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The Clinical Frailty Scale: Estimating the Prevalence of Frailty in Older Patients Hospitalised with COVID-19. The COPE Study

Department of Geriatric Medicine, Aneurin Bevan UHB, Caerphilly CF82 7GP, UK
Department of Forensic and Neurodevelopmental Sciences, King’s College London, London SE5 8AF, UK
Department of Biostatistics and Health Informatics, King’s College London, London SE5 8AF, UK
Respiratory Unit, Hospital Policlinico, University of Modena and Reggio Emilia, 41121 Modena, Italy
Institute of Applied Health Sciences, University of Aberdeen, Aberdeen AB25 2ZD, UK
Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G12 8TA, UK
Ageing and Complex Medicine Department, Salford Royal NHS Trust, University of Manchester, Manchester M6 8HD, UK
Department of Surgery, Cardiff and Vale UHB, Cardiff CF14 4XW, UK
Department of Surgery, Royal Alexandra Hospital, Paisley PA2 9PN, UK
Department of Surgery, Southmead Hospital, North Bristol NHS Trust, Bristol BS10 5NB, UK
Division of Population Medicine, Aneurin Bevan UHB, Cardiff University, Cardiff CF14 4XN, UK
Author to whom correspondence should be addressed.
Geriatrics 2020, 5(3), 58;
Received: 30 July 2020 / Revised: 21 August 2020 / Accepted: 15 September 2020 / Published: 21 September 2020
(This article belongs to the Special Issue SARS-CoV-2 Infections in the Elderly)
Frailty assessed using Clinical Frailty Scale (CFS) is a good predictor of adverse clinical events including mortality in older people. CFS is also an essential criterion for determining ceilings of care in people with COVID-19. Our aims were to assess the prevalence of frailty in older patients hospitalised with COVID-19, their sex and age distribution, and the completion rate of the CFS tool in evaluating frailty. Methods: Data were collected from thirteen sites. CFS was assessed routinely at the time of admission to hospital and ranged from 1 (very fit) to 9 (terminally ill). The completion rate of the CFS was assessed. The presence of major comorbidities such as diabetes and cardiovascular disease was noted. Results: A total of 1277 older patients with COVID-19, aged ≥ 65 (79.9 ± 8.1) years were included in the study, with 98.5% having fully completed CFS. The total prevalence of frailty (CFS ≥ 5) was 66.9%, being higher in women than men (75.2% vs. 59.4%, p < 0.001). Frailty was found in 161 (44%) patients aged 65–74 years, 352 (69%) in 75–84 years, and 341 (85%) in ≥85 years groups, and increased across the age groups (<0.0001, test for trend). Conclusion: Frailty was prevalent in our cohort of older people admitted to hospital with COVID-19. This indicates that older people who are also frail, who go on to contract COVID-19 may have disease severity significant enough to warrant hospitalization. These data may help inform health care planners and targeted interventions and appropriate management for the frail older person. View Full-Text
Keywords: frailty; Clinical Frailty Scale; COVID-19; prevalence; hospital frailty; Clinical Frailty Scale; COVID-19; prevalence; hospital
MDPI and ACS Style

Collins, J.T.; Short, R.; Carter, B.; Verduri, A.; Myint, P.K.; Quinn, T.J.; Vilches-Moraga, A.; Stechman, M.J.; Moug, S.; McCarthy, K.; Hewitt, J. The Clinical Frailty Scale: Estimating the Prevalence of Frailty in Older Patients Hospitalised with COVID-19. The COPE Study. Geriatrics 2020, 5, 58.

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