Risk factors for hospitalization and death due to COVID-19 among frail community-dwelling elderly people: a retrospective cohort study

Sao Paulo Med J. 2022 Sep-Oct;140(5):676-681. doi: 10.1590/1516-3180.2021.0649.R1.20122021.

Abstract

Background: Advanced age, multiple chronic diseases and frailty have been correlated with worse prognosis among coronavirus disease 2019 (COVID-19) inpatients.

Objective: To investigate potential risk factors for hospitalization and death due to COVID-19 among frail community-dwelling elderly people.

Design and setting: Retrospective cohort study of patients followed up at a geriatric outpatient clinic in Belo Horizonte, Minas Gerais, Brazil.

Methods: The associations of demographic characteristics (age and sex) and clinical characteristics (frailty, multimorbidity, number of medications with long-term use, obesity, smoking, diabetes mellitus, pulmonary diseases, cardiovascular diseases, cerebrovascular disease, and chronic kidney disease) with the risk of hospitalization and death due to COVID-19 were explored using a multivariable logistic regression model.

Results: 5,295 patients (mean age 78.6 ± 9.4 years; 72.6% females) were included. After adjustments, the number of medications with long-term use was found to increase the odds of hospitalization due to COVID-19 (odds ratio, OR: 1.13; 95% confidence interval, CI: 1.06-1.22). Frailty, multimorbidity and diabetes mellitus also increased the odds of hospitalization (OR: 1.06, 95% CI: 1.02-1.09; OR: 1.17, 95% CI: 1.09-1.26; and OR: 2.27, 95% CI: 1.45-3.54, respectively) and the odds of death due to COVID-19 (OR: 1.07, 95% CI: 1.00-1.14; OR: 1.16, 95% CI: 1.03-1.32; and OR: 2.69, 95% CI: 1.79-6.14, respectively).

Conclusions: Multimorbidity, frailty and diabetes mellitus increased the odds of hospitalization and death due to COVID-19 and the number of medications with long-term use increased the odds of hospitalization due to COVID-19 among frail community-dwelling elderly people.

MeSH terms

  • Aged
  • Aged, 80 and over
  • COVID-19*
  • Diabetes Mellitus* / epidemiology
  • Female
  • Frail Elderly
  • Frailty* / epidemiology
  • Geriatric Assessment
  • Hospitalization
  • Humans
  • Independent Living
  • Male
  • Retrospective Studies
  • Risk Factors