In a new paper published in the journal, Age And Ageing, a team of researchers at the University of Birmingham determined that clinical frailty—defined as the decline in reserve and function across multiple physiologic systems—increases one’s likelihood of succumbing to COVID-19.
The researchers recruited 5,711 patients with COVID at 55 different hospitals across 12 countries. The risk of death increased independently with age, inflammation, renal disease, cardiovascular disease, and cancer.
Moreover, frail patients who survived COVID-19 were 7 times more likely to require at-home care after being discharged from the hospital.
“Increased mortality has been demonstrated in older adults with COVID-19, but the effect of frailty has been unclear,” the authors wrote in the paper.
Even though medical frailty is more common among elderly populations, its correlative effect on COVID’s pathology was discernible irrespective of the age of the frail participants being reviewed.
Meaning, it’s possible to develop frailty before old age just as it’s possible to delay it in old age. Its onset depends on behavioral, psychological, genetic, and dietary conditions. All in all, medically frail patients are 3x more likely to die of COVID-19 as per the findings featured in the new report.
Frailty scores are typically calculated via the presence of the following occurrences:
- Unintentional weight loss
- Low physical activity levels
- Poor handgrip strength and slow walking speed
Delirium, dementia, and generalized mental health problems were listed alongside age and frailty as pre-existing illnesses that can compound COVID-19 symptoms for patients receiving at-home care.
“This multi-center cohort study involved patients aged 18 years and older hospitalized with COVID-19, using routinely collected data. We used Cox regression analysis to assess the impact of age, frailty, and delirium on the risk of inpatient mortality, adjusting for sex, illness severity, inflammation, and co-morbidities. We used ordinal logistic regression analysis to assess the impact of age, Clinical Frailty Scale (CFS), and delirium on risk of increased care requirements on discharge, adjusting for the same variables,” the authors added in the new paper.
“Age and frailty are independently associated with adverse outcomes in COVID-19. Risk of increased care needs was also increased in survivors of COVID-19 with frailty or older age.”
Comorbidities have a huge impact on the rate of decline in frail patients. More often than not, some degree of pre-frailty, which includes poor balance, a decreased ability to control spinal and pelvic posture, diminished foot sensations, and an impaired ability to maintain weight and nutrition, occurs in 45% of people between the ages of 40 and 49.
In addition to maintaining a balanced diet (The Mediterranean was recently ranked as optimal on this front by various health systems) receiving daily physical activity is the best way to put off developing frailty, even in old age.
Most physicians recommend adults try and receive at least 60 minutes of moderate-intensity aerobic activity a day.
“If they’re not watching TV, then they’re in front of some type of a screen (such as a computer or handheld device), reading, doing puzzles — anything but moving around,” he says. As a result, the muscles in these older adults lose their functional capacity and tone, and may eventually become infiltrated with fat,” explained geriatric specialist, Ronan Factora, MD.
“Aside from the obvious change in muscle tissue, an older adult’s ability to function is also affected. As a result, this also leads to reported physical exhaustion, muscle weakness, and potentially a decline in walking speed.”
Roughly one out of every five people hospitalized with severe COVID-19 are younger than 50. As data sets lengthen, it’s becoming more and more apparent that pre-existing conditions are comparably influential as age with respect to coronavirus mortality rates.