Risk factors for death in adult COVID-19 patients: Frailty predicts fatal outcome in older patients

Int J Infect Dis. 2021 Jan:102:415-421. doi: 10.1016/j.ijid.2020.10.071. Epub 2020 Oct 30.


Objectives: This study investigated demographics, comorbidities, and death rate in hospitalized patients with confirmed COVID-19. In addition, we hypothesized that functional status, according to the Clinical Frailty Scale (CFS), in patients aged 65 years or older is a better predictor of poor outcome than age and comorbidities.

Methods: A total of 255 randomly selected COVID-19 patients admitted to a university hospital were included and followed up for 60 days. Patient data were extracted manually from the electronic health records with use of a standardized protocol.

Results: The age of the study population ranged between 20 and 103 years (mean age 66 years ± 17 years). Hypertension, diabetes mellitus, and obesity were the three most prevalent comorbidities. At the 60-day follow-up, 70 patients (27%) had died. In multivariate analyses, age, chronic kidney disease, and previous stroke were associated with death. Most fatal cases (90%) occurred in patients aged 65 years or older. Among such patients, CFS level was the only predictor of death in multivariate analyses.

Conclusions: This study shows that increasing age, chronic kidney disease, and previous stroke significantly contribute to a fatal outcome in hospitalized patients with COVID-19. In patients aged 65 years or older, CFS level was the strongest prognostic factor for death.

Keywords: COVID-19; Clinical Frailty Scale; Frailty; Mortality; Risk factors; SARS-CoV-2.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • COVID-19 / mortality*
  • Comorbidity
  • Female
  • Frailty*
  • Humans
  • Male
  • Middle Aged
  • Renal Insufficiency, Chronic / complications
  • Risk Factors
  • SARS-CoV-2*
  • Stroke / complications
  • Young Adult