The relationship between frailty, nutritional status, co-morbidity, CT-Body composition and systemic inflammation in patients with COVID-19

Josh McGovern*, Yassir Al-Azzawi, Olivia Kemp, Peter Moffitt, Conor Richards, Ross Dolan, Barry J A Laird, Donald McMillan, Donogh Maguire

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

Background

Frailty, determined by the Canadian Study of Health and Aging-Clinical Frailty Scale (CFS), is strongly associated with clinical outcomes including mortality in patients with COVID-19. However, the relationship between frailty and other recognised prognostic factors including age, nutritional status, obesity, sarcopenia and systemic inflammation is poorly understood. Therefore, the aim of this study was to examine the relationship between frailty and other prognostic domains, in patients admitted with COVID-19.
Methods

Patients who presented to our institutions between 1st April 2020–6th July 2020 with confirmed COVID-19 were assessed for inclusion. Data collected included general demographic details, clinicopathological variables, CFS admission assessment, Malnutrition Universal Screening Tool (MUST), CT-BC measurements and markers of systemic inflammation.
Results

106 patients met the study inclusion criteria. The majority of patients were aged ≥ 70 years (67%), male (53%) and frail (scoring > 3 on the CFS, 72%). The majority of patients were not malnourished (MUST 0, 58%), had ≥ 1 co-morbidity (87%), were sarcopenic (low SMI, 80%) and had systemic inflammation (mGPS ≥ 1, 81%, NLR > 5, 55%). On multivariate binary logistics regression analysis, age (p < 0.01), COPD (p < 0.05) and NLR (p < 0.05) remained independently associated with frailty. On univariate binary logistics regression, NLR (p < 0.05) was significantly associated with 30-day mortality.
Conclusion

Frailty was independently associated with age, co-morbidity, and systemic inflammation. The basis of the relationship between frailty and clinical outcomes in COVID-19 requires further study.

Trial registration Registered with clinicaltrials.gov (NCT04484545)
Original languageEnglish
Article number98
JournalJournal of translational medicine
Volume20
DOIs
Publication statusPublished - 21 Feb 2022

Keywords / Materials (for Non-textual outputs)

  • frailty
  • elderly
  • COVID-19
  • body composition

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