Older Age and Frailty are Associated with Higher Mortality but Lower ICU Admission with COVID-19

Melissa K. Andrew; Judith Godin; Jason LeBlanc; Guy Boivin; Louis Valiquette; Allison McGeer; Janet E. McElhaney; Todd F. Hatchette; May ElSherif; Donna MacKinnon-Cameron; Kevin Wilson; Ardith Ambrose; Sylvie Trottier; Mark Loeb; Stephanie W. Smith; Kevin Katz; Anne McCarthy; Shelly A. McNeil

doi:10.5770/CGJ.25.546

Older Age and Frailty are Associated with Higher Mortality but Lower ICU Admission with COVID-19

Melissa K. Andrew, Judith Godin, Jason LeBlanc, Guy Boivin, Louis Valiquette, Allison McGeer, Janet E. McElhaney, Todd F. Hatchette, May ElSherif, Donna MacKinnon-Cameron, Kevin Wilson, Ardith Ambrose, Sylvie Trottier, Mark Loeb, Stephanie W. Smith, Kevin Katz, Anne McCarthy, Shelly A. McNeil

Medicine

Research output: Contribution to journal › Article › peer-review

9 Citations (Scopus)

Abstract

We report characteristics and outcomes of adults admitted to Canadian Immunization Research Network (CIRN) Serious Outcomes Surveillance (SOS) Network hospitals with COVID-19 in 2020. Methods Patients with laboratory-confirmed COVID-19 admitted to 11 sites in Ontario, Quebec, Alberta, and Nova Scotia up to December 31, 2020 were enrolled in this prospective observational cohort study. Measures included age, sex, demographics, housing, exposures, Clinical Frailty Scale, comorbidities; in addition, length of stay, intensive care unit (ICU) admission, mechanical ventilation, and survival were assessed. Descriptive analyses and multivariable logistic regressions were conducted. Results Among 2,011 patients, mean age was 71.0 (range 19–105) years. 29.7% were admitted from assisted living or long-term care facilities. The full spectrum of frailty was represented in both younger and older age groups. 81.8% had at least one underlying comorbidity and 27.2% had obesity. Mortality was 14.3% without ICU admission, and 24.6% for those admitted to ICU. Older age and frailty were independent predictors of lower ICU use and higher mortality; accounting for frailty, obesity was not an independent predictor of mortality, and associations of comorbidities with mortality were weakened. Conclusions Frailty is a critical clinical factor in predicting outcomes of COVID-19, which should be considered in research and clinical settings.

Original language	English
Pages (from-to)	183-196
Number of pages	14
Journal	Canadian Geriatrics Journal
Volume	25
Issue number	2
DOIs	https://doi.org/10.5770/CGJ.25.546
Publication status	Published - Jun 2022

Bibliographical note

Funding Information:
The Canadian Immunization Research Network (CIRN) Serious Outcomes Surveillance Network is funded by the Canadian Institutes of Health Research (FRN #96974), Public Health Agency of Canada and the COVID-19 Immunity Task Force (CITF).

Funding Information:
We have read and understood the Canadian Geriatrics Journal’s policy on conflicts of interest disclosure and declare the following interests: MKA reports grant funding from the Public Health Association of Canada, CIHR, Canadian Frailty Network, Sanofi Pasteur and GSK group of companies, and payments from Pfizer, Sanofi Pasteur and Seqirus outside the submitted work. AM reports payments from GSK, Seqirus and Sanofi Pasteur, outside the submitted work. JEM reports payments from RestorBio, Sanofi, GSK, Merck and Medicago outside of the submitted work. TFH reports grants from Pfizer and GSK. ML reports payments from Sanofi, Medicago, Sequirus, and Pfizer outside the submitted work. SAM reports grants and payments from Pfizer, GSK, Merck, Novartis and Sanofi, outside the submitted work. JG, JJL, GB, LV, ME, DM-C, AA, KW, ST, SS, AMc and KK report no conflicts of interest.

Publisher Copyright:
© 2022 Author(s).

ASJC Scopus Subject Areas

Gerontology
Geriatrics and Gerontology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.5770/CGJ.25.546

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Andrew, M. K., Godin, J., LeBlanc, J., Boivin, G., Valiquette, L., McGeer, A., McElhaney, J. E., Hatchette, T. F., ElSherif, M., MacKinnon-Cameron, D., Wilson, K., Ambrose, A., Trottier, S., Loeb, M., Smith, S. W., Katz, K., McCarthy, A., & McNeil, S. A. (2022). Older Age and Frailty are Associated with Higher Mortality but Lower ICU Admission with COVID-19. Canadian Geriatrics Journal, 25(2), 183-196. https://doi.org/10.5770/CGJ.25.546

Andrew, MK , Godin, J, LeBlanc, J, Boivin, G, Valiquette, L, McGeer, A, McElhaney, JE, Hatchette, TF, ElSherif, M, MacKinnon-Cameron, D, Wilson, K, Ambrose, A, Trottier, S, Loeb, M, Smith, SW, Katz, K, McCarthy, A & McNeil, SA 2022, 'Older Age and Frailty are Associated with Higher Mortality but Lower ICU Admission with COVID-19', Canadian Geriatrics Journal, vol. 25, no. 2, pp. 183-196. https://doi.org/10.5770/CGJ.25.546

@article{ff189454a7e2451890197ff9fd7edcca,

title = "Older Age and Frailty are Associated with Higher Mortality but Lower ICU Admission with COVID-19",

abstract = "We report characteristics and outcomes of adults admitted to Canadian Immunization Research Network (CIRN) Serious Outcomes Surveillance (SOS) Network hospitals with COVID-19 in 2020. Methods Patients with laboratory-confirmed COVID-19 admitted to 11 sites in Ontario, Quebec, Alberta, and Nova Scotia up to December 31, 2020 were enrolled in this prospective observational cohort study. Measures included age, sex, demographics, housing, exposures, Clinical Frailty Scale, comorbidities; in addition, length of stay, intensive care unit (ICU) admission, mechanical ventilation, and survival were assessed. Descriptive analyses and multivariable logistic regressions were conducted. Results Among 2,011 patients, mean age was 71.0 (range 19–105) years. 29.7% were admitted from assisted living or long-term care facilities. The full spectrum of frailty was represented in both younger and older age groups. 81.8% had at least one underlying comorbidity and 27.2% had obesity. Mortality was 14.3% without ICU admission, and 24.6% for those admitted to ICU. Older age and frailty were independent predictors of lower ICU use and higher mortality; accounting for frailty, obesity was not an independent predictor of mortality, and associations of comorbidities with mortality were weakened. Conclusions Frailty is a critical clinical factor in predicting outcomes of COVID-19, which should be considered in research and clinical settings.",

author = "Andrew, {Melissa K.} and Judith Godin and Jason LeBlanc and Guy Boivin and Louis Valiquette and Allison McGeer and McElhaney, {Janet E.} and Hatchette, {Todd F.} and May ElSherif and Donna MacKinnon-Cameron and Kevin Wilson and Ardith Ambrose and Sylvie Trottier and Mark Loeb and Smith, {Stephanie W.} and Kevin Katz and Anne McCarthy and McNeil, {Shelly A.}",

note = "Funding Information: The Canadian Immunization Research Network (CIRN) Serious Outcomes Surveillance Network is funded by the Canadian Institutes of Health Research (FRN #96974), Public Health Agency of Canada and the COVID-19 Immunity Task Force (CITF). Funding Information: We have read and understood the Canadian Geriatrics Journal{\textquoteright}s policy on conflicts of interest disclosure and declare the following interests: MKA reports grant funding from the Public Health Association of Canada, CIHR, Canadian Frailty Network, Sanofi Pasteur and GSK group of companies, and payments from Pfizer, Sanofi Pasteur and Seqirus outside the submitted work. AM reports payments from GSK, Seqirus and Sanofi Pasteur, outside the submitted work. JEM reports payments from RestorBio, Sanofi, GSK, Merck and Medicago outside of the submitted work. TFH reports grants from Pfizer and GSK. ML reports payments from Sanofi, Medicago, Sequirus, and Pfizer outside the submitted work. SAM reports grants and payments from Pfizer, GSK, Merck, Novartis and Sanofi, outside the submitted work. JG, JJL, GB, LV, ME, DM-C, AA, KW, ST, SS, AMc and KK report no conflicts of interest. Publisher Copyright: {\textcopyright} 2022 Author(s).",

year = "2022",

month = jun,

doi = "10.5770/CGJ.25.546",

language = "English",

volume = "25",

pages = "183--196",

journal = "Canadian Geriatrics Journal",

issn = "1718-1879",

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TY - JOUR

T1 - Older Age and Frailty are Associated with Higher Mortality but Lower ICU Admission with COVID-19

AU - Andrew, Melissa K.

AU - Godin, Judith

AU - LeBlanc, Jason

AU - Boivin, Guy

AU - Valiquette, Louis

AU - McGeer, Allison

AU - McElhaney, Janet E.

AU - Hatchette, Todd F.

AU - ElSherif, May

AU - MacKinnon-Cameron, Donna

AU - Wilson, Kevin

AU - Ambrose, Ardith

AU - Trottier, Sylvie

AU - Loeb, Mark

AU - Smith, Stephanie W.

AU - Katz, Kevin

AU - McCarthy, Anne

AU - McNeil, Shelly A.

N1 - Funding Information: The Canadian Immunization Research Network (CIRN) Serious Outcomes Surveillance Network is funded by the Canadian Institutes of Health Research (FRN #96974), Public Health Agency of Canada and the COVID-19 Immunity Task Force (CITF). Funding Information: We have read and understood the Canadian Geriatrics Journal’s policy on conflicts of interest disclosure and declare the following interests: MKA reports grant funding from the Public Health Association of Canada, CIHR, Canadian Frailty Network, Sanofi Pasteur and GSK group of companies, and payments from Pfizer, Sanofi Pasteur and Seqirus outside the submitted work. AM reports payments from GSK, Seqirus and Sanofi Pasteur, outside the submitted work. JEM reports payments from RestorBio, Sanofi, GSK, Merck and Medicago outside of the submitted work. TFH reports grants from Pfizer and GSK. ML reports payments from Sanofi, Medicago, Sequirus, and Pfizer outside the submitted work. SAM reports grants and payments from Pfizer, GSK, Merck, Novartis and Sanofi, outside the submitted work. JG, JJL, GB, LV, ME, DM-C, AA, KW, ST, SS, AMc and KK report no conflicts of interest. Publisher Copyright: © 2022 Author(s).

PY - 2022/6

Y1 - 2022/6

N2 - We report characteristics and outcomes of adults admitted to Canadian Immunization Research Network (CIRN) Serious Outcomes Surveillance (SOS) Network hospitals with COVID-19 in 2020. Methods Patients with laboratory-confirmed COVID-19 admitted to 11 sites in Ontario, Quebec, Alberta, and Nova Scotia up to December 31, 2020 were enrolled in this prospective observational cohort study. Measures included age, sex, demographics, housing, exposures, Clinical Frailty Scale, comorbidities; in addition, length of stay, intensive care unit (ICU) admission, mechanical ventilation, and survival were assessed. Descriptive analyses and multivariable logistic regressions were conducted. Results Among 2,011 patients, mean age was 71.0 (range 19–105) years. 29.7% were admitted from assisted living or long-term care facilities. The full spectrum of frailty was represented in both younger and older age groups. 81.8% had at least one underlying comorbidity and 27.2% had obesity. Mortality was 14.3% without ICU admission, and 24.6% for those admitted to ICU. Older age and frailty were independent predictors of lower ICU use and higher mortality; accounting for frailty, obesity was not an independent predictor of mortality, and associations of comorbidities with mortality were weakened. Conclusions Frailty is a critical clinical factor in predicting outcomes of COVID-19, which should be considered in research and clinical settings.

AB - We report characteristics and outcomes of adults admitted to Canadian Immunization Research Network (CIRN) Serious Outcomes Surveillance (SOS) Network hospitals with COVID-19 in 2020. Methods Patients with laboratory-confirmed COVID-19 admitted to 11 sites in Ontario, Quebec, Alberta, and Nova Scotia up to December 31, 2020 were enrolled in this prospective observational cohort study. Measures included age, sex, demographics, housing, exposures, Clinical Frailty Scale, comorbidities; in addition, length of stay, intensive care unit (ICU) admission, mechanical ventilation, and survival were assessed. Descriptive analyses and multivariable logistic regressions were conducted. Results Among 2,011 patients, mean age was 71.0 (range 19–105) years. 29.7% were admitted from assisted living or long-term care facilities. The full spectrum of frailty was represented in both younger and older age groups. 81.8% had at least one underlying comorbidity and 27.2% had obesity. Mortality was 14.3% without ICU admission, and 24.6% for those admitted to ICU. Older age and frailty were independent predictors of lower ICU use and higher mortality; accounting for frailty, obesity was not an independent predictor of mortality, and associations of comorbidities with mortality were weakened. Conclusions Frailty is a critical clinical factor in predicting outcomes of COVID-19, which should be considered in research and clinical settings.

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Older Age and Frailty are Associated with Higher Mortality but Lower ICU Admission with COVID-19

Abstract

Bibliographical note

ASJC Scopus Subject Areas

UN SDGs

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