@article{Alsahab_M-2021_16721, title = {Age and frailty are independently associated with increased COVID-19 mortality and increased care needs in survivors: results of an international multi-centre study}, author = {Alsahab, M. and Beishon, L. and Brown, B. and Burn, E. and Burton, J. and Cox, N. and Dani, M. and Elhadi, M. and Freshwater, S. and Gaunt, V. and Gordon, A. and Goujon, M. and Hale, M. and Hughes, T. and Jackson, T. and Jelley, B. and Khan, A. and Khiroya, H. and Lal, R. and Madden, K. and Magill, L. and Masoli, J. and Masud, T. and McCluskey, L. and McNeela, N. and Mohammedseid-Nurhussien, A. and Moorey, H. and Lochlainn, M. and Nirantharakumar, K. and Okoth, K. and Osuafor, C. and Patterson, K. and Pearson, G. and Perry, R. and Pettitt, M. and Pigott, J. and Pinkney, T. and Quinn, T. and Reynolds, A. and Richardson, S. and Sanyal, N. and Seed, A. and Sleeman, I. and Soo, C. and Steves, C. and Strain, W. and Taylor, J. and Torsney, K. and Welch, C. and Wilson, D. and Witham, M.}, month = {feb}, year = {2021}, abstract = {Introduction: Increased mortality has been demonstrated in older adults with COVID-19, but the effect of frailty has been unclear. Methods: This multi-centre cohort study involved patients aged 18 years and older hospitalised with COVID-19, using routinely collected data. We used Cox regression analysis to assess the impact of age, frailty, and delirium on the risk of inpatient mortality, adjusting for sex, illness severity, inflammation, and co-morbidities. We used ordinal logistic regression analysis to assess the impact of age, Clinical Frailty Scale (CFS), and delirium on risk of increased care requirements on discharge, adjusting for the same variables. Results: Data from 5,711 patients from 55 hospitals in 12 countries were included (median age 74, IQR 54–83; 55.2% male). The risk of death increased independently with increasing age (>80 vs 18–49: HR 3.57, CI 2.54–5.02), frailty (CFS 8 vs 1–3: HR 3.03, CI 2.29–4.00) inflammation, renal disease, cardiovascular disease, and cancer, but not delirium. Age, frailty (CFS 7 vs 1–3: OR 7.00, CI 5.27–9.32), delirium, dementia, and mental health diagnoses were all associated with increased risk of higher care needs on discharge. The likelihood of adverse outcomes increased across all grades of CFS from 4 to 9. Conclusions: Age and frailty are independently associated with adverse outcomes in COVID-19. Risk of increased care needs was also increased in survivors of COVID-19 with frailty or older age.}, journal = {Age and Ageing}, publisher = {Oxford University Press}, url = {http://dx.doi.org/10.1093/ageing/afab026}, }