Outcomes from COVID-19 across the range of frailty: excess mortality in fitter older people

  1. Amy Miles
  2. Thomas E. Webb
  3. Benjamin C. Mcloughlin
  4. Imran Mannan
  5. Arshad Rather
  6. Paul Knopp
  7. Daniel Davis

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Abstract

Purpose

Our aim was to quantify the mortality from COVID-19 and identify any interactions with frailty and other demographic factors.

Methods

Hospitalised patients aged ≥ 70 were included, comparing COVID-19 cases with non-COVID-19 controls admitted over the same period. Frailty was prospectively measured and mortality ascertained through linkage with national and local statutory reports.

Results

In 217 COVID-19 cases and 160 controls, older age and South Asian ethnicity, though not socioeconomic position, were associated with higher mortality. For frailty, differences in effect size were evident between cases (HR 1.02, 95% CI 0.93–1.12) and controls (HR 1.99, 95% CI 1.46–2.72), with an interaction term (HR 0.51, 95% CI 0.37–0.71) in multivariable models.

Conclusions

Our findings suggest that (1) frailty is not a good discriminator of prognosis in COVID-19 and (2) pathways to mortality may differ in fitter compared with frailer older patients.

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  1. Version published to 10.1007/s41999-020-00354-7
  2. ScreenIT

    SciScore for 10.1101/2020.05.22.20110486: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Stata 14.1 (StataCorp, Texas, USA) was used for all analyses.
    StataCorp
    suggested: (Stata, RRID:SCR_012763)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

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  3. Version published to 10.1101/2020.05.22.20110486v1 on medRxiv