COVID-19 and associations with frailty and multimorbidity: a prospective analysis of UK Biobank participants
COVID-19 and associations with frailty and multimorbidity: a prospective analysis of UK Biobank participants
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DOI：
10.1007/s40520-020-01653-6
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发表时间：
2020-07-23
影响因子：
4
通讯作者：
Harvey, N. C.
中科院分区：
文献类型：
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作者：
Woolford, S. J.;D'Angelo, S.;Harvey, N. C.
背景虚弱和多病已被认为是严重COVID-19疾病的危险因素。我们在英国生物银行（UK Biobank）调查了虚弱和多病是否与COVID-19住院风险相关。方法2006- 2010年在英国招募502640名基线年龄为40-69岁（COVID-19检测年龄为54-79岁）的参与者。根据基线数据，使用Fried的分类对虚弱进行了改进评估。COVID-19检测结果（英格兰）可于2020年3月16日至2020年6月1日获得，主要是在医院环境中获得的。在调整性别、年龄、BMI、种族、教育程度、吸烟和合并症分组数量，比较COVID-19阳性、COVID-19阴性和未检测组后，使用逻辑回归来识别虚弱、多病和COVID-19诊断之间的关联。结果共有4510人接受COVID-19检测（阳性1326人，阴性3184人）。497,996名参与者没有接受测试。与未检测组相比，调整后，COVID-19阳性参与者更容易身体虚弱（OR = 1.4 [95%CI = 1.1, 1.8]），报告步行速度慢（OR = 1.3[1.1, 1.6]），报告过去一年两次或两次以上跌倒（OR = 1.3[1.0, 1.5]）和多病（>= 4共病组vs 0-1: OR = 1.9[1.5, 2.3]）。然而，在比较COVID-19阴性组和未检测组时，相似的关联强度也很明显。然而，在比较COVID-19阳性和COVID-19阴性参与者时，虚弱和多病与COVID-19诊断无关。讨论和结论就COVID-19检测阳性和阴性结果而言，虚弱和多病似乎无助于风险分层。迫切需要研究这些标志物对COVID-19疾病不良临床后遗症的预后价值。
Background Frailty and multimorbidity have been suggested as risk factors for severe COVID-19 disease. Aims We investigated, in the UK Biobank, whether frailty and multimorbidity were associated with risk of hospitalisation with COVID-19. Methods 502,640 participants aged 40-69 years at baseline (54-79 years at COVID-19 testing) were recruited across UK during 2006-10. A modified assessment of frailty using Fried's classification was generated from baseline data. COVID-19 test results (England) were available for 16/03/2020-01/06/2020, mostly taken in hospital settings. Logistic regression was used to discern associations between frailty, multimorbidity and COVID-19 diagnoses, after adjusting for sex, age, BMI, ethnicity, education, smoking and number of comorbidity groupings, comparing COVID-19 positive, COVID-19 negative and non-tested groups. Results 4510 participants were tested for COVID-19 (positive = 1326, negative = 3184). 497,996 participants were not tested. Compared to the non-tested group, after adjustment, COVID-19 positive participants were more likely to be frail (OR = 1.4 [95%CI = 1.1, 1.8]), report slow walking speed (OR = 1.3 [1.1, 1.6]), report two or more falls in the past year (OR = 1.3 [1.0, 1.5]) and be multimorbid (>= 4 comorbidity groupings vs 0-1: OR = 1.9 [1.5, 2.3]). However, similar strength of associations were apparent when comparing COVID-19 negative and non-tested groups. However, frailty and multimorbidity were not associated with COVID-19 diagnoses, when comparing COVID-19 positive and COVID-19 negative participants. Discussion and conclusions Frailty and multimorbidity do not appear to aid risk stratification, in terms of positive versus negative results of COVID-19 testing. Investigation of the prognostic value of these markers for adverse clinical sequelae following COVID-19 disease is urgently needed.