{"doi":"10.1093/ageing/afab008","title":"What is the relationship between validated frailty scores and mortality for adults with COVID-19 in acute hospital care? A systematic review","abstract":"BACKGROUND AND AIM: The aim of this systematic review was to quantify the association between frailty and COVID-19 in relation to mortality in hospitalised patients. METHODS: Medline, Embase, Web of Science and the grey literature were searched for papers from inception to 10 September 2020; the search was re-run in Medline up until the 9 December 2020. Screening, data extraction and quality grading were undertaken by two reviewers. Results were summarised using descriptive statistics, including a meta-analysis of overall mortality; the relationships between frailty and COVID-19 mortality were summarised narratively. RESULTS: A total of 2,286 papers were screened resulting in 26 being included in the review. Most studies were from Europe, half from the UK, and one from Brazil; the median sample size was 242.5, median age 73.1 and 43.5% were female. In total, 22/26 used the Clinical Frailty Scale; reported mortality ranged from 14 to 65%. Most, but not all studies showed an association between increasing frailty and a greater risk of dying. Two studies indicated a sub-additive relationship between frailty, COVID-19 and death, and two studies showed no association. CONCLUSIONS: Whilst the majority of studies have shown a positive association between COVID-19-related death and increasing frailty, some studies suggested a more nuanced understanding of frailty and outcomes in COVID-19 is needed. Clinicians should exert caution in placing too much emphasis on the influence of frailty alone when discussing likely prognosis in older people with COVID-19 illness.","journal":"Age and Ageing","year":2021,"id":157582,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":49,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.7902,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":390812,"name":"John R. Best","orcid":"0000-0001-5775-7053","position":1,"is_corresponding":false},{"id":664812,"name":"Daniel Davis","orcid":"0000-0002-1560-1955","position":2,"is_corresponding":false},{"id":665597,"name":"Daniele Bryden","orcid":null,"position":3,"is_corresponding":false},{"id":664813,"name":"Suzanne Arkill","orcid":"0000-0002-3778-5919","position":4,"is_corresponding":false},{"id":664814,"name":"James David van Oppen","orcid":"0000-0002-2570-7112","position":5,"is_corresponding":false},{"id":664815,"name":"Indira Riadi","orcid":"0000-0001-6474-5384","position":6,"is_corresponding":false},{"id":664816,"name":"Kevin Wagner","orcid":"0000-0002-8110-368X","position":7,"is_corresponding":false},{"id":664817,"name":"Simon Conroy","orcid":"0000-0002-4306-6064","position":8,"is_corresponding":false},{"id":244603,"name":"Theodore D. Cosco","orcid":"0000-0002-9977-8888","position":0,"is_corresponding":true}],"reference_count":55,"raw_metadata":null,"created_at":"2026-07-18T23:44:21.786014Z","pmid":"33951151","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}