Biomarkers of ageing and frailty may predict COVID-19 severity

Wanhella, Kailyn J.; Fernández-Patrón, Carlos

doi:10.1016/j.arr.2021.101513

Cited by 24 publications

(24 citation statements)

References 96 publications

(206 reference statements)

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“…Besides the non-biomolecular factors, we acknowledge that it is essential to understand pathophysiological mechanisms via addressing potential biomolecular markers of frailty and aging as an increasing amount of research has reported how these biomarkers could predict COVID-19 progress [ 6 ]. The biomarkers of frailty might also substantially mediate the association between frailty and COVID-19 hospitalization in our study and present as sensitive indicators for frailty, as we still observed a trend for positive association even after accounting for two related elements of frailty, i.e., the presence of chronic diseases and BMI.…”

Section: Discussionmentioning

confidence: 99%

“…Despite the evolving and debatable conceptualization of frailty, adverse outcomes have been associated with frailty, including hospitalization, admission to long-term care, and mortality [ 4 ], which yield additional healthcare costs and extra burden for the healthcare system [ 5 ]. In addition, while age is a well-documented risk factor for COVID-19 outcomes, identifying frailty status is clinically relevant in further prioritizing vulnerable older individuals for the intensive care unit admission [ 4 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

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Frailty and risk of hospitalization from COVID-19 infection among older adults: evidence from the Dutch Lifelines COVID-19 Cohort study

et al. 2022

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Background Frailty is associated with COVID-19 severity in clinical settings. No general population-based studies on the association between actual frailty status and COVID-19 hospitalization are available. Aims To investigate the association between frailty and the risk of COVID-19 hospitalization once infected. Methods 440 older adults who participated in the Lifelines COVID-19 Cohort study in the Northern Netherlands and reported positive COVID-19 testing results (54.2% women, age 70 ± 4 years in 2021) were included in the analyses. COVID-19 hospitalization status was self-reported. The Groningen Frailty Indicator (GFI) was derived from 15 self-reported questionnaire items related to daily activities, health problems, and psychosocial functioning, with a score ≥ 4 indicating frailty. Both frailty and COVID-19 hospitalization were assessed in the same period. Poisson regression models with robust standard errors were used to analyze the associations between frailty and COVID-19 hospitalization. Results Of 440 older adults included, 42 were hospitalized because of COVID-19 infection. After adjusting for sociodemographic and lifestyle factors, a higher risk of COVID-19 hospitalization was observed for frail individuals (risk ratio (RR) [95% CI] 1.97 [1.06–3.67]) compared to those classified as non-frail. Discussion Frailty was positively associated with COVID-19 hospitalization once infected, independent of sociodemographic and lifestyle factors. Future research on frailty and COVID-19 should consider biomarkers of aging and frailty to understand the pathophysiological mechanisms and manifestations between frailty and COVID-19 outcomes. Conclusions Frailty was positively associated with the risk of hospitalization among older adults that were infected with COVID-19. Public health strategies for frailty prevention in older adults need to be advocated, as it is helpful to reduce the burden of the healthcare system, particularly during a pandemic like COVID-19.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Frailty and risk of hospitalization from COVID-19 infection among older adults: evidence from the Dutch Lifelines COVID-19 Cohort study

et al. 2022

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“…In addition to these molecular mechanisms, reduced disease tolerance (as associated with chronological ageing), accelerated biological ageing, 19 comorbidities, and frailty drive disease progression. 20 Of note, the key results shown in the figure were adjusted for sex, age, BMI, and the WHO stage at enrolment. Furthermore, socioeconomic deprivation, low educational attainment, insufficient disease awareness, misinformation, and inadequate access to health care or vaccination are non-biomolecular factors underlying adverse health outcomes in people with COVID-19.…”

Section: Discussionmentioning

confidence: 99%

Predictive performance and clinical application of COV50, a urinary proteomic biomarker in early COVID-19 infection: a prospective multicentre cohort study

Staessen

Wendt

et al. 2022

The Lancet Digital Health

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“…Immunologische Mechanismen im Zusammenhang mit dem Altern („Inflammaging“) führen zur vermehrten Produktion von proinflammatorischen Zytokinen, wie Interleukin‑6 und Tumor-Nekrose-Faktor‑α, die den Abbau von Muskelzellen fördern. Diese Biomarker sind auch mit dem Schweregrad des COVID-19-Verlaufs assoziiert [ 29 ]. Diese immunologischen Mechanismen, wie sie bei vielen Infektionen und so auch COVID-19 auftreten, beschleunigen den Muskelabbau und bedingen den raschen Funktionsverlust bei älteren Menschen [ 11 ].…”

Section: Frailty-syndromunclassified

„Coronavirus disease 2019“ und Frailty

Köller¹

2022

Z Gerontol Geriat

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Der Verlauf der Coronavirus disease 2019 (COVID-19) ist individuell sehr unterschiedlich. Menschen höheren Lebensalters mit Komorbiditäten sind gefährdeter, schwer zu erkranken oder zu versterben. Gebrechlichkeit (Frailty) ist ein wesentlicher Risikofaktor. Ein Fünftel der Bevölkerung in Mitteleuropa ist älter als 65 Jahre, 10–15 % davon sind als „frail“ anzusehen. Die Pandemie bringt die Gesundheitssysteme vieler Länder an deren Grenzen. Die Entscheidung, welche Patienten noch intensivmedizinisch behandelt werden, führt zu ethischen Diskussionen. Die Clinical Frailty Scale von Rockwood (CFS; CMAJ 173:489–495, 2005) wird in manchen Ländern eingesetzt, diese Entscheidungen zu unterstützen. Von COVID-19 betroffene 80-jährige Patienten haben ein fast 3,6faches Sterblichkeitsrisiko, verglichen mit der Altersgruppe von 18 bis 49 Jahren. Das Risiko gebrechlicher Patienten (CFS-Scores 6–9) ist mehr als 3fach höher als von robusten (CFS-Scores 1–3). Ein CFS-Cut-off-Wert ≥ 6 korreliert mit der Mortalität von COVID-19-Patienten über 65 Jahre. Das mittel- und längerfristige Überleben ist auch mit dem Ausmaß von „Frailty“ vor der Erkrankung und weniger mit dem Schweregrad der COVID-19 assoziiert. Besonders Patienten über 60 Jahre sind gefährdet, bei moderaten und schweren COVID-19-Verläufen rasch Muskelmasse zu verlieren. Patienten auf Intensive Care Units (ICU) verlieren innerhalb von 10 Tagen 20–30 % der Oberschenkelstreckmuskulaturmasse. Das Ausmaß der COVID-19-assoziierten Sarkopenie bestimmt wesentlich den Verlauf der Erkrankung und macht individuelle Rehabilitationsprogrammen erforderlich. Bis zu 50 % der hospitalisierten Patienten benötigen weitere Rehabilitation nach der Entlassung. Aerobes Training mit niedriger Intensität, kombiniert mit Krafttraining, sowie die Sicherstellung einer ausreichenden Energie- und Eiweißzufuhr sind unerlässlich.

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Biomarkers of ageing and frailty may predict COVID-19 severity

Cited by 24 publications

References 96 publications

Frailty and risk of hospitalization from COVID-19 infection among older adults: evidence from the Dutch Lifelines COVID-19 Cohort study

Frailty and risk of hospitalization from COVID-19 infection among older adults: evidence from the Dutch Lifelines COVID-19 Cohort study

Predictive performance and clinical application of COV50, a urinary proteomic biomarker in early COVID-19 infection: a prospective multicentre cohort study

„Coronavirus disease 2019“ und Frailty

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