Age and frailty are independently associated with increased COVID-19 mortality and increased care needs in survivors: results of an international multi-centre study

Introduction: Increased mortality has been demonstrated in older adults with COVID-19, but the effect of frailty has been unclear. Methods: This multi-centre cohort study involved patients aged 18 years and older hospitalised with COVID-19, using routinely collected data. We used Cox regression analysis to assess the impact of age, frailty, and delirium on the risk of inpatient mortality, adjusting for sex, illness severity, inflammation, and co-morbidities. We used ordinal logistic regression analysis to assess the impact of age, Clinical Frailty Scale (CFS), and delirium on risk of increased care requirements on discharge, adjusting for the same variables. Results: Data from 5,711 patients from 55 hospitals in 12 countries were included (median age 74, IQR 54–83; 55.2% male). The risk of death increased independently with increasing age (>80 vs 18–49: HR 3.57, CI 2.54–5.02), frailty (CFS 8 vs 1–3: HR 3.03, CI 2.29–4.00) inflammation, renal disease, cardiovascular disease, and cancer, but not delirium. Age, frailty (CFS 7 vs 1–3: OR 7.00, CI 5.27–9.32), delirium, dementia, and mental health diagnoses were all associated with increased risk of higher care needs on discharge. The likelihood of adverse outcomes increased across all grades of CFS from 4 to 9. Conclusions: Age and frailty are independently associated with adverse outcomes in COVID-19. Risk of increased care needs was also increased in survivors of COVID-19 with frailty or older age

Digital In-Line Holography as a Three-Dimensional Tool to Study Motile Marine Organisms During Their Exploration of Surfaces

The swimming patterns of zoospores of the green alga Ulva linza in the vicinity of a surface were investigated by digital in-line holography. Full 3D motion patterns were retrieved from measurements and the traces obtained were compared with known swimming patterns of spores of the brown alga Hincksia irregularis and the green alga Ulva linza as seen in a conventional optical microscope. Quantitative information such as swimming velocity was calculated from the 3D traces. The results demonstrate the potential of digital in-line holography to image and quantify exploratory patterns of behavior of motile spores close to surfaces. This technique can give detailed insight into mechanisms of surface colonization by spores and larvae of fouling organisms in response to changes in surface properties