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Frailty and COVID-19: A Systematic Scoping Review
Giuseppe Maltese1,2, Andrea Corsonello3, Mirko Di Rosa3
1Department of Diabetes and Endocrinology, Epsom & St Helier University Hospitals, Surrey SM5 1AA, UK.
Journal of Clinical Medicine
|July 9, 2020
Summary
Older adults experienced high mortality during the COVID-19 pandemic, with frailty potentially increasing vulnerability. Limited evidence suggests frailty impacts COVID-19 outcomes, necessitating further research and patient-centered care.
Area of Science:
- Gerontology
- Infectious Diseases
- Public Health
Background:
- The coronavirus disease-19 (COVID-19) pandemic disproportionately affected older adults, leading to significant mortality.
- Frailty is hypothesized to be a key factor in the increased vulnerability and severe clinical presentation of older individuals with COVID-19.
Purpose of the Study:
- To systematically review the existing evidence on the relationship between frailty and COVID-19.
- To identify knowledge gaps regarding frailty assessment and its impact on clinical management and outcomes in older COVID-19 patients.
Main Methods:
- A comprehensive literature search was conducted across major databases (PubMed, Web of Science, EMBASE) for studies published between December 1, 2019, and May 29, 2020.
- Study selection, data extraction, and qualitative synthesis were performed by three independent reviewers, with quantitative data extracted where available.
Main Results:
- Forty papers were included, comprising editorials, recommendations, reviews, a clinical trial, observational studies, and case reports.
- While editorials and reviews highlighted the clinical importance of frailty assessment in COVID-19, observational studies showed limited investigation into frailty's specific associations with mortality, hospital contagion, ICU admission, and disease phenotypes.
- No studies evaluated specific interventions for frailty in the context of COVID-19 treatment.
Conclusions:
- Current evidence on frailty and COVID-19 is limited, particularly regarding interventions.
- Despite limited data, clinical recommendations suggest using frailty assessment tools to guide decision-making for escalation plans in older COVID-19 patients.
- Further research is needed to understand the complex interaction between COVID-19 and frailty, promoting patient-centered care approaches.
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