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COVID-19 in Older People
The effect of frailty on survival in patients with COVID-19: a multicentre, European, observational cohort
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Links to the publications are found below

Chief Investigator: Dr Jonathan Hewitt, Consultant Geriatrician Ysbyty Ystrad Fawr

Co-Chief Investigator: Miss Kathryn McCarthy, Consultant General Surgeon, North Bristol Trust

Study Co-Ordinator and Methodological Lead: Dr Ben Carter

COPE Steering Committee Chair: Prof Phyo Kyaw Myint

Sponsor: Cardiff University 

Funding: None

Co-ordinated from King's College London, London, UK. 

The Study Protocol for the COPE study can be found published here

Background and Aims

COVID-19 has proven to be one of the biggest hazards to health care systems around the world. Frailty has been used in the clinical decision making for COVID-19, yet the prevalence and effect of frailty in people with COVID-19 is unknown.

The COVID-19 in Older Persons (COPE) study is an international observational cohort study with centres in the UK and Italy. The main aims are to establish the prevalence of frailty and its effect on clinically important outcomes such as length of stay and mortality in patients with COVID-19.

HRA Approval can be found here


Centres and Members involved with the COPE study:

Division of Population Medicine, Department of Surgery, Cardiff University, Cardiff, UK. 

(Dr Jonathan Hewitt FRCP,  Mr Michael Stechman FRCS) 

Aneurin Bevan University Health Board, Caerphilly, UK. 

(Dr Jonathan Hewitt FRCP, Dr Jemima T Collins MRCP) 


Department of Biostatistics and Health Informatics, King's College London, London, UK. 

(Dr Ben Carter) 


Forensic and Neurodevelopmental Sciences King's College London, London, UK. 

(Dr Roxanna Short, Visualisation Specialist) 


Ageing and Complex Medicine Department, Salford Royal NHS Trust, Manchester, UK. 

(Dr Arturo Vilches-Moraga FRCP,  Miss Angeline Price MSc)  


Department of Colorectal Surgery Department, Salford Royal NHS Trust, Manchester, UK. 

(Miss Lyndsay Pearce FRCS) 


Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK. 

(Dr Terry J Quinn FRCP, Dr Aine McGovern) 


Department of Surgery and Care of the Elderly, Southmead Hospital, North Bristol NHS Trust, 

Bristol, UK.  

(Dr Philip Braude MRCP, Dr Frances Rickard MRCP, Dr Emma Mitchell MRCP, Dr Mark Holloway MBChB, Dr James Hesford MBChB, Miss Kathryn McCarthy FRCS) 

Department of Vascular Surgery, Aberdeen Royal Infirmary, NHS Grampian, Aberdeen, UK. 

(Eilidh Bruce MBChB) 


Department of Medicine for the Elderly, Woodend Hospital, Aberdeen, UK. 

(Alice Einarsson MBChB) 


Department of Anaesthesia. Royal Alexandra Hospital, Paisley, UK. 

(Fenella Barlow-Pay MBChB) 


Department of Surgery. Royal Alexandra Hospital, Paisley, UK. 

(Prof Susan J Moug FRCS) 


Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK. 

(Prof Phyo K Myint FRCP) 


Respiratory Unit, University of Modena and Reggio Emilia, University Hospital of Modena Policlinico, Modena, Italy. 

(Alessia Verduri MD, Prof Enrico Clini MD) 

Department of General Surgery, Ysbyty Gwynedd Bangor, Wales, UK.

(Mr Louis Evans MRCS, Website Curator)


COPE study collaborators 

Charlotte Davey, Sheila Jones, Kiah Lunstone, Alice Cavenagh, Charlotte Silver, Thomas Telford, and Rebecca Simmons (Ysbyty Yystad Fawr); Tarik El Jichi Mutasem, Sandeep Singh, Dolcie Paxton, and Will Harris (North Bristol Trust); Norman Galbraith, Emma Bhatti,  Jenny Edwards, and Siobhan Duffy (Royal Alexandra Hospital, Paisley)

Carly Bisset and Ross Alexander (Inverclyde Royal Infirmary); Madeline Garcia, Shefali Sangani, Thomas Kneen, George Kyriakopoulos, Michael Thomas, Denise Tan, Thomas Lee (Salford Royal Infirmary); Prof Giovanni Guaraldi (University Hospital of Modena Policlinico, Italy)

Publications from the COPE study collaborative 

  1. The effect of frailty on survival in patients with Covid-19: A multicentre, European, Observational Cohort Study - LANCET

    • Response from the authors regarding the paper - Link

  2. The COPE Study Protocol - BMJ OPEN

  3. The role of C-reactive protein as a prognostic marker in COVID-19 - International Journal of Epidemiology

  4. Increased care at discharge from COVID-19: The association between pre-admission frailty and increased care needs after hospital discharge; a multicentre European observational cohort study - BMC Medicine

  5. Nosocomial COVID-19 infection: examining the risk of mortality. The COPE-Nosocomial study (COVID in Older PEople). The Journal of Hospital Infection - Journal of Hospital Infection

  6. The influence of ACE inhibitors and ARBs on hospital length of stay and survival in people with COVID-19 - IJC Heart & Vasculature

  7. Prior Routine Use of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) and Important Outcomes in Hospitalised Patients with COVID-19 -Journal of Clinical Medicine

  8. Routine use of immunosuppressants is associated with mortality in hospitalised patients with COVID-19 - Therapeutic Advances in Drug Safety

  9. The Clinical Frailty Scale: Estimating the Prevalence of Frailty in Older Patients Hospitalised with COVID-19. The COPE Study - Geriatrics

  10. Decision-Making in COVID-19 and Frailty. 2020 - Geriatrics

  11. Resumption of elective colorectal surgery during COVID-19 and risk of death. Colorectal Disease - Colorectal Disease