The impact of frailty on survival in elderly intensive care patients with COVID-19: the COVIP study

The impact of frailty on survival in elderly intensive care patients with COVID-19: the COVIP study

Michael Joannidis, Muhammed Elhadi, Finn H. Andersen, Brian Marsh, Sandra Oeyen, Jesper Fjølner, Joerg C. Schefold, Tilemachos Zafeiridis, Dylan W. de Lange, Antonio Artigas, Christian Jung, Hans Flaatten, Raphael Romano Bruno, Bernhard Wernly, Bernardo Bollen Pinto, Georg Wolff, Malte Kelm, Michael Beil, Sigal Sviri, Peter Vernon van Heerden, Wojciech Szczeklik, Miroslaw Czuczwar, Rui Moreno, Maurizio Cecconi, Susannah Leaver, Ariane Boumendil, Bertrand Guidet, COVIP study group

Abstract Background The COVID-19 pandemic has led highly developed healthcare systems to the brink of collapse due to the large numbers of patients being admitted into hospitals. One of the potential prognostic indicators in patients with COVID-19 is frailty. The degree of frailty could be used to assist both the triage into intensive care, and decisions regarding treatment limitations. Our study sought to determine the interaction of frailty and age in elderly COVID-19 ICU patients. Methods A prospective multicentre study of COVID-19 patients ≥ 70 years admitted to intensive care in 138 ICUs from 28 countries was conducted. The primary endpoint was 30-day mortality. Frailty was assessed using the clinical frailty scale. Additionally, comorbidities, management strategies and treatment limitations were recorded. Results The study included 1346 patients (28% female) with a median age of 75 years (IQR 72–78, range 70–96), 16.3% were older than 80 years, and 21% of the patients were frail. The overall survival at 30 days was 59% (95% CI 56–62), with 66% (63–69) in fit, 53% (47–61) in vulnerable and 41% (35–47) in frail patients (p 

2021

outcome, covid-19, pandemia, Frailty, elderly

10.1186/s13054-021-03551-3

Epidemiology and Health

Korean Society of Epidemiology

Medical emergencies. Critical care. Intensive care. First aid