Older Age and Frailty are Associated with Higher Mortality but Lower ICU Admission with COVID-19


  • Melissa K. Andrew Dalhousie University; Canadian Center for Vaccinology https://orcid.org/0000-0001-7514-8972
  • Judith Godin Dalhousie University
  • Jason LeBlanc Canadian Center for Vaccinology; Dalhousie University
  • Guy Boivin CHU de Québec-Université Laval
  • Louis Valiquette Université de Sherbrooke
  • Allison McGeer Mount Sinai Hospital
  • Janet E. McElhaney Health Sciences North Research Institute
  • Todd F. Hatchette Canadian Center for Vaccinology; Dalhousie University
  • May ElSherif Canadian Center for Vaccinology
  • Donna MacKinnon-Cameron Canadian Center for Vaccinology
  • Kevin Wilson Canadian Center for Vaccinology
  • Ardith Ambrose Canadian Center for Vaccinology
  • Sylvie Trottier Université Laval
  • Mark Loeb McMaster University
  • Stephanie W. Smith University of Alberta
  • Kevin Katz North York General Hospital
  • Anne McCarthy University of Ottawa
  • Shelly A. McNeil Dalhousie University




age, frailty, frail elderly, COVID-19, SARS-CoV-2, outcomes, hospitalization, surveillance


We report characteristics and outcomes of adults admitted to Canadian Immunization Research Network (CIRN) Ser-ious Outcomes Surveillance (SOS) Network hospitals with COVID-19 in 2020.

Patients with laboratory-confirmed COVID-19 admitted to 11 sites in Ontario, Quebec, Alberta, and Nova Scotia up to December 31, 2020 were enrolled in this prospective observational cohort study. Measures included age, sex, demographics, housing, exposures, Clinical Frailty Scale, comorbidities; in addition, length of stay, intensive care unit (ICU) admission, mechanical ventilation, and survival were assessed. Descriptive analyses and multivariable logistic regressions were conducted.

Among 2,011 patients, mean age was 71.0 (range 19–105) years. 29.7% were admitted from assisted living or long-term care facilities. The full spectrum of frailty was represented in both younger and older age groups. 81.8% had at least one underlying comorbidity and 27.2% had obesity. Mortality was 14.3% without ICU admission, and 24.6% for those admitted to ICU. Older age and frailty were independent predictors of lower ICU use and higher mortality; accounting for frailty, obesity was not an independent predictor of mortality, and associations of comorbidities with mortality were weakened.

Frailty is a critical clinical factor in predicting outcomes of COVID-19, which should be considered in research and clinical settings. 


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How to Cite

Andrew MK, Godin J, LeBlanc J, Boivin G, Valiquette L, McGeer A, McElhaney JE, Hatchette TF, ElSherif M, MacKinnon-Cameron D, Wilson K, Ambrose A, Trottier S, Loeb M, Smith SW, Katz K, McCarthy A, McNeil SA. Older Age and Frailty are Associated with Higher Mortality but Lower ICU Admission with COVID-19. Can Geriatr J [Internet]. 2022 Jun. 1 [cited 2023 Jun. 6];25(2):183-96. Available from: https://cgjonline.ca/index.php/cgj/article/view/546



Original Research