Jeong Jong Hwan, Heo Manbong, Park Sunghoon, Lee Su Hwan, Park Onyu, Kim Taehwa, Yeo Hye Ju, Jang Jin Ho, Cho Woo Hyun, Yoo Jung-Wan
Department of Internal Medicine, Gyeongsang National University Hospital, Jinju, Republic of Korea.
Division of Pulmonary, Allergy and Critical Care Medicine, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea.
Tuberc Respir Dis (Seoul). 2025 Apr;88(2):361-368. doi: 10.4046/trd.2024.0160. Epub 2024 Dec 5.
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.
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.
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.
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.
出院时衰弱的发生会影响2019年冠状病毒病（COVID-19）重症幸存者的临床结局，这些患者在住院前并无衰弱。我们旨在使用临床衰弱量表（CFS）描述新出现衰弱的患病率，并评估其在住院前无衰弱的重症COVID-19患者中的相关因素。
我们对2020年1月1日至2021年8月31日期间从22家医院收集的全国性回顾性队列的临床数据进行了二次分析。患者年龄至少19岁，因重症COVID-19入住重症监护病房（ICU）后存活至出院。新出现衰弱的定义为出院时CFS评分≥5分。
在669例入住ICU且住院前无衰弱的重症COVID-19幸存者中，平均年龄为65.2±12.8岁，男性占62.5%，50.2%接受了机械通气（MV）。入院时CFS平均评分为2.4±0.9分，27.8%（186/483）出现了新的衰弱。多因素分析显示，年龄较大、患有心血管疾病、住院前CFS评分为3-4分、C反应蛋白水平升高、皮质类固醇治疗时间延长以及使用MV和体外膜肺氧合是与新发衰弱相关的因素。
我们的研究表明，新出现的衰弱并不罕见，且与住院前无衰弱的重症COVID-19幸存者中的多种因素相关。
