Evidence map›Paper›PMID 32892742›Full record

ArticleBMC medicine2020

The association between frailty and severe disease among COVID-19 patients aged over 60 years in China: a prospective cohort study.

Yao Ma, Lisha Hou, Xiufang Yang, Zhixin Huang, Xue Yang, Na Zhao, Min He, Yixin Shi, Yan Kang, Jirong Yue and 1 more

Registry-linked trialOpen access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04732663 (Understanding Exertional Dyspnea and Exercise Intolerance in COVID-19), which is not on this map. Cited by 55 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
55citing papers in PubMed, 5 pooled it
12.1field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04732663 completednot on this mapstarted 2021, after this paper: background citation

Understanding Exertional Dyspnea and Exercise Intolerance in COVID-19

TypeobservationalSponsorUniversity of AlbertaRan2021 to 2024Enrolled64ConditionsCovid19, DyspneaArmsNo Intervention
3 · Its place in the literature

Who cites it

55 citing papers in PubMed, 5 syntheses or guidelines pooled it, 120 citations in OpenAlex.

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  17. Long COVID and hypertension-related disorders: a report from the Japanese Society of Hypertension Project Team on COVID-19.Hypertension research : official journal of the Japanese Society of Hypertension · 2023
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 4 institutions in 1 country.

Yao MaDepartment of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
Lisha HouDepartment of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
Xiufang YangCOVID-19 Medical Assistance Teams (Hubei) of West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
Zhixin HuangDepartment of Obstetrics and Gynecology, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, China.
Xue YangDepartment of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
Na ZhaoDepartment of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, China.
Min HeCOVID-19 Medical Assistance Teams (Hubei) of West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
Yixin ShiState Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & West China School of Stomatology, Sichuan University, Chengdu, Sichuan Province, China.
Yan KangCOVID-19 Medical Assistance Teams (Hubei) of West China Hospital, Sichuan University, Chengdu, Sichuan Province, China. kangyan@scu.edu.cn.
Jirong YueDepartment of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China. yuejirong11@hotmail.com.
Chenkai WuGlobal Health Research Center Duke Kunshan University, Suzhou, Jiangsu Province, China.
Sichuan University · CNDuke Kunshan University · CNRenmin Hospital of Wuhan University · CNWuhan University · CN

Funding

1·3·5 project for disciplines of excellence-Clinical Research Incubation Project, West China Hospital, Sichuan University 19HXFH012Chinese National Science & Technology Pillar Program 2020YFC2005600,2020YFC2005604National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University Z20191003Project of Novel Coronavirus Pneumonia in West China Hospital HX2019nCoV027Sichuan Science and Technology Program 2020YFS0148
6 · The paper itself

Abstract

backgroundThe coronavirus disease 2019 (COVID-19) has been a pandemic worldwide. Old age and underlying illnesses are associated with poor prognosis among COVID-19 patients. However, whether frailty, a common geriatric syndrome of reduced reserve to stressors, is associated with poor prognosis among older COVID-19 patients is unknown. The aim of our study is to investigate the association between frailty and severe disease among COVID-19 patients aged ≥ 60 years.

methodsA prospective cohort study of 114 hospitalized older patients (≥ 60 years) with confirmed COVID-19 pneumonia was conducted between 7 February 2020 and 6 April 2020. Epidemiological, demographic, clinical, laboratory, and outcome data on admission were extracted from electronic medical records. All patients were assessed for frailty on admission using the FRAIL scale, in which five components are included: fatigue, resistance, ambulation, illnesses, and loss of weight. The outcome was the development of the severe disease within 60 days. We used the Cox proportional hazards models to identify the unadjusted and adjusted associations between frailty and severe illness. The significant variables in univariable analysis were included in the adjusted model.

resultsOf 114 patients, (median age, 67 years; interquartile range = 64-75 years; 57 [50%] men), 39 (34.2%), 39 (34.2%), and 36 (31.6%) were non-frail, pre-frail, and frail, respectively. During the 60 days of follow-up, 43 severe diseases occurred including eight deaths. Four of 39 (10.3%) non-frail patients, 15 of 39 (38.5%) pre-frail patients, and 24 of 36 (66.7%) frail patients progressed to severe disease. After adjustment of age, sex, body mass index, haemoglobin, white blood count, lymphocyte count, albumin, CD8+ count, D-dimer, and C-reactive protein, frailty (HR = 7.47, 95% CI 1.73-32.34, P = 0.007) and pre-frailty (HR = 5.01, 95% CI 1.16-21.61, P = 0.03) were associated with a higher hazard of severe disease than the non-frail.

conclusionsFrailty, assessed by the FRAIL scale, was associated with a higher risk of developing severe disease among older COVID-19 patients. Our findings suggested that the use of a clinician friendly assessment of frailty could help in early warning of older patients at high-risk with severe COVID-19 pneumonia.

Indexed as

Coronavirus InfectionsFrail ElderlyPandemicsPneumonia, ViralAgedAged, 80 and overBetacoronavirusChinaCOVID-19FemaleFrailtyGeriatric AssessmentHumansMaleMiddle AgedProportional Hazards ModelsCOVID-19FrailtyOlderProspective studySevere disease

Identifiers

PMID32892742
PMCPMC7474968
OpenAlexW3083601077

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LicenceCC BY
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.