• Robert De Smet, Bea Mellaerts, Hannelore Vandewinckele, Peter Lybeert, Eric Frans, Sara Ombelet, Wim Lemahieu, Rolf Symons, Erwin Ho, Johan Frans, Annick Smismans, and Michaël R Laurent.
• Geriatrics Department, Imelda Hospital, Bonheiden, Belgium.
• J Am Med Dir Assoc. 2020 Jul 1; 21 (7): 928-932.e1.

ObjectivesTo determine the association between frailty and short-term mortality in older adults hospitalized for coronavirus disease 2019 (COVID-19).DesignRetrospective single-center observational study.Setting And ParticipantsEighty-one patients with COVID-19 confirmed by reverse-transcriptase polymerase chain reaction (RT-PCR), at the Geriatrics department of a general hospital in Belgium.MeasurementsFrailty was graded according to the Rockwood Clinical Frailty Scale (CFS). Demographic, biochemical, and radiologic variables, comorbidities, symptoms, and treatment were extracted from electronic medical records.ResultsParticipants (N = 48 women, 59%) had a median age of 85 years (range 65-97 years) and a median CFS score of 7 (range 2-9); 42 (52%) were long-term care residents. Within 6 weeks, 18 patients died. Mortality was significantly but weakly associated with age (Spearman r = 0.241, P = .03) and CFS score (r = 0.282, P = .011), baseline lactate dehydrogenase (LDH; r = 0.301, P = .009), lymphocyte count (r = -0.262, P = .02), and RT-PCR cycle threshold (Ct, r = -0.285, P = .015). Mortality was not associated with long-term care residence, dementia, delirium, or polypharmacy. In multivariable logistic regression analyses, CFS, LDH, and RT-PCR Ct (but not age) remained independently associated with mortality. Both age and frailty had poor specificity to predict survival. A multivariable model combining age, CFS, LDH, and viral load significantly predicted survival.Conclusions And ImplicationsAlthough their prognosis is worse, even the oldest and most severely frail patients may benefit from hospitalization for COVID-19, if sufficient resources are available.Copyright © 2020 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

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