Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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Prevalence of New Frailty at Hospital Discharge in Severe COVID-19 Survivors and Its Associated Factors

  • Jong Hwan Jeong (Department of Internal Medicine, Gyeongsang National University Hospital) ;
  • Manbong Heo (Department of Internal Medicine, Gyeongsang National University Hospital) ;
  • Sunghoon Park (Division of Pulmonary, Allergy and Critical Care Medicine, Hallym University Sacred Heart Hospital) ;
  • Su Hwan Lee (Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine) ;
  • Onyu Park (BioMedical Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital) ;
  • Taehwa Kim (Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Internal Medicine, Transplant Research Center, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital) ;
  • Hye Ju Yeo (Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Internal Medicine, Transplant Research Center, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital) ;
  • Jin Ho Jang (Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Internal Medicine, Transplant Research Center, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital) ;
  • Woo Hyun Cho (Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Internal Medicine, Transplant Research Center, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital) ;
  • Jung-Wan Yoo (Department of Internal Medicine, Gyeongsang National University Hospital) ;
  • Korean Intensive Care Study Group (Korean Intensive Care Study Group)
  • Received : 2024.10.17
  • Accepted : 2024.11.27
  • Published : 2025.04.30
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Abstract

Background: The development of frailty at hospital discharge affects the clinical outcomes in severe coronavirus disease 2019 (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.

Keywords

Acknowledgement

The members of the Korean Intensive Care Study Group are as follows: Jin-Won Huh, Sang-Min Lee, Chi Ryang Chung, Jongmin Lee, Jung Soo Kim, Sung Yoon Lim, Ae-Rin Baek, Moon Seong Baek, Ho Cheol Kim, Eun Young Choi, Chul Park, TaeOk Kim, Do Sik Moon, Song-I Lee, Jae Young Moon, Sun Jung Kwon, Gil Myeong Seong, and Won Jai Jung. The final manuscript was written with the assistance of a professional editing service.

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