Factors associated with mortality in hospitalised, non-severe, older COVID-19 patients – the role of sarcopenia and frailty assessment

BMC Geriatrics

Research

Wojciech Sydor¹  Agnieszka Olszanecka²  Ian Perera³  Barbara Gryglewska³  Małgorzata Fedyk-Łukasik³  Barbara Wizner³  Monika Ryś³  Tomasz Grodzicki³  Karolina Piotrowicz³  Jerzy Gąsowski⁴  Jean-Pierre Michel⁵ 

[1] Center for Innovative Therapies, Clinical Research Coordination Center, University Hospital in Kraków, Kraków, Poland;Department of Rheumatology and Immunology, Jagiellonian University Medical College, Kraków, Poland;Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Kraków, Poland;Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Kraków, Poland;Department of Internal Medicine and Geriatrics, University Hospital in Kraków, Kraków, Poland;Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Kraków, Poland;Department of Internal Medicine and Geriatrics, University Hospital in Kraków, Kraków, Poland;Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, University Hospital, 2 Jakubowskiego St., building I, 5th floor, 30-688, Kraków, Poland;University of Geneva, Geneva, Switzerland;

关键词: COVID-19;    Skeletal muscles;    Sarcopenia;    Frailty;    Handgrip strength;    Dynapenia;    SARC-F;    Rockwood;   

DOI  :  10.1186/s12877-022-03571-w

 received in 2022-05-17, accepted in 2022-10-31,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundCOVID-19 has affected older persons the most. The propensity to have severe COVID-19 or die of the infection was especially prevalent among older subjects with multimorbidity, frailty and sarcopenia. The aim of our study was to check which of the simple clinical biomarkers, including the assessment of muscle and frailty, would associate with the survival and the length of hospital stay in older patients with COVID-19. An additional aim was to report the influence of chronic diseases, chronic medication use, and COVID-19 signs and symptoms on the aforementioned outcome measures.MethodsThe CRACoV study was a prospective single-center (University Hospital in Krakow, Krakow, Poland) observational study of clinical outcomes in symptomatic COVID-19 patients that required hospital treatment. We analysed data of persons aged ≥ 65 years. We assessed muscular parameters in accordance with EWGSOP2, frailty with the Rockwood Clinical Frailty Scale. We used the data of the initial and 3-month assessment. Demographic characteristics, past medical history, and baseline laboratory values were gathered as a part of routine care. We calculated sex and age, and additionally number-of-diseases adjusted odds ratios of mortality associated with studied factors and betas of the relation with these factors and the length of hospital stay.ResultsThe mean (standard deviation, SD) age of 163 participants (44.8% women, 14.8% died) was 71.8 (5.6) years, age range 65–89 years. One score greater SARC-F was associated with 34% (p = 0.003) greater risk of death, and 16.8 h longer hospital stay (p = 0.01). One score greater Rockwood was associated with 86% (p = 0.002) greater risk of death, but was unrelated to the length of hospital stay. Hand grip strength and dynapenia were unrelated to mortality, but dynapenia was related to longer hospital stay. Probable sarcopenia was associated with 441% (p = 0.01) greater risk of death.ConclusionsIn conclusion, the patient assessment with SARC-F and the Rockwood Clinical Frailty Scale may significantly improve the prediction of outcomes in older patients with COVID-19 and by extension might be of use in other acute severe infections. This, however, requires further research to confirm.

【 授权许可】

CC BY   
© The Author(s) 2022

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