Frailty assessment for COVID-19 follow-up: a prospective cohort study.

DOI
Publisher DOI
PubMed ID
35459694
Abstract
BACKGROUND

The Clinical Frailty Scale (CFS) is increasingly used for clinical decision making in acute care but little is known about frailty after COVID-19.

OBJECTIVES

To investigate frailty and the CFS for post-COVID-19 follow-up.

METHODS

This prospective multicentre cohort study included COVID-19 survivors aged ≥50 years presenting for a follow-up visit ≥3 months after the acute illness. Nine centres retrospectively collected pre-COVID-19 CFS and prospectively CFS at follow-up. Three centres completed the Frailty Index (FI), the short physical performance battery (SPPB), 30 s sit-to-stand test and handgrip strength measurements. Mixed effect logistic regression models accounting for repeated measurements and potential confounders were used to investigate factors associated with post-COVID-19 CFS. Criterion and construct validity were determined by correlating the CFS to other concurrently assessed frailty measurements and measures of respiratory impairment, respectively.

RESULTS

Of the 288 participants 65% were men, mean (SD) age was 65.1 (9) years. Median (IQR) CFS at follow-up was 3 (2-3), 21% were vulnerable or frail (CFS ≥4). The CFS was responsive to change, correlated with the FI (r=0.69, p<0.001), the SPPB score (r=-0.48, p<0.001) (criterion validity) and with the St George's Respiratory Questionnaire score (r=0.59, p<0.001), forced vital capacity %-predicted (r=-0.25, p<0.001), 6 min walk distance (r=-0.39, p<0.001) and modified Medical Research Council (mMRC) (r=0.59, p<0.001). Dyspnoea was significantly associated with a higher odds for vulnerability/frailty (per one mMRC adjusted OR 2.01 (95% CI 1.13 to 3.58), p=0.02).

CONCLUSIONS

The CFS significantly increases with COVID-19, and dyspnoea is an important risk factor for post-COVID-19 frailty and should be addressed thoroughly.
Date Issued
2022-04
Publication Type
Article
Subject(s)
Subjects
COVID-19 respiratory infection
Language(s)
en
Author(s)
Müller, Ilena
Mancinetti, Marco
Renner, Anja
Bridevaux, Pierre-Olivier
Brutsche, Martin H
Clarenbach, Christian
Lenoir, Alexandra
Naccini, Bruno
Ott, Sebastian
Piquilloud, Lise
Prella, Maura
Soccal, Paola Marina
von Garnier, Christophe
Additional Credits
Journal
BMJ Open Respiratory Research
Publisher
BMJ Publishing Group: Open Access
ISSN
2052-4439
Access(Rights)
open.access
Show full item