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
. 2022 Jun 1;25(2):183-196.
doi: 10.5770/cgj.25.546. eCollection 2022 Jun.

Older Age and Frailty are Associated with Higher Mortality but Lower ICU Admission with COVID-19

Melissa K Andrew  1   2 , Judith Godin  1 , Jason LeBlanc  2   3   4 , Guy Boivin  5 , Louis Valiquette  6 , Allison McGeer  7 , Janet E McElhaney  8 , Todd F Hatchette  2   3   4 , May ElSherif  2 , Donna MacKinnon-Cameron  2 , Kevin Wilson  2 , Ardith Ambrose  2 , Sylvie Trottier  9 , Mark Loeb  10 , Stephanie W Smith  11 , Kevin Katz  12 , Anne McCarthy  13 , Shelly A McNeil  2   4
Affiliations

Older Age and Frailty are Associated with Higher Mortality but Lower ICU Admission with COVID-19

Melissa K Andrew et al. Can Geriatr J. .

Abstract

Background: We report characteristics and outcomes of adults admitted to Canadian Immunization Research Network (CIRN) Serious Outcomes Surveillance (SOS) Network hospitals with COVID-19 in 2020.

Methods: Patients with laboratory-confirmed COVID-19 admitted to 11 sites in Ontario, Quebec, Alberta, and Nova Scotia up to December 31, 2020 were enrolled in this prospective observational cohort study. Measures included age, sex, demographics, housing, exposures, Clinical Frailty Scale, comorbidities; in addition, length of stay, intensive care unit (ICU) admission, mechanical ventilation, and survival were assessed. Descriptive analyses and multivariable logistic regressions were conducted.

Results: Among 2,011 patients, mean age was 71.0 (range 19-105) years. 29.7% were admitted from assisted living or long-term care facilities. The full spectrum of frailty was represented in both younger and older age groups. 81.8% had at least one underlying comorbidity and 27.2% had obesity. Mortality was 14.3% without ICU admission, and 24.6% for those admitted to ICU. Older age and frailty were independent predictors of lower ICU use and higher mortality; accounting for frailty, obesity was not an independent predictor of mortality, and associations of comorbidities with mortality were weakened.

Conclusions: Frailty is a critical clinical factor in predicting outcomes of COVID-19, which should be considered in research and clinical settings.

Keywords: COVID-19; SARS-CoV-2; age; frail elderly; frailty; hospitalization; outcomes; surveillance.

PubMed Disclaimer

Conflict of interest statement

CONFLICT OF INTEREST DISCLOSURES We have read and understood the Canadian Geriatrics Journal’s policy on conflicts of interest disclosure and declare the following interests: MKA reports grant funding from the Public Health Association of Canada, CIHR, Canadian Frailty Network, Sanofi Pasteur and GSK group of companies, and payments from Pfizer, Sanofi Pasteur and Seqirus outside the submitted work. AM reports payments from GSK, Seqirus and Sanofi Pasteur, outside the submitted work. JEM reports payments from RestorBio, Sanofi, GSK, Merck and Medicago outside of the submitted work. TFH reports grants from Pfizer and GSK. ML reports payments from Sanofi, Medicago, Sequirus, and Pfizer outside the submitted work. SAM reports grants and payments from Pfizer, GSK, Merck, Novartis and Sanofi, outside the submitted work. JG, JJL, GB, LV, ME, DM-C, AA, KW, ST, SS, AMc and KK report no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Epidemic curve of admissions to Serious Outcomes Surveillance (SOS) Network hospitals, colour-coded by province
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Public Health Agency of Canada. COVID-19 daily epidemiology update [Internet] Ottawa: PHAC; 2020. [cited 2020 November 18]. Available from: https://health-infobase.canada.ca/covid-19/epidemiological-summary-covid....
    1. Nichols MK, Andrew MK, Hatchette TF, et al. Influenza vaccine effectiveness to prevent influenza-related hospitalizations and serious outcomes in Canadian adults over the 2011/12 through 2013/14 influenza seasons: a pooled analysis from the Canadian Immunization Research Network (CIRN) Serious Outcomes Surveillance (SOS Network) Vaccine. 2018;36(16):2166–75. doi: 10.1016/j.vaccine.2018.02.093. - DOI - PubMed
    1. McNeil S, Shinde V, Andrew M, et al. Interim estimates of 2013/14 influenza clinical severity and vaccine effectiveness in the prevention of laboratory-confirmed influenza-related hospitalisation, Canada, February 2014. Euro Surveill. 2014;19(9):20729. doi: 10.2807/1560-7917.ES2014.19.9.20729. - DOI - PubMed
    1. LeBlanc JJ, Li Y, Bastien N, Forward KR, Davidson RJ, Hatchette TF. Switching gears for an influenza pandemic: validation of a duplex reverse transcriptase PCR assay for simultaneous detection and confirmatory identification of pandemic (H1N1) 2009 influenza virus. J Clin Microbiol. 2009;47(12):3805–13. doi: 10.1128/JCM.01344-09. - DOI - PMC - PubMed
    1. Public Health Agency of Canada. National case definition: Coronavirus disease (COVID-19) [Internet] Ottawa: PHAC; 2020. [cited 2020 October 20]. Available from: https://www.canada.ca/en/public-health/services/diseases/2019-novel-coro....

LinkOut - more resources