About: The effect of frailty on survival in patients with COVID-19 (COPE): a multicentre, European, observational cohort study

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type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
title	The effect of frailty on survival in patients with COVID-19 (COPE): a multicentre, European, observational cohort study
Creator	Clini, Enrico Holloway, Mark Collins, J Carter, Ben Hewitt, J Hewitt, Jonathan Moug, Susan Myint, Phyo Pearce, Lyndsay Mccarthy, Kathryn Quinn, Terence Barlow-Pay, Fenella Braude, Philip Bruce, Eilidh Clini, E Collins, Jemima Einarsson, Alice Hesford, James Mitchell, Emma Price, Angeline Rickard, Frances Short, Roxanna Stechman, Michael Verduri, A Verduri, Alessia Vilches-Moraga, Arturo
source	Elsevier; Medline; PMC
abstract	BACKGROUND: The COVID-19 pandemic has placed unprecedented strain on health-care systems. Frailty is being used in clinical decision making for patients with COVID-19, yet the prevalence and effect of frailty in people with COVID-19 is not known. In the COVID-19 in Older PEople (COPE) study we aimed to establish the prevalence of frailty in patients with COVID-19 who were admitted to hospital and investigate its association with mortality and duration of hospital stay. METHODS: This was an observational cohort study conducted at ten hospitals in the UK and one in Italy. All adults (≥18 years) admitted to participating hospitals with COVID-19 were included. Patients with incomplete hospital records were excluded. The study analysed routinely generated hospital data for patients with COVID-19. Frailty was assessed by specialist COVID-19 teams using the clinical frailty scale (CFS) and patients were grouped according to their score (1–2=fit; 3–4=vulnerable, but not frail; 5–6=initial signs of frailty but with some degree of independence; and 7–9=severe or very severe frailty). The primary outcome was in-hospital mortality (time from hospital admission to mortality and day-7 mortality). FINDINGS: Between Feb 27, and April 28, 2020, we enrolled 1564 patients with COVID-19. The median age was 74 years (IQR 61–83); 903 (57·7%) were men and 661 (42·3%) were women; 425 (27·2%) had died at data cutoff (April 28, 2020). 772 (49·4%) were classed as frail (CFS 5–8) and 27 (1·7%) were classed as terminally ill (CFS 9). Compared with CFS 1–2, the adjusted hazard ratios for time from hospital admission to death were 1·55 (95% CI 1·00–2·41) for CFS 3–4, 1·83 (1·15–2·91) for CFS 5–6, and 2·39 (1·50–3·81) for CFS 7–9, and adjusted odds ratios for day-7 mortality were 1·22 (95% CI 0·63–2·38) for CFS 3–4, 1·62 (0·81–3·26) for CFS 5–6, and 3·12 (1·56–6·24) for CFS 7–9. INTERPRETATION: In a large population of patients admitted to hospital with COVID-19, disease outcomes were better predicted by frailty than either age or comorbidity. Our results support the use of CFS to inform decision making about medical care in adult patients admitted to hospital with COVID-19. FUNDING: None.
has issue date	2020-06-30(xsd:dateTime)
bibo:doi	10.1016/s2468-2667(20)30146-8
bibo:pmid	32619408
has license	no-cc
sha1sum (hex)	53de42bfe4b3c3ff0608a2c4f029a365a5862ddb
schema:url	https://doi.org/10.1016/s2468-2667%2820%2930146-8
resource representing a document's title	The effect of frailty on survival in patients with COVID-19 (COPE): a multicentre, European, observational cohort study
has PubMed Central identifier	PMC7326416
has PubMed identifier	32619408
schema:publication	Lancet Public Health
resource representing a document's body	covid:53de42bfe4b3c3ff0608a2c4f029a365a5862ddb#body_text
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