COVID-19 and associations with frailty and multimorbidity: a prospective analysis of UK Biobank participants
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ORIGINAL ARTICLE
COVID‑19 and associations with frailty and multimorbidity: a prospective analysis of UK Biobank participants S. J. Woolford1 · S. D’Angelo1 · E. M. Curtis1 · C. M. Parsons1 · K. A. Ward1 · E. M. Dennison1 · H. P. Patel1,2,3,4 · C. Cooper1,4,5 · N. C. Harvey1,4 Received: 8 June 2020 / Accepted: 7 July 2020 © The Author(s) 2020
Abstract Background Frailty and multimorbidity have been suggested as risk factors for severe COVID-19 disease. Aims We investigated, in the UK Biobank, whether frailty and multimorbidity were associated with risk of hospitalisation with COVID-19. Methods 502,640 participants aged 40–69 years at baseline (54–79 years at COVID-19 testing) were recruited across UK during 2006–10. A modified assessment of frailty using Fried’s classification was generated from baseline data. COVID-19 test results (England) were available for 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, after 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 4510 participants were tested for COVID-19 (positive = 1326, negative = 3184). 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. However, 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 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. Keywords COVID-19 · Frailty · Musculoskeletal · UK biobank · Osteoporosis · Epidemiology
Background S. J. Woolford and S. D’Angelo are joint first authors. C. Cooper and N. C. Harvey are joint senior authors. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s40520-020-01653-6) contains supplementary material, which is available to authorized users. * N. C. Harvey [email protected] 1
MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
2
Medicine for Older People, University Hospital Southampton, Southampton, UK
3
Academic Geriatric Medicine, University of Southampton, Southampton, UK
The first case of 2019 Novel Coronavirus (COVID-19) disease (caused by the Severe Acute Respiratory Syndrome Coronavirus 2 [SARS-CoV-2]) was reported in W
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