Role of Frailty Index-Laboratory to predict COVID-19 mortality: a prospective study

IntroductionThe COVID-19 pandemic has disproportionately impacted frail individuals, highlighting the urgent need for effective prognostic tools to improve patient outcomes. Early identification of at-risk individuals can optimize management and resource allocation, reducing mortality and morbidity....

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Main Authors: Elda De Vita, Nicola Veronese, Giacomo Guido, Luisa Frallonardo, Sergio Cotugno, Giorgia Manco Cesari, Marinella Cibelli, Alessandra Vigna, Davide Capruzzi, Monica Fiorella, Carmen Rita Santoro, Gaetano Brindicci, Francesco Di Gennaro, Annalisa Saracino
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Public Health
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Online Access:https://www.frontiersin.org/articles/10.3389/fpubh.2025.1591767/full
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Summary:IntroductionThe COVID-19 pandemic has disproportionately impacted frail individuals, highlighting the urgent need for effective prognostic tools to improve patient outcomes. Early identification of at-risk individuals can optimize management and resource allocation, reducing mortality and morbidity. This study evaluates the Frailty Index-Laboratory (FI-LAB) as a predictor of mortality in COVID-19 patients.MethodsWe included all COVID-19 patients admitted to the Clinic of Infectious Diseases of the “Azienda Ospedaliera Policlinico di Bari” from March 2020 to February 2024. FI-LAB scores were calculated using 37 laboratory parameters obtained within the first 4 days of hospitalization. Mortality data were collected up to 90 days post-admission. Cox regression analysis, adjusting for demographics, comorbidities, COVID-19 symptoms, and vaccination status, was employed to examine the relationship between FI-LAB scores and mortality.ResultsOne thousand, four hundred ninety-two patients were included in the study population, the mean age was 57.2 years (SD = 15.9), with 56.6% being male. Patients in the highest FI-LAB tertile (>0.432) exhibited a 17.10-fold higher risk of death compared to those in the lowest tertile (<0.135), same result has been shown in the intermediate FI-LAB scores (0.135–0.432) when compared to the lowest tertile. Additionally, each 0.10-point increase in FI-LAB was linked to a nearly twofold increase in mortality hazard (HR = 1.99, 95% CI 1.69–2.37, p < 0.0001).ConclusionFrailty Index-Laboratory is a robust and practical tool for predicting mortality in hospitalized COVID-19 patients, aiding early identification of high-risk individuals. Implementing FI-LAB enhances patient management and resource allocation. Further studies are needed to confirm its effectiveness across diverse populations and healthcare settings.
ISSN:2296-2565