BMJ Open (Sep 2020)

Study protocol for the COPE study: COVID-19 in Older PEople: the influence of frailty and multimorbidity on survival. A multicentre, European observational study

  • Thomas Lee,
  • Sandeep Singh,
  • Phyo Kyaw Myint,
  • Sheila Jones,
  • Ben Carter,
  • Susan Moug,
  • Terry Quinn,
  • Michael Thomas,
  • Emma Bhatti,
  • Angeline Price,
  • Fenella Barlow-Pay,
  • Siobhan Duffy,
  • Lyndsay Pearce,
  • Arturo Vilches-Moraga,
  • Michael Stechman,
  • Philip Braude,
  • Emma Mitchell,
  • Alessia Verduri,
  • Kathryn McCarthy,
  • Jonathan Hewitt,
  • Charlotte Davey,
  • Kiah Lunstone,
  • Alice Cavenagh,
  • Charlotte Silver,
  • Thomas Telford,
  • Rebecca Simmons,
  • Dolcie Paxton,
  • Francis Rickard,
  • Mark Holloway,
  • James Hesford,
  • Tarik Jichi,
  • Norman Galbraith,
  • Jenny Edwards,
  • Carly Bisset,
  • Ross Alexander,
  • Abigail Ingham,
  • Roxanna Short,
  • Aine McGovern,
  • Jemima Collins,
  • Eilidh Bruce,
  • Alice Einarsson,
  • Enrico Clini,
  • Giovanni Guaraldi,
  • Madeline Garcia,
  • Shefali Sangani,
  • Thomas Kneen,
  • George Kyriakopoulos,
  • Denise Tan

DOI
https://doi.org/10.1136/bmjopen-2020-040569
Journal volume & issue
Vol. 10, no. 9

Abstract

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Introduction This protocol describes an observational study which set out to assess whether frailty and/or multimorbidity correlates with short-term and medium-term outcomes in patients diagnosed with COVID-19 in a European, multicentre setting.Methods and analysis Over a 3-month period we aim to recruit a minimum of 500 patients across 10 hospital sites, collecting baseline data including: patient demographics; presence of comorbidities; relevant blood tests on admission; prescription of ACE inhibitors/angiotensin receptor blockers/non-steroidal anti-inflammatory drugs/immunosuppressants; smoking status; Clinical Frailty Score (CFS); length of hospital stay; mortality and readmission. All patients receiving inpatient hospital care >18 years who receive a diagnosis of COVID-19 are eligible for inclusion. Long-term follow-up at 6 and 12 months is planned. This will assess frailty, quality of life and medical complications.Our primary analysis will be short-term and long-term mortality by CFS, adjusted for age (18–64, 65–80 and >80) and gender. We will carry out a secondary analysis of the primary outcome by including additional clinical mediators which are determined statistically important using a likelihood ratio test. All analyses will be presented as crude and adjusted HR and OR with associated 95% CIs and p values.Ethics and dissemination This study has been registered, reviewed and approved by the following: Health Research Authority (20/HRA1898); Ethics Committee of Hospital Policlinico Modena, Italy (369/2020/OSS/AOUMO); Health and Care Research Permissions Service, Wales; and NHS Research Scotland Permissions Co-ordinating Centre, Scotland. All participating units obtained approval from their local Research and Development department consistent with the guidance from their relevant national organisation.Data will be reported as a whole cohort. This project will be submitted for presentation at a national or international surgical and geriatric conference. Manuscript(s) will be prepared following the close of the project.