Frailty as a mortality predictor in older adults with COVID-19: A systematic review and meta-analysis of cohort studies

Abstract

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which has caused the coronavirus diseases 2019 (COVID-19) pandemic, continues to spread rapidly worldwide and is associated with high rates of mortality among older adults, those with comorbidities, and those in poor physiological states. This paper aimed to systematically identify the impact of frailty on overall mortality among older adults with COVID-19. We conducted a systematic review of the literature indexed in 4 databases. A random-effects model with inverse variance-weighted meta-analysis using the odds ratio was used to study the association of frailty levels with clinical outcomes among older adults with COVID-19. Heterogeneity was measured using the I 2 statistic and Egger's test. We identified 22 studies that met our inclusion criteria, including 924,520 total patients. Overall, frailty among older adults was associated with high rates of COVID-19-related mortality compared with non-frail older adults (OR [odds ratio]:5.76; 95% confidence interval [95% CI]: 3.85–8.61, I 2 : 40.5%). Our results show that physical limitations, such as those associated with frailty among older adults, are associated with higher rates of COVID-19-related mortality.

The Impact of the Otago Exercise Program on Frailty and Empowerment in Older Nursing Home Residents: A Randomized Controlled Trial

“…The factors affecting frailty include a combination of deficiencies in strength, balance, motor processing, cognition, nutrition, endurance, and physical activity. 34 , 35 ) Our comparisons of the mean EFS scores before and 3 months after the intervention showed a significant difference between the OEG and CG (p=0.0001). Sadjapong et al 9 ) also reported a significant change (<0.01) in the frailty score of the intervention group compared to the control group.…”

Routine laboratory parameters, including complete blood count, predict COVID-19 in-hospital mortality in geriatric patients

“…before the onset of COVID 19 disease, estimated with the use of CFS. A number of recent studies demonstrated that the presence of severe frailty can stratify patients with COVID-19 at increased risk of in-hospital death, thus suggesting that the evaluation of frailty can support decision making about medical care in adult patients admitted to hospital with COVID-19 ( Covino et al, 2021 , Marengoni et al, 2021 , Rebora et al, 2021 , Saragih et al, 2021 , Yang et al, 2021 , Zhang et al, 2021 ).…”

COVID-19 in Older Individuals Requiring Hospitalization

“…Other factors associated with mortality such as frailty have also been described in other studies involving older patients with COVID-19. For example, in a recent systematic review including data from 924,520 patients, frailty was found to increase more than five-fold the likelihood of COVID-19-associated mortality [ 49 ]. These findings have been also verified by other studies [ 50 , 51 ].…”