Frailty, covid-19 disease severity and outcome among hospitalised older adults

Aim To examine the characteristics and outcomes of hospitalised older adults with COVID-19 Methods Retrospective, multi-centre, cohort observational study Data from sixty-nine hospitalised patients aged over 70 years with reverse transcriptase polymerase chain reaction-confirmed COVID-19 at three Irish hospitals were collected from health records Symptom profile, COVID-19 severity level based on Irish Thoracic Society guidelines, Clinical Frailty Scale (CFS), Cumulative Illness Rating Scale-Geriatric (CIRS-G) scores, laboratory and radiological data were reviewed Results Patient mortality rate was 23 2% (n=16) Median survivor age was 81 5 years (IQR 76 5-86 5) Mean CFS and CIRS-G scores were 5;(SD1 6) and 8 19;(SD4 4) Most patients (n=56, 81 1%) were categorised as mild COVID-19 cases Five patients (n=5, 7%) were asymptomatic Atypical symptom presentation was 7%(n=5) Delirium was noted in almost one-third of patients (n=21, 30 4%) Seven patients (n=7,10 1%) required intubation and intensive care unit admission Over 1/3 of delirious patients died (n=8, 38%) Frail patients were older (P= 0 005), more likely to have dementia (P=0 04) and required less ventilatory support than non-frail patients (P=0 001) but were categorised as mild COVID-19 on admission (P=0 004) Conclusion Despite mild COVID-19 symptoms, mortality and delirium rates remained high Low co-morbidity burden & atypical symptom rates were recorded despite high frailty rates © 2020, Irish Medical Association All rights reserved