COVID-19 and associations with frailty and multimorbidity: a prospective analysis of UK Biobank participants

Abstract

Aims
We investigated whether frailty and multimorbidity were associated with risk of hospitalisation with COVID-19 in the UK Biobank.

Methods
502,640 participants aged 40-69 years at baseline (54-79 years at COVID-19 testing) were recruited across UK 2006-10. A modified assessment of frailty using Fried’s classification was generated from baseline data. COVID-19 test results (England) were available 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, 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
4,510 participants were tested for COVID-19 (positive=1,326, negative=3,184). 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. Furthermore, 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 a 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.

More information

Identifiers

ORCID for Stefania D'angelo: orcid.org/0000-0002-7267-1837

ORCID for Elizabeth Curtis: orcid.org/0000-0002-5147-0550

ORCID for Kathryn Ward: orcid.org/0000-0001-7034-6750

ORCID for Elaine Dennison: orcid.org/0000-0002-3048-4961

ORCID for Harnish Patel: orcid.org/0000-0002-0081-1802

ORCID for Cyrus Cooper: orcid.org/0000-0003-3510-0709

ORCID for Nicholas Harvey: orcid.org/0000-0002-8194-2512

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