Clinical frailty score as an independent predictor of outcome in COVID-19 hospitalised patients.

PURPOSE OF THE STUDY: We explored potential predictive variables associated with outcomes using baseline clinical parameters of 500 hospitalised patients with COVID -19 in a single centre, UK. METHODS: Retrospective study collecting demographic and clinical characteristics of patients admitted at Southend University Hospital from 20th February to 7th May 2020. RESULTS: The mean age of the cohort admitted to hospital with Covid-19 was 69.4 and 58% were over 70. Comorbidities were more frequently observed in non-survivors, whose mean Clinical Frailty Scale was significantly higher (5 vs 3) than survivors, p < 0.001. In addition, mean C-reactive protein was significantly higher. CONCLUSION: Older and frailer patients with high inflammatory markers were at risk of poor outcomes. Integrated frailty and age-based risk stratification is essential, in addition to monitoring saturation /FiO2 ratio (SFR) and inflammatory markers throughout the disease course to allow for early intervention to improve patient outcomes. A frailty-based risk-stratification approach, rather than age may prove more valuable when considering interventions in patients with multiple comorbidities.

Evaluation of mesoporous carbon aerogels as carriers of the non-steroidal anti-inflammatory drug ibuprofen.

Towards the development of novel drug carriers for oral delivery of poorly soluble drugs mesoporous aerogel carbons (CAs), namely CA10 and CA20 with different pore sizes (10 and 20nm, respectively), were evaluated. The non-steroidal anti-inflammatory lipophilic compound ibuprofen was incorporated via passive loading. The drug loaded carbon aerogels were systemically investigated by means of High-Resolution Transmission Electron Microscopy (HR-TEM), Nitrogen physisorption studies, X-ray diffraction (XRD), Differential Scanning Calorimetry (DSC), X-ray photon electron spectroscopy (XPS) and ζ-potential studies. In vitro release studies were performed in simulated intestinal fluids reflecting both fasted (FaSSIF) and fed (FeSSIF) state conditions. Cytotoxicity studies were conducted with human intestinal cells (Caco-2). Drug was in an amorphous state in the pores of the carbon carrier as shown from the physicochemical characterization studies. The results showed marked differences in the release profiles for ibuprofen from the two aerogels in the media tested whereas in vitro toxicity profiles appear to be compatible with potential therapeutic applications at low concentrations.