Sara Hägg 1 , # , ∗ , Juulia Jylhävä 1 , ∗ , Yunzhang Wang 1 , Hong Xu 2 , 3 , Carina Metzner 2 , Martin Annetorp 2 , Sara Garcia-Ptacek 2 , 3 , Masih Khedri 2 , Anne-Marie Boström 2 , 4 , 5 , Ahmadul Kadir 2 , Anna Johansson 2 , Miia Kivipelto 2 , 3 , Maria Eriksdotter 2 , 3 , Tommy Cederholm 2 , 3 , Dorota Religa 2 , 3
14 August 2020
To analyze whether frailty and comorbidities are associated with in-hospital mortality and discharge to home in older adults hospitalized for coronavirus disease 2019 (COVID-19).
and Participants: Patients admitted to geriatric care in a large hospital in Sweden, between March 1 st – June 11 th 2020; 250 were treated for COVID-19 and 717 for other diagnoses.
COVID-19 diagnosis was clinically confirmed by positive RT-PCR test or, if negative, by other methods. Patient data were extracted from electronic medical records, which included Clinical Frailty Scale (CFS), and were further used for assessments of the Hospital Frailty Risk Score (HFRS) and the Charlson Comorbidity Index (CCI). In-hospital mortality and home discharge were followed up for up to 25 and 28 days, respectively. Multivariate Cox regression models adjusted for age and sex were used.
Among the COVID-19 patients, in-hospital mortality rate was 24% and home discharge rate was 44%. Higher age was associated with in-hospital mortality (hazard ratio [HR]=1.05 per each year, 95% confidence interval [CI]=1.01-1.08) and lower probability of home discharge (HR=0.97, 95% CI=0.95-0.99). CFS (>5) and CCI, but not HFRS, were predictive of in-hospital mortality (HR=1.93, 95% CI=1.02-3.65 and HR=1.27, 95% CI=1.02-1.58, respectively). Patients with CFS>5 had a lower probability of being discharged home (HR=0.38, 95% CI=0.25-0.58). CCI and HFRS were not associated with home discharge. In general, effects were more pronounced in men. Acute kidney injury was associated with in-hospital mortality and hypertension with discharge to home. Other comorbidities (diabetes, cardiovascular disease, lung diseases, chronic kidney disease and dementia) were not associated with either outcome.
Age, frailty and comorbidities are associated with in-hospital mortality and a decreased probability to be discharged to home in geriatric COVID-19 patients from a large hospital in Stockholm, Sweden.