Frailty prevalent 5 months following hospitalisation for COVID-19

A study following nearly 1,400 people who were hospitalised for COVID-19 for up to 5 months after discharge drew some concerning conclusions about the prevalence and progression of frailty among these patients. In total, 75% of the patients had at least 1 criterion of frailty, even though they were relatively young, working-aged adults.

Although frailty is a known risk factor for severe acute COVID-19, including death, as well as being a marker of increased risk for adverse outcomes, it remains unknown what the burden of frailty among COVID-19 survivors is and whether it contributes to long-COVID or post-disease sequelae. The Post-Hospitalisation COVID-19 study (PHOSP-COVID; ISRCTN10980107) aimed to investigate this association [1]. Interim data were recently published in The Lancet Respiratory Medicine [2].

PHOSP-COVID examined 1,399 patients 5 months post-discharge for COVID-19 and tested them for Fried’s frailty phenotype [1]. Frailty by the Fried’s frailty phenotypes scores inactivity, weight loss, weakness, slowness, and exhaustion to form a composite score. Multivariable logistic regression was performed for the primary outcome of patient-perceived recovery, with the covariates age, sex, ethnicity, BMI, comorbidities, and severity of acute illness. Dr Hamish McAuley (University of Leicester, UK) presented the preliminary data.

At 5 months post-discharge, 22% (n=305) met none of Fried’s criteria and were considered not frail; 63% (n=879) fell into the ‘pre-frail’ category, meeting 1 or 2 of the criteria; and 15% (n=215) met at least 3 criteria. Significant risk factors for frailty were age at admission (P<0.001), the presence of comorbidities, and whether the patient had been working before COVID-19 illness. BMI was not a risk factor in this cohort.

In summary, 75% of adults were pre-frail or frail at 5 months post-hospitalisation for COVID-19, and this included a working-age population. Most (84%) had been working before they had COVID-19. Pre-frailty and frailty are associated with worse symptoms and reduced exercise tolerance and function, whereas frail individuals appear to have a greater decrease in quality of life and are less likely to feel recovered.

1. McAuley H, et al. Frailty and Physical Performance in 1,133 Patients Five Months Following Hospitalisation for COVID-19. Session C16, ATS International Conference 2022, San Francisco, CA, USA, 13–18 May.
2. Evans RA et al. Lancet Respir Med. 2021;9(11):1275–1287.

 

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Posted on 18 July 2022