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What is the relationship between validated frailty scores and mortality for adults with COVID-19 in acute hospital care? A systematic review

Cosco, T; Best, J; Bryden, D; Davis, D; Wagner, K; Arkil, S; Conroy, S; (2020) What is the relationship between validated frailty scores and mortality for adults with COVID-19 in acute hospital care? A systematic review. MedRxiv: Cold Spring Harbor, NY, USA. Green open access

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Abstract

Background & aim: The COVID-19 pandemic has had a disproportionate impact upon older people; the frailty construct has been used to assess risk of poor outcomes in many settings. The aim of this systematic review was to quantify the association between frailty and COVID-19 in relation to mortality in hospitalised patients. / Methods: Medline, Embase and the grey literature were searched for papers from inception to 10th September 2020. Screening (and grading) was undertaken by two reviewers according to pre-defined inclusion and exclusion criteria. Met-analysis was not possible so the result were summarised narratively. / Results: 2276 papers were screened resulting in 16 being included in the review. All studies were from Europe, mostly the UK; the median sample size was 308.5, mean age of participants 78.7 and 42% were female. 15/16 used the Clinical Frailty Scale; reported mortality ranged from 19 to 65%. Most, but not all studies showed an association between increasing frailty and a greater risk of dying. Two studies indicated a sub-additive relationship between frailty, COVID-19 and death, and one study showed no increase in dying. / Conclusions: This review showed that whilst many studies have shown an association between an increased risk of COVID-19 related death with increasing frailty, other studies demonstrate a more nuanced understanding of frailty and outcomes in COVID-19 is needed. Clinicians should exert caution in placing too much emphasis on the influence of frailty alone when discussing likely prognosis in older people with COVID-19 infection.

Type: Working / discussion paper
Title: What is the relationship between validated frailty scores and mortality for adults with COVID-19 in acute hospital care? A systematic review
Open access status: An open access version is available from UCL Discovery
DOI: 10.1101/2020.11.13.20231365
Publisher version: https://doi.org/10.1101/2020.11.13.20231365
Language: English
Additional information: The copyright holder for this preprint is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY-NC 4.0 International license (http://creativecommons.org/licenses/by-nc/4.0/).
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Population Science and Experimental Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Population Science and Experimental Medicine > MRC Unit for Lifelong Hlth and Ageing
URI: https://discovery.ucl.ac.uk/id/eprint/10116766
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