Increases in Frailty Following Hospitalization With COVID-19: An Analysis of Claims and Annual Health Check Data
Author(s)
Harriet Dickinson, PhD1, Paul McDwyer, MSc2, Manami Yoshida, MSc3, Yi Piao, PhD4, Mark Berry, PhD5, Anand Chokkalingam, PhD6.
1Gilead, Uxbridge, United Kingdom, 2Gilead Sciences, Dublin, Ireland, 3Gilead Sciences, Tokyo, Japan, 4Gilead Sciences, Chiyoda-ku, Japan, 5Gilead Sciences, Baltimore, MD, USA, 6Gilead Sciences, Foster City, CA, USA.
1Gilead, Uxbridge, United Kingdom, 2Gilead Sciences, Dublin, Ireland, 3Gilead Sciences, Tokyo, Japan, 4Gilead Sciences, Chiyoda-ku, Japan, 5Gilead Sciences, Baltimore, MD, USA, 6Gilead Sciences, Foster City, CA, USA.
OBJECTIVES: COVID-19 has been associated with long-term health consequences, including increased frailty, particularly among older adults. However, evidence on the development of frailty after COVID-19 remains limited. This retrospective cohort study investigated changes in frailty following COVID-19 hospitalisation using both claims data and annual health check (AHC) records.
METHODS: Linked Japanese health insurance claims and annual health check data from 01/01/2020 to 31/08/2023 was extracted for adults hospitalised with COVID-19 infection, and who also met enrolment criteria. Frailty was assessed using modified claims-based electronic frailty index (eFI) score -61 to -1 days prior to admission and 2-62 days post-admission. AHC data pre/post-COVID-19 hospitalization was analysed in individuals with two AHCs 251-479 days apart.
RESULTS: A total of 108,452 patients were identified, with an average age of 79.7 (s.d.13.6) years and 51.7% female. The mean frailty index increased from 0.033 to 0.052 post-infection (an increase of 57.6%, p<0.0001). At an individual level, 50.5% of patients increased their frailty score, while only 15.5% of patients decreased their score.
In patients with two AHCs (3,799), 61.6% decreased weight post-infection, with an average of 2.6kg (s.d. 2.5kg) lost (in comparison, -0.23 to -0.28 kg/year is expected). In AHC questionnaire data, 19.1% (216/1,133) of patients newly reported losing 2-3kg in the last few months, 15.3% (174/1,134) newly reported walking slower than before, 17.4% (197/1,134) newly reported falling down in the past year, 10.5% (119/1,132) newly reported forgetting things, and 11.2% (127/1,131) newly had trouble knowing what day it is.
CONCLUSIONS: The increase in frailty after COVID-19 hospitalisation is notable, even within the context of normal ageing over time, and is reflected both in claims and AHC data. Further research into whether early treatment could mitigate functional decline and support recovery in vulnerable populations could be conducted.
METHODS: Linked Japanese health insurance claims and annual health check data from 01/01/2020 to 31/08/2023 was extracted for adults hospitalised with COVID-19 infection, and who also met enrolment criteria. Frailty was assessed using modified claims-based electronic frailty index (eFI) score -61 to -1 days prior to admission and 2-62 days post-admission. AHC data pre/post-COVID-19 hospitalization was analysed in individuals with two AHCs 251-479 days apart.
RESULTS: A total of 108,452 patients were identified, with an average age of 79.7 (s.d.13.6) years and 51.7% female. The mean frailty index increased from 0.033 to 0.052 post-infection (an increase of 57.6%, p<0.0001). At an individual level, 50.5% of patients increased their frailty score, while only 15.5% of patients decreased their score.
In patients with two AHCs (3,799), 61.6% decreased weight post-infection, with an average of 2.6kg (s.d. 2.5kg) lost (in comparison, -0.23 to -0.28 kg/year is expected). In AHC questionnaire data, 19.1% (216/1,133) of patients newly reported losing 2-3kg in the last few months, 15.3% (174/1,134) newly reported walking slower than before, 17.4% (197/1,134) newly reported falling down in the past year, 10.5% (119/1,132) newly reported forgetting things, and 11.2% (127/1,131) newly had trouble knowing what day it is.
CONCLUSIONS: The increase in frailty after COVID-19 hospitalisation is notable, even within the context of normal ageing over time, and is reflected both in claims and AHC data. Further research into whether early treatment could mitigate functional decline and support recovery in vulnerable populations could be conducted.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EPH145
Topic
Clinical Outcomes, Epidemiology & Public Health
Disease
Infectious Disease (non-vaccine)