Coronavirus: Frailty ‘indicator’ to survival


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Patients who were considered to be severely frail were 2.4 times more likely to die from coronavirus, the research found

Frailty is as important as age or underlying health issues in determining whether someone may die from Covid-19, a study has found.

It looked at more than 1,500 patients at 10 UK hospitals and one in Italy.

Researchers from Cardiff University, King’s College London, Salford Royal and North Bristol NHS trusts said frailty assessment was crucial to make clinical decisions on treatment.

They urged its use as a key indicator to assess a patient’s risk of dying.

Frailty is a clinical condition signified by a loss of reserves, energy and well-being which leaves people vulnerable to sudden changes in health and at risk of hospital admission, the need for long-term care or death.

The study by specialists in geriatric care, published in the Lancet medical journal, is believed to be the first to explore the impact of frailty on death risk in the current pandemic.

Lead author Jonathan Hewitt, from Cardiff University’s school of medicine, said: “Every Covid-19 patient should be assessed for frailty because we now know that being frail – no matter how old you are or what underlying conditions you may have – affects your chance of recovery from this disease.

“Up until now the focus has been on age and other health issues but we believe this should now shift to frailty to make sure patients are receiving the appropriate, targeted treatment.”

Kathryn McCarthy, a surgeon from North Bristol NHS Trust who researches frailty, said an assessment was quick and easy to carry out.

“Our findings may also adjust people’s understanding of their own personal risk from Covid-19,” she said.

“For example, younger people can be frail and higher risk but are told they are in a lower risk group, while older people who are not frail have been told they are at risk and need to shield just because of their age.

Of 1,564 people admitted with Covid-19, two-thirds were aged 65 and over but not all of them were deemed frail.

Further analysis showed patients who were considered to be severely frail were 2.4 times more likely to die from Covid-19, after accounting for age, other health problems and the severity of illness when patients were admitted to hospital.

Ben Carter of King’s College London said: “With the measures in shielding being relaxed in coming months and the ongoing possibility of a second wave of Covid-19 it will be important to have a meaningful indicator to help inform decisions as to who may have to shield again.”