of comprehensive geriatric assessment and categorized in three groups (MPI 1 ≤ 0.33, MPI 2 0.34–0.66, MPI 3 > 0.66). A multivariable Cox's regression analysis was used reporting the results as hazard ratios (HRs) with 95% confidence intervals (CIs). Results 227 older patients hospitalized for SARS-CoV-2 infection were enrolled (mean age: 80.5 years, 59% females). Inpatients in the MPI 3 were subjected less frequently than those in the MPI 1 to non-invasive ventilation (NIV). In the multivariable analysis, people in MPI 3 experienced a higher risk of in hospital mortality (HR = 6.30, 95%CI: 1.44–27.61), compared to MPI 1. The accuracy of MPI in predicting in hospital mortality was good (Area Under the Curve (AUC) = 0.76, 95%CI: 0.68–0.83). People in MPI 3 experienced a significant longer length of stay (LOS) in hospital compared to other participants. No association between MPI and ICU admission was found. Conclusions Frailty- as assessed by high MPI score - was associated with a significant higher risk of in-hospital mortality, longer LOS, and lower use NIV, whilst the association with ICU admission was not significant. These findings suggest that prognostic stratification by using the MPI could be useful in clinical decision making in older inpatients affected by COVID-19.

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The unavoidable costs of frailty: a geriatric perspective in the time of COVID-19

Cited by 20 publications

References 10 publications

Epidemiological, socio-demographic and clinical features of the early phase of the COVID-19 epidemic in Ecuador

Epidemiological, socio-demographic and clinical features of the early phase of the COVID-19 epidemic in Ecuador

Epidemiological, socio-demographic and clinical features of the early phase of the COVID-19 epidemic in Ecuador

The multidimensional prognostic index (MPI) for the prognostic stratification of older inpatients with COVID-19: A multicenter prospective observational cohort study

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