A study by the Geriatric Medicine Research Collaborative (GeMRC) has found that severely frail patients with Covid-19 are three times more likely to die than those who were not frail, even taking into account their age.
The clinical observational study, published in Age and Ageing and involving 5,711 patients with Covid-19 at 55 hospitals across 12 countries, also found that those with severe frailty who survived the virus were seven times more likely to go on to need increased care at home or in care homes.
GeMRC hopes the research findings will influence public health policy, including advice on shielding and recommendations for prioritisation on vaccination for those with frailty.
The researchers said that frailty is a state where the body becomes more vulnerable to the effects of illness. It is identified by clinicians using a holistic assessment that considers how much support the person needs from others in their daily living before becoming unwell - not just their medical problems, but the person as a whole. The risk of frailty increases as we get older, but it can develop at different ages.
Frailty develops at different ages
Senior author Dr Carly Welch, clinical research fellow in geriatric medicine at the University of Birmingham's Institute of Inflammation & Ageing, and Chair and Co-Founder of GeMRC, said: "It was identified very early in the pandemic that older age was a significant risk factor for a higher chance of death with Covid-19. However, not all older people are the same, we all age differently - some people can live well into their 90s without developing frailty, and it can develop even without the presence of other long-term conditions.
"Our findings are important as we have been able to demonstrate that not only older age but also frailty, independently from one another, increase the risk of death from Covid-19 and also a subsequent increased need in care for survivors."
The results also showed that delirium - a state of clouding of the mind and extremely prevalent in patients with Covid-19 - is not itself independently associated with increased risk of mortality.
Further research is encouraged to understand what factors affect recovery of physical function and quality of life with Covid-19, and the inclusion of older adults with frailty in such research is paramount.