Prevalence of new frailty at hospital discharge in severe COVID-19 survivors and its associated factors

Backgrounds: The development of frailty at hospital discharge affects the clinical outcomes in severe coronavirus disease (COVID-19) survivors who had no frailty before hospitalization. We aimed to describe the prevalence of new frailty using the Clinical Frailty Scale (CFS) and evaluate its associated factors in patients with severe COVID-19 without pre-existing frailty before hospitalization.

Methods: We performed a secondary analysis of clinical data from a nationwide retrospective cohort collected from 22 hospitals between January 1, 2020 and August 31, 2021. The patients were at least 19 years old and survived until discharge after admission to the intensive care unit (ICU) because of severe COVID-19. Development of new frailty was defined as a CFS score ≥ 5 at hospital discharge.

Results: Among 669 severe COVID-19 survivors without pre-existing frailty admitted to the ICU, the mean age was 65.2 ± 12.8 years, 62.5% were male, and 50.2% received mechanical ventilation (MV). The mean CFS score at admission was 2.4 ± 0.9, and new frailty developed in 27.8% (186/483). In multivariate analysis, older age, cardiovascular disease, CFS score of 3-4 before hospitalization, increased C-reactive protein level, longer duration of corticosteroid treatment, and use of MV and extracorporeal membrane oxygenation were identified as factors associated with new-onset frailty.

Conclusion: Our study suggests that new frailty is not uncommon and is associated with diverse factors in survivors of severe COVID-19 without pre-existing frailty.