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Front Public Health . Role of Frailty Index-Laboratory to predict COVID-19 mortality: a prospective study

tetano

Editor, Senior Moderator
Front Public Health


. 2025 Jul 2:13:1591767.
doi: 10.3389/fpubh.2025.1591767. eCollection 2025. Role of Frailty Index-Laboratory to predict COVID-19 mortality: a prospective study

Elda De Vita[SUP] #[/SUP][SUP] 1 [/SUP], Nicola Veronese[SUP] #[/SUP][SUP] 2 [/SUP], Giacomo Guido[SUP] 1 [/SUP], Luisa Frallonardo[SUP] 1 [/SUP], Sergio Cotugno[SUP] 1 [/SUP], Giorgia Manco Cesari[SUP] 1 [/SUP], Marinella Cibelli[SUP] 1 [/SUP], Alessandra Vigna[SUP] 1 [/SUP], Davide Capruzzi[SUP] 1 [/SUP], Monica Fiorella[SUP] 1 [/SUP], Carmen Rita Santoro[SUP] 1 [/SUP], Gaetano Brindicci[SUP] 1 [/SUP], Francesco Di Gennaro[SUP] 1 [/SUP], Annalisa Saracino[SUP] 1 [/SUP]



Affiliations
Abstract

Introduction: The 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.
Methods: We 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.
Results: One 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).
Conclusion: Frailty 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.

Keywords: COVID-19; Frailty Index-Laboratory; aging; frailty; mortality.

 
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