Clinical frailty scale as a point of care prognostic indicator of mortality in COVID-19: a systematic review and meta-analysis

Stavroula Kastora, Georgios Kounidas, Sarah Perrott, Ben Carter, Jonathan Hewitt* (Corresponding Author), Phyo Kyaw Myint

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background COVID-19 has resulted in the largest pandemic experienced since 1918, accounting for over 2 million deaths globally. Frail and older people are at the highest risk of mortality. The main objective of the present research was to quantify the impact of clinical frailty scale (CFS) by increasing severity of frailty and to identify other personal prognostic factors associated with increased mortality from COVID-19. Methods This study offers a contemporary systematic review and meta-analysis to analyse the stratified mortality risk by increasing CFS sub-categories (1–3, 4–5 and 6–9). Databases searched included EMBASE, MEDLINE, CAB Abstracts, PsychInfo, and Web of Science with end-search restriction the 18th December 2020. Publications identified via MedRevix were followed up on the 23rd March 2021 in peer-reviewed database search, and citations were updated as published. Prospective and retrospective cohort studies which reported the association between CFS and COVID-19 mortality were included. Thirty-four studies were eligible for systematic review and seventeen for meta-analysis, with 81–87% (I2) heterogeneity. Findings All studies [N: 34] included patients from a hospital setting, comprising a total of 18,042 patients with mean age 72.8 (Min: 56; Max: 86). The CFS 4–5 patient group had significantly increased mortality when compared to patients with CFS 1–3 [(RE) OR 1.95 (1.32 (95% CI), 2.87 (95% CI)); I2 81%; p = 0.0008]. Furthermore, CFS 6–9 patient group displayed an even more noticeable mortality increase when compared to patients with CFS 1–3 [(RE) OR 3.09 (2.03, 4.71); I2 87%; p
Original languageEnglish
Article number100896
Number of pages7
JournalEClinicalMedicine
Volume36
Early online date21 May 2021
DOIs
Publication statusPublished - 1 Jun 2021

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