Initial functional disability as a 1-year prognostic factor in geriatric patients hospitalized with SARS-CoV-2 infection

Abstract

Background: SARS-CoV2 infection has affected many older people and has required us to adapt our practices to this new pathology. Initial functional capacity is already considered an important prognostic marker in older patients particularly during infections.

Aim: The objective of this longitudinal study was to determine whether baseline functional disability was associated with mortality risk after 1 year in older patients hospitalized for COVID-19.

Methods: All COVID-19 patients admitted to the geriatric acute care unit of Angers University Hospital, France, between March-June 2020 received a group iso-ressource (GIR) assessment upon admission. Disability was defined as a GIR score≤3. All-cause mortality was collected after 1 year of follow-up. Covariables were age, sex, history of malignancies, hypertension, cardiomyopathy, number of acute diseases at baseline, and use of antibiotics or respiratory treatments during COVID-19 acute phase.

Results: In total, 97 participants (mean±SD 88.0+5.4 years; 49.5% women; 46.4% GIR score≤3) were included. 24 of the 36 patients who did not survive 1 year had a GIR score ≤ 3 (66.7%; P = 0.003). GIR score≤3 was directly associated with 1-year mortality (fully adjusted HR = 2.27 95% CI: 1.07-4.89). Those with GIR≤3 at baseline had shorter survival time than the others (log-rank P = 0.0029).

Conclusions: Initial functional disability was associated with poorer survival in hospitalized frail elderly COVID-19 patients.

Clinical trial registration: ClinicalTrials.gov: NCT04560608 registered on September 23, 2022.

Fig 1. Kaplan-Meier estimates of the cumulative probability of COVID-19 participants’ survival according to GIR (n = 97).