TY - JOUR
T1 - Prevalence of physical frailty, including risk factors, up to 1 year after hospitalisation for COVID-19 in the UK: a multicentre, longitudinal cohort study
AU - PHOSP-COVID Study Collaborative Group
AU - McAuley, Hamish J.C.
AU - Evans, Rachael A.
AU - Bolton, Charlotte E.
AU - Brightling, Christopher E.
AU - Chalmers, James D.
AU - Docherty, Annemarie B.
AU - Elneima, Omer
AU - Greenhaff, Paul L.
AU - Gupta, Ayushman
AU - Harris, Victoria C.
AU - Harrison, Ewen M.
AU - Ho, Ling Pei
AU - Horsley, Alex
AU - Houchen-Wolloff, Linzy
AU - Jolley, Caroline J.
AU - Leavy, Olivia C.
AU - Lone, Nazir I.
AU - Man, William D.C.
AU - Marks, Michael
AU - Parekh, Dhruv
AU - Poinasamy, Krisnah
AU - Quint, Jennifer K.
AU - Raman, Betty
AU - Richardson, Matthew
AU - Saunders, Ruth M.
AU - Sereno, Marco
AU - Shikotra, Aarti
AU - Singapuri, Amisha
AU - Singh, Sally J.
AU - Steiner, Michael
AU - Tan, Ai Lyn
AU - Wain, Louise V.
AU - Welch, Carly
AU - Whitney, Julie
AU - Witham, Miles D.
AU - Lord, Janet
AU - Greening, Neil J.
AU - Abel, K.
AU - Adamali, H.
AU - Adeloye, D.
AU - Adeyemi, O.
AU - Adrego, R.
AU - Aguilar Jimenez, L. A.
AU - Ahmad, S.
AU - Ahmad Haider, N.
AU - Ahmed, R.
AU - Ahwireng, N.
AU - Ainsworth, M.
AU - Al-Sheklly, B.
AU - Defres, Sylviane
PY - 2023/3/1
Y1 - 2023/3/1
N2 - Background: The scale of COVID-19 and its well documented long-term sequelae support a need to understand long-term outcomes including frailty. Methods: This prospective cohort study recruited adults who had survived hospitalisation with clinically diagnosed COVID-19 across 35 sites in the UK (PHOSP-COVID). The burden of frailty was objectively measured using Fried's Frailty Phenotype (FFP). The primary outcome was the prevalence of each FFP group—robust (no FFP criteria), pre-frail (one or two FFP criteria) and frail (three or more FFP criteria)—at 5 months and 1 year after discharge from hospital. For inclusion in the primary analysis, participants required complete outcome data for three of the five FFP criteria. Longitudinal changes across frailty domains are reported at 5 months and 1 year post-hospitalisation, along with risk factors for frailty status. Patient-perceived recovery and health-related quality of life (HRQoL) were retrospectively rated for pre-COVID-19 and prospectively rated at the 5 month and 1 year visits. This study is registered with ISRCTN, number ISRCTN10980107. Findings: Between March 5, 2020, and March 31, 2021, 2419 participants were enrolled with FFP data. Mean age was 57.9 (SD 12.6) years, 933 (38.6%) were female, and 429 (17.7%) had received invasive mechanical ventilation. 1785 had measures at both timepoints, of which 240 (13.4%), 1138 (63.8%) and 407 (22.8%) were frail, pre-frail and robust, respectively, at 5 months compared with 123 (6.9%), 1046 (58.6%) and 616 (34.5%) at 1 year. Factors associated with pre-frailty or frailty were invasive mechanical ventilation, older age, female sex, and greater social deprivation. Frail participants had a larger reduction in HRQoL compared with before their COVID-19 illness and were less likely to describe themselves as recovered. Interpretation: Physical frailty and pre-frailty are common following hospitalisation with COVID-19. Improvement in frailty was seen between 5 and 12 months although two-thirds of the population remained pre-frail or frail. This suggests comprehensive assessment and interventions targeting pre-frailty and frailty beyond the initial illness are required. Funding: UK Research and Innovation and National Institute for Health Research.
AB - Background: The scale of COVID-19 and its well documented long-term sequelae support a need to understand long-term outcomes including frailty. Methods: This prospective cohort study recruited adults who had survived hospitalisation with clinically diagnosed COVID-19 across 35 sites in the UK (PHOSP-COVID). The burden of frailty was objectively measured using Fried's Frailty Phenotype (FFP). The primary outcome was the prevalence of each FFP group—robust (no FFP criteria), pre-frail (one or two FFP criteria) and frail (three or more FFP criteria)—at 5 months and 1 year after discharge from hospital. For inclusion in the primary analysis, participants required complete outcome data for three of the five FFP criteria. Longitudinal changes across frailty domains are reported at 5 months and 1 year post-hospitalisation, along with risk factors for frailty status. Patient-perceived recovery and health-related quality of life (HRQoL) were retrospectively rated for pre-COVID-19 and prospectively rated at the 5 month and 1 year visits. This study is registered with ISRCTN, number ISRCTN10980107. Findings: Between March 5, 2020, and March 31, 2021, 2419 participants were enrolled with FFP data. Mean age was 57.9 (SD 12.6) years, 933 (38.6%) were female, and 429 (17.7%) had received invasive mechanical ventilation. 1785 had measures at both timepoints, of which 240 (13.4%), 1138 (63.8%) and 407 (22.8%) were frail, pre-frail and robust, respectively, at 5 months compared with 123 (6.9%), 1046 (58.6%) and 616 (34.5%) at 1 year. Factors associated with pre-frailty or frailty were invasive mechanical ventilation, older age, female sex, and greater social deprivation. Frail participants had a larger reduction in HRQoL compared with before their COVID-19 illness and were less likely to describe themselves as recovered. Interpretation: Physical frailty and pre-frailty are common following hospitalisation with COVID-19. Improvement in frailty was seen between 5 and 12 months although two-thirds of the population remained pre-frail or frail. This suggests comprehensive assessment and interventions targeting pre-frailty and frailty beyond the initial illness are required. Funding: UK Research and Innovation and National Institute for Health Research.
KW - COVID-19
KW - Fried's frailty phenotype
KW - Hospitalisation
KW - Long-COVID
KW - Physical frailty
U2 - 10.1016/j.eclinm.2023.101896
DO - 10.1016/j.eclinm.2023.101896
M3 - Article
SN - 2589-5370
VL - 57
JO - eClinicalMedicine
JF - eClinicalMedicine
M1 - 101896
ER -