CO-FRAIL. Frailty and Adverse Outcomes in Middle-Aged Adults Hospitalized by COVID-19

About 19% of patients affected by COVID-19 require hospitalization due to severe pneumonia and respiratory failure. Age has been identified as the main marker of worse prognosis. In Italy, for example, it was observed that patients over 70 years old correspond to 37% of hospital admissions and deaths in COVID-19. The lack of prognostic studies on this new disease has induced several countries to make decisions about hospital resource allocation based exclusively on age criteria. This strategy raises the debate about the principle of justice, since chronological age alone is not capable of determining the real prognosis of patients. Frailty is a measure of physiological reserve that predicts unfavorable outcomes in the elderly population. A striking biological characteristic of frailty in aging is related to a chronic pro-inflammatory state, with an increase in cytokines such as interleukin 6 (IL-6) and tumor necrosis factor alpha (TNF-α). Early work in individuals with COVID-19 has linked elevated IL-6 levels to increased mortality. This finding points to a potential prognostic factor for frailty in individuals with COVID-19. However, we did not find studies investigating the prognostic usefulness of frailty in these patients. That is why, The present study aims to assess the performance of frailty in predicting mortality and other adverse outcomes within six months after hospital discharge in patients over 50 years of age admitted by COVID-19 at the Hospital das Clínicas of the Faculty of Medicine of the University of São Paulo. This type of research is essential for the COVID-19 pandemic as the need to make quick decisions regarding resource allocation is part of daily clinical practice due to the overload of the Health System. Marlon Aliberti, Wilson Jacob-Filho, Thiago Avelino -Silva. Clinical Hospital. Estimated completion of the study: April 2021. This type of research is essential for the COVID-19 pandemic as the need to make quick decisions regarding resource allocation is part of daily clinical practice due to the overload of the Health System.