Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jan:102:415-421.
doi: 10.1016/j.ijid.2020.10.071. Epub 2020 Oct 30.

Risk factors for death in adult COVID-19 patients: Frailty predicts fatal outcome in older patients

Sara Tehrani  1 , Anna Killander  2 , Per Åstrand  2 , Jan Jakobsson  3 , Patrik Gille-Johnson  2
Affiliations

Risk factors for death in adult COVID-19 patients: Frailty predicts fatal outcome in older patients

Sara Tehrani et al. Int J Infect Dis. 2021 Jan.

Abstract

Objectives: This study investigated demographics, comorbidities, and death rate in hospitalized patients with confirmed COVID-19. In addition, we hypothesized that functional status, according to the Clinical Frailty Scale (CFS), in patients aged 65 years or older is a better predictor of poor outcome than age and comorbidities.

Methods: A total of 255 randomly selected COVID-19 patients admitted to a university hospital were included and followed up for 60 days. Patient data were extracted manually from the electronic health records with use of a standardized protocol.

Results: The age of the study population ranged between 20 and 103 years (mean age 66 years ± 17 years). Hypertension, diabetes mellitus, and obesity were the three most prevalent comorbidities. At the 60-day follow-up, 70 patients (27%) had died. In multivariate analyses, age, chronic kidney disease, and previous stroke were associated with death. Most fatal cases (90%) occurred in patients aged 65 years or older. Among such patients, CFS level was the only predictor of death in multivariate analyses.

Conclusions: This study shows that increasing age, chronic kidney disease, and previous stroke significantly contribute to a fatal outcome in hospitalized patients with COVID-19. In patients aged 65 years or older, CFS level was the strongest prognostic factor for death.

Keywords: COVID-19; Clinical Frailty Scale; Frailty; Mortality; Risk factors; SARS-CoV-2.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Age distribution of inpatients with COVID-19 in the study cohort and at Danderyd University Hospital between March 5 and April 28, 2020. The data show the number of survivors (striped bars) and nonsurvivors (black bars) in the study cohort (left y-axis) and the total number of inpatients at Danderyd University Hospital (light gray bars) during the same period (right y-axis).
Figure 2
Figure 2
Kaplan–Meier survival analyses in relation to Clinical Frailty Scale (CFS) category in patients aged 65 years or older.
See this image and copyright information in PMC

References

    1. Argenziano M.G., Bruce S.L., Slater C.L., Tiao J.R., Baldwin M.R., Barr R.G. Characterization and clinical course of 1000 patients with coronavirus disease 2019 in New York: retrospective case series. BMJ. 2020;369:m1996. - PMC - PubMed
    1. Cardona M., Lewis E.T., Kristensen M.R., Skjot-Arkil H., Ekmann A.A., Nygaard H.H. Predictive validity of the CriSTAL tool for short-term mortality in older people presenting at emergency departments: a prospective study. Eur Geriatr Med. 2018;9:891–901. - PMC - PubMed
    1. Cheng Y., Luo R., Wang K., Zhang M., Wang Z., Dong L. Kidney disease is associated with in-hospital death of patients with COVID-19. Kidney Int. 2020;97:829–838. - PMC - PubMed
    1. Chou C.Y., Wang S.M., Liang C.C., Chang C.T., Liu J.H., Wang I.K. Risk of pneumonia among patients with chronic kidney disease in outpatient and inpatient settings. Medicine (Baltimore) 2014;93:e174. - PMC - PubMed
    1. Clegg A., Young J., Iliffe S., Rikkert M.O., Rockwood K. Frailty in elderly people. Lancet. 2013;381:752–762. - PMC - PubMed