Prognostic Significance of Functional Dependency in Older Patients Hospitalized for COVID-19: An Observational Cross-Sectional Study

Background: Coronavirus disease 2019 (COVID-19) is a pandemic infection with substantial risk of death, especially in elderly persons. Information about the prognostic significance of functional status in older patients with COVID-19 is scarce. Methods Demographic, clinical, laboratory and short-term mortality data were collected of 186 consecutive patients aged ≥ 65 years hospitalized with COVID-19. Data were compared between 4 groups: 1) age 65–79 years without severe functional dependency ( n  = 69); 2) age ≥ 80 years without severe functional dependency ( n  = 28); 3) age 65–79 years with severe functional dependency ( n  = 32); and 4) age ≥ 80 years with severe functional dependency ( n  = 57). Results Statistically significant differences were observed between the groups in the proportions of patients with hypertension, diabetes mellitus, cerebrovascular disease, renal failure, dementia, heart failure, pressure sores and malignant disorders; and of the proportions that resided in nursing homes. Compared to groups 1 and 2, patients in groups 3 and 4 presented with lower mean serum albumin levels on admission; and were treated more often with antibiotics and less often with convalescent plasma, tocilizumab and remdesivir. The mortality rate was higher in group 4 than in groups 1 − 3: 45.6% vs. 8.7%, 17.9% and 18.3%, respectively ( p  < 0.001). On multivariate analysis, age ≥ 80 years with severe functional dependency remained one of the variables most significantly associated with mortality (odds ratio 10.42 and 95% confidence interval 3.27–33.24). Conclusions Among patients with COVID-19, the association of severe functional dependency with mortality is stronger among those aged ≥ 80 years than aged 65–79 years. Assessment of functional status may contribute to decision making for care of older inpatients with COVID-19.