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The Impact of Frailty on Survival in Elderly Intensive Care Patients with COVID-19: the COVIP Study

2021Journal article Open access
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dc.contributor.authorJung, C
dc.contributor.authorFlaatten, H
dc.contributor.authorFjolner, J
dc.contributor.authorBruno, R
dc.contributor.authorWernly, B
dc.contributor.authorArtigas, A
dc.contributor.authorPinto, B
dc.contributor.authorSchefold, J
dc.contributor.authorWolff, G
dc.contributor.authorKelm, M
dc.contributor.authorBeil, M
dc.contributor.authorSviri, S
dc.contributor.authorHeerden, P
dc.contributor.authorSzczeklil, W
dc.contributor.authorCzuczwar, M
dc.contributor.authorElhadi, M
dc.contributor.authorJoannidis, M
dc.contributor.authorOeyen, S
dc.contributor.authorZafeiridis, T
dc.contributor.authorMarsh, B
dc.contributor.authorAndersen, F
dc.contributor.authorMoreno, R
dc.contributor.authorCecconi, M
dc.contributor.authorLeaver, S
dc.contributor.authorBoumendil, A
dc.contributor.authorDe Lange, D
dc.contributor.authorGuidet, B
dc.contributor.authorCOVIP Study Group
dc.date.accessioned2022-05-13T14:46:06Z
dc.date.available2022-05-13T14:46:06Z
dc.date.issued2021
dc.description.abstractBackground: 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.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationCrit Care. 2021 Apr 19;25(1):149.pt_PT
dc.identifier.doi10.1186/s13054-021-03551-3.pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/4079
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherBMCpt_PT
dc.subjectHSJ UCIpt_PT
dc.subjectAgedpt_PT
dc.subjectAged, 80 and overpt_PT
dc.subjectCOVID-19 / mortality*pt_PT
dc.subjectFemalept_PT
dc.subjectMalept_PT
dc.subjectHumanspt_PT
dc.subjectCOVID-19 / therapy*pt_PT
dc.subjectCritical Carept_PT
dc.subjectFrail Elderly / statistics & numerical data*pt_PT
dc.subjectFrailty / mortality*pt_PT
dc.subjectPrognosispt_PT
dc.subjectProspective Studiespt_PT
dc.subjectSurvival Analysispt_PT
dc.titleThe Impact of Frailty on Survival in Elderly Intensive Care Patients with COVID-19: the COVIP Studypt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.startPage149pt_PT
oaire.citation.titleCritical Carept_PT
oaire.citation.volume25pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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