Frailty as a predictor of clinical severity in geriatric COVID-19 patients: A prospective observational study.

In the last two decades there has been an increase in the number of geriatric populations throughout the world. Recently  India has also acquired the label of “an aging nationâ€. According to the UNDP data, 7.7% of the Indian population is more than 60 years old and the number is expected to reach 324 million by 2050.This has led to the increase in the number of elederly population, that had added to the health burden.The older patients have decreased physiologic reserve and that makes them vulnerable to various illnesses. Until, recently frailty in particular, has become an area of increased interest. This is a multidimensional state of loss of physiologic reserves including energy, physical ability, cognition, and health that gives rise to vulnerability to poor health outcomes due to a decreased ability to withstand physiologic stress.There is consensus that frailty, as measured by any number of these metrics, is associated with adverse perioperative outcomes including major morbidity, mortality, and increased length of stay. The Initial observational studies by the Chinese CDC on COVID -19, from Wuhan published  the mortality was high in old age patients, ranging from 8% to 14.8% indicating poor outcome in them. Besides this fatality rate was associated with comorbidities such as diabetes, hypertension, respiratory diseases and cancer. The various risk factors contributing to the death and mortality in old age COVID-19 patients need evaluation. Frailty can be one of the causes for the high mortality in elderly patients. No studies has used frailty as a predictor for the severity in COVID-19 patients. Therefore a study planned to predict the outcome in.COVID-19 patients by assessing the frailty by various scales. We hypothesised that frailty assessment  will help in predicting the clinical severity of COVID-19 patients and outcome. The study will be conducted on COVID positive patients who will be receiving  treatment according to the AIIMS, guideline at COVID centre. After obtaining institutional ethical clearance patients will be recruited and the consent will be taken. Patients will be  assessed and screened for frailty at the time of admission in the hospital. The admission frailty scores will be calculated by the two different scales that are: the CFS and mFI-5 scores. Assessors may not be present daily and data will be collected on days the patient will be followed up.  Patients will be clinical follow up for the outcome and severity. Patients will be followed till it is discharged or any adverse outcomes will be noted over 28 days. All the in hospital complications, the total length of stay including ward and ICU will be noted down. Also the morbid condition and the multiple drugs, if the patient  is taking them will be written.