Abstract
Background Frailty and multimorbidity have been suggested as risk factors for severe COVID-19 disease.
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=1.3 [95% CI=1.1, 1.7]), 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 COIVD-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.
- COVID-19
- frailty
- musculoskeletal
- UK Biobank
- osteoporosis
- epidemiology
Competing Interest Statement
The authors have declared no competing interest.
Funding Statement
This work was supported by the UK Medical Research Council, Wellcome Trust, National Institute for Health Research, Versus Arthritis, Royal Osteoporosis Society Osteoporosis and Bone Research Academy, International Osteoporosis Foundation, NIHR Southampton Biomedical Research Centre, University of Southampton, University Hospital Southampton NHS Foundation Trust and NIHR Oxford Biomedical Research Centre. EMC is supported by the Wellcome Trust (201268/Z/16/Z).
Author Declarations
I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.
Yes
The details of the IRB/oversight body that provided approval or exemption for the research described are given below:
This study had ethics approval as part of overall UK Biobank ethics approval (NHS National Research Ethics Service 16/NW/0274). We undertook the study under UK Biobank Access Application 3593.
All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived.
Yes
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Yes
Data Availability
Approval for access to data used in this study is via UK Biobank (approved Access Application 3593).