The impact of frailty on survival in elderly intensive care patients with COVID-19: the COVIP study
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 a...
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2021-04-01
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Online Access: | https://doi.org/10.1186/s13054-021-03551-3 |
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Article |
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DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Christian Jung Hans Flaatten Jesper Fjølner Raphael Romano Bruno Bernhard Wernly Antonio Artigas Bernardo Bollen Pinto Joerg C. Schefold Georg Wolff Malte Kelm Michael Beil Sigal Sviri Peter Vernon van Heerden Wojciech Szczeklik Miroslaw Czuczwar Muhammed Elhadi Michael Joannidis Sandra Oeyen Tilemachos Zafeiridis Brian Marsh Finn H. Andersen Rui Moreno Maurizio Cecconi Susannah Leaver Ariane Boumendil Dylan W. De Lange Bertrand Guidet COVIP study group |
spellingShingle |
Christian Jung Hans Flaatten Jesper Fjølner Raphael Romano Bruno Bernhard Wernly Antonio Artigas Bernardo Bollen Pinto Joerg C. Schefold Georg Wolff Malte Kelm Michael Beil Sigal Sviri Peter Vernon van Heerden Wojciech Szczeklik Miroslaw Czuczwar Muhammed Elhadi Michael Joannidis Sandra Oeyen Tilemachos Zafeiridis Brian Marsh Finn H. Andersen Rui Moreno Maurizio Cecconi Susannah Leaver Ariane Boumendil Dylan W. De Lange Bertrand Guidet COVIP study group The impact of frailty on survival in elderly intensive care patients with COVID-19: the COVIP study Critical Care COVID-19 Frailty Outcome Elderly Pandemia |
author_facet |
Christian Jung Hans Flaatten Jesper Fjølner Raphael Romano Bruno Bernhard Wernly Antonio Artigas Bernardo Bollen Pinto Joerg C. Schefold Georg Wolff Malte Kelm Michael Beil Sigal Sviri Peter Vernon van Heerden Wojciech Szczeklik Miroslaw Czuczwar Muhammed Elhadi Michael Joannidis Sandra Oeyen Tilemachos Zafeiridis Brian Marsh Finn H. Andersen Rui Moreno Maurizio Cecconi Susannah Leaver Ariane Boumendil Dylan W. De Lange Bertrand Guidet COVIP study group |
author_sort |
Christian Jung |
title |
The impact of frailty on survival in elderly intensive care patients with COVID-19: the COVIP study |
title_short |
The impact of frailty on survival in elderly intensive care patients with COVID-19: the COVIP study |
title_full |
The impact of frailty on survival in elderly intensive care patients with COVID-19: the COVIP study |
title_fullStr |
The impact of frailty on survival in elderly intensive care patients with COVID-19: the COVIP study |
title_full_unstemmed |
The impact of frailty on survival in elderly intensive care patients with COVID-19: the COVIP study |
title_sort |
impact of frailty on survival in elderly intensive care patients with covid-19: the covip study |
publisher |
BMC |
series |
Critical Care |
issn |
1364-8535 |
publishDate |
2021-04-01 |
description |
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 < 0.001). In frail patients, there was no difference in 30-day survival between different age categories. Frailty was linked to an increased use of treatment limitations and less use of mechanical ventilation. In a model controlling for age, disease severity, sex, treatment limitations and comorbidities, frailty was independently associated with lower survival. Conclusion Frailty provides relevant prognostic information in elderly COVID-19 patients in addition to age and comorbidities. Trial registration Clinicaltrials.gov: NCT04321265 , registered 19 March 2020. |
topic |
COVID-19 Frailty Outcome Elderly Pandemia |
url |
https://doi.org/10.1186/s13054-021-03551-3 |
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doaj-cc56eb45c9fe4788a0d6c8efb8fd56752021-04-25T11:21:52ZengBMCCritical Care1364-85352021-04-012511910.1186/s13054-021-03551-3The impact of frailty on survival in elderly intensive care patients with COVID-19: the COVIP studyChristian Jung0Hans Flaatten1Jesper Fjølner2Raphael Romano Bruno3Bernhard Wernly4Antonio Artigas5Bernardo Bollen Pinto6Joerg C. Schefold7Georg Wolff8Malte Kelm9Michael Beil10Sigal Sviri11Peter Vernon van Heerden12Wojciech Szczeklik13Miroslaw Czuczwar14Muhammed Elhadi15Michael Joannidis16Sandra Oeyen17Tilemachos Zafeiridis18Brian Marsh19Finn H. Andersen20Rui Moreno21Maurizio Cecconi22Susannah Leaver23Ariane Boumendil24Dylan W. De Lange25Bertrand Guidet26COVIP study groupDepartment of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich-Heine-University DuesseldorfDepartment of Clinical Medicine, University of BergenDepartment of Intensive Care, Aarhus University HospitalDepartment of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich-Heine-University DuesseldorfDepartment of Cardiology, Paracelsus Medical UniversityDepartment of Intensive Care Medicine, CIBER Enfermedades Respiratorias, Corporacion Sanitaria Universitaria Parc Tauli, Autonomous University of BarcelonaDepartment of Acute Medicine, Geneva University HospitalsDepartment of Intensive Care Medicine, Inselspital, Universitätsspital, University of BernDepartment of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich-Heine-University DuesseldorfDepartment of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich-Heine-University DuesseldorfDepartment of Medical Intensive Care, Hadassah University Medical CenterDepartment of Medical Intensive Care, Hadassah University Medical CenterGeneral Intensive Care Unit, Hadassah University Medical CenterCenter for Intensive Care and Perioperative Medicine, Jagiellonian University Medical College2nd Department of Anesthesiology and Intensive Care, Medical University of LublinFaculty of Medicine, University of TripoliDivision of Intensive Care and Emergency Medicine, Department of Internal Medicine, Medical University InnsbruckDepartment of Intensive Care 1K12IC, Ghent University HospitalIntensive Care Unit General Hospital of LarissaMater Misericordiae University HospitalDepartment of Anaesthesia and Intensive Care, Ålesund HospitalUnidade de Cuidados Intensivos Neurocríticos e Trauma, Hospital de São José, Centro Hospitalar Universitário de Lisboa Central, Faculdade de Ciências Médicas de Lisboa, Nova Médical SchoolDepartment of Anaesthesia, IRCCS Instituto Clínico Humanitas, Humanitas UniversityGeneral Intensive Care, St George’s University Hospitals NHS Foundation TrustSorbonne Universités, UPMC Univ Paris 06, INSERM, UMR_S 1136, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Equipe: épidémiologie hospitalière qualité et organisation des soinsDepartment of Intensive Care Medicine, University Medical Center, University UtrechtSorbonne Universités, UPMC Univ Paris 06, INSERM, UMR_S 1136, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Equipe: épidémiologie hospitalière qualité et organisation des soinsAbstract 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 < 0.001). In frail patients, there was no difference in 30-day survival between different age categories. Frailty was linked to an increased use of treatment limitations and less use of mechanical ventilation. In a model controlling for age, disease severity, sex, treatment limitations and comorbidities, frailty was independently associated with lower survival. Conclusion Frailty provides relevant prognostic information in elderly COVID-19 patients in addition to age and comorbidities. Trial registration Clinicaltrials.gov: NCT04321265 , registered 19 March 2020.https://doi.org/10.1186/s13054-021-03551-3COVID-19FrailtyOutcomeElderlyPandemia |