Impact of Frailty on Inpatient Outcomes of COVID-19 Patients: Evidence From a US National Inpatient Sample

Authors

Ali Jaan, Division of Internal Medicine, Rochester General Hospital, Rochester, New York, USFollow
Priyanshi Shah, Division of Internal Medicine, Narendra Modi Medical College, Ahmedabad, Gujarat, IndiaFollow
Ashish Dhawan, Division of Internal Medicine, Gian Sagar Medical College and Hospital, Punjab, IndiaFollow
Saria Qaiser, Division of Internal Medicine, Rutgers Health, NJ, USAFollow
Azka Ali, Division of Internal Medicine, Rosalind Franklin Institute of Medicine and Sciences, Illinois, USAFollow
Hla Myo Thwe, Division of Internal Medicine, University of Medicine, Yangon, MyanmarFollow
Oluwatosin Abimbolu, Division of Internal Medicine, University of Lagos, NigeriaFollow
Clara Chimuanya Okpara, Division of Internal Medicine, American University of Barbados, School of Medicine (AUB)Follow
Michael Rajnik, Division of Pediatrics, F. Edward Hebert School of Medicine Uniformed Services University of the Health SciencesFollow

Author Credentials

Authors: Ali Jaan¹, Priyanshi Shah², Ashish Dhawan³, Saria Qaiser⁴, Azka Ali⁵, Hla Myo Thwe⁶, Oluwatosin Abimbolu⁷, Clara Chimuanya Okpara⁸, Michael Rajnik⁹

Affiliations: 1Division of Internal Medicine, Rochester General Hospital, Rochester, New York, US; ²Division of Internal Medicine, Narendra Modi Medical College, Ahmedabad, Gujarat, India; ³Division of Internal Medicine, Gian Sagar Medical College and Hospital, Punjab, India; ⁴Division of Internal Medicine, Rutgers Health, NJ, USA; ⁵Division of Internal Medicine, Rosalind Franklin Institute of Medicine and Sciences, Illinois, USA; ⁶Division of Internal Medicine, University of Medicine, Yangon, Myanmar; ⁷Division of Internal Medicine, University of Lagos, Nigeria; ⁸Division of Internal Medicine, American University of Barbados, School of Medicine (AUB); ⁹Division of Pediatrics, F. Edward Hebert School of Medicine Uniformed Services University of the Health Sciences

Abstract

Introduction: The global impact of Coronavirus Disease 2019 (COVID-19), caused by severe-acute-respiratory-syndrome coronavirus 2 (SARS-CoV-2), has been profound, claiming the lives of more than 3 million individuals within a year and a half. Among the affected population, heightened vulnerability is observed among older and frailer individuals, leading to more severe symptoms and adverse outcomes compared to their younger, non-frail counterparts. This study to analyze the impact of frailty on the outcomes of adult patients admitted with COVID-19.

Methods: Using the National Inpatient Sample (NIS) database 2020, we identified adult patients admitted with a principal diagnosis of COVID-19. The patients were then divided into two groups, i.e., frail and non-frail, based on the Hospital Frailty Risk Score (HFRS) cut-off of 5. Using a multivariate regression model, we compared COVID-19 hospitalizations, with frailty status serving as the exposure variable. Statistical analysis was performed using STATA version 14.2.

Results: Out of 1,050,045 adult patients hospitalized with COVID-19, 509,915 (48.56%) met the criteria for frailty. Among these frail patients, the majority were white, older females with a high comorbidity burden. Compared to their non-frail counterparts, these frail patients experienced greater odds of mortality (adjusted odds ratio [aOR] 4.00, 95% confidence interval [CI] 3.78–4.23;P.

Conclusion: In conclusion, our findings highlight a complex interplay between COVID-19 and frailty, revealing that frailty is associated with increased odds of mortality as well as associated complications. These findings contribute to a deeper understanding of the clinical complexities surrounding COVID-19 in frail patients, necessitating tailored management strategies.

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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License

Recommended Citation

Jaan A, Shah P, Dhawan A, Qaiser S, Ali A, Thwe H, Abimbolu O, Okpara C, Rajnik M. Impact of Frailty on Inpatient Outcomes of COVID-19 Patients: Evidence From a US National Inpatient Sample. Advances in Clinical Medical Research and Healthcare Delivery. 2025; 5(4):22-32. doi: 10.53785/2769-2779.1268.