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Title: The Clinical Frailty Scale: estimating the prevalence of frailty in older patients hospitalised with COVID-19. The COPE study

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Jemima T. Collins, Roxanna Short, Ben Carter, Alessia Verduri, Phyo Kyaw Myint, Terry J. Quinn, Arturo Vilches-Moraga, Michael J Stechman, Susan J Moug, Kathryn McCarthy, Jonathan Hewitt

Original languageEnglish
JournalGeriatrics
Published15 Sep 2020

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Abstract

Frailty assessed using Clinical Frailty Scale (CFS) is a good predictor of adverse clinical events including mortality in older people. CFS is also an essential criterion for determining ceilings of care in people with COVID-19. Our aims were to assess the prevalence of frailty in older patients hospitalised with COVID-19, their sex and age distribution, and the completion rate of the CFS tool in evaluating frailty. Methods Data were collected from thirteen sites. CFS was assessed routinely at the time of admission to hospital and ranged from 1 (very fit) to 9 (terminally ill). The completion rate of the CFS was assessed. The presence of major comorbidities such as diabetes and cardiovascular disease was noted. Results A total of 1277 older patients with COVID-19, aged ≥65 (79.9±8.1) years were included in the study, with 98.5% having fully completed CFS. The total prevalence of frailty (CFS≥5) was 66.9%, being higher in women than men (75.2% vs 59.4%, p<0.001). Frailty was found in 161 (44%) patients aged 65-74 years, 352 (69%) in 75-84 years, and 341 (85%) in ≥85 years groups, and increased across the age groups (<0.0001, test for trend). Conclusion Frailty was prevalent in our cohort of older people admitted to hospital with COVID-19. This indicates that older people who are also frail, who go on to contract COVID-19 may have disease severity significant enough to warrant hospitalization. These data may help inform health care planners and targeted interventions and appropriate management for the frail older person.

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