ArticleJournal of the American Medical Directors Association2022
COVID-19, Vulnerability, and Long-Term Mortality in Hospitalized and Nonhospitalized Older Persons.
Article in Journal of the American Medical Directors Association, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 13 citations in OpenAlex.
- Association between physical activity and frailty transitions in middle-aged and older adults: a nationwide longitudinal study.The international journal of behavioral nutrition and physical activity · 2025Article
- Polypharmacy or potentially inappropriate medications among older adults with COVID-19 in a secondary hospital in China and their association with mortality.Scientific reports · 2025Article
- One-year mortality and associated factors in older hospitalized COVID-19 survivors: a Nationwide Cohort Study in Korea.Scientific reports · 2024Article
- Causes of deaths in long-term care and hospice care facilities during the first year of COVID-19 pandemic: a snapshot of Italy during 2020.Aging clinical and experimental research · 2023Article
- One-Year Adverse Outcomes Among US Adults With Post-COVID-19 Condition vs Those Without COVID-19 in a Large Commercial Insurance Database.JAMA health forum · 2023Article
- Factors associated with mortality in hospitalised, non-severe, older COVID-19 patients - the role of sarcopenia and frailty assessment.BMC geriatrics · 2022Observational
- Performance status: A key factor in predicting mortality in the first wave of COVID-19 in South-East Scotland.The journal of the Royal College of Physicians of Edinburgh · 2022Article
- The Short- and Long-Term Clinical, Radiological and Functional Consequences of COVID-19.Archivos de bronconeumologia · 2022Review
Corrections and comments
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Authors and funding
9 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveStudies suggesting that vulnerability increased short-term mortality in older patients with COVID-19 enrolled hospitalized patients and lacked COVID-negative comparators. Aim of this study was to examine the relationship between frailty and 1-year mortality in older patients with and without COVID-19, hospitalized and nonhospitalized.
designCohort study. SETTING AND
participantsPatients over 75 years old accessing the emergency departments (ED) were identified from the ED archives in Florence, Italy.
methodsVulnerability status was estimated with the Dynamic Silver Code (DSC). COVID-19 hospital discharges (HC+) were compared with non-COVID-19 discharges (HC-). Linkage with a national COVID-19 registry identified nonhospitalized ED visitors with (NHC+) or without COVID-19 (NHC-).
resultsIn 1 year, 48.4% and 33.9% of 1745 HC+ and 15,846 HC- participants died (P < .001). Mortality increased from 27.5% to 64.0% in HC+ and from 19.9% to 51.1% in HC- across DSC classes I to IV, with HC+ vs HC- hazard ratios between 1.6 and 2.2. Out of 1039 NHC+ and 18,722 NHC- participants, 18% and 8.7% died (P < .001). Mortality increased from 14.2% to 46.7% in NHC+ and from 2.9% to 26% in NHC- across DSC; NHC+ vs NHC- hazard ratios decreased from 5.3 in class I to 2.0 in class IV. CONCLUSIONS AND IMPLICATIONS: In hospitalized older patients, mortality increases with vulnerability similarly in the presence and in the absence of COVID-19. In nonhospitalized patients, vulnerability-associated excess mortality is milder in individuals with than in those without COVID-19. The disease reduces survival even when background risk is low. Thus, apparently uncomplicated patients deserve closer clinical monitoring than commonly applied.
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