• Darren Aw, Lauren Woodrow, Giulia Ogliari, and Rowan Harwood.
• Health Care of the Older Person, Nottingham University Hospitals NHS Trust, Queen's Medical Centre, Nottingham NG7 2UH, UK.
• Age Ageing. 2020 Oct 23; 49 (6): 915-922.

BackgroundCOVID-19 has disproportionately affected older people.ObjectiveThe objective of this paper to investigate whether frailty is associated with all-cause mortality in older hospital inpatients, with COVID-19.DesignCohort study.SettingSecondary care acute hospital.ParticipantsParticipants included are 677 consecutive inpatients aged 65 years and over.MethodsCox proportional hazards models were used to examine the association of frailty with mortality. Frailty was assessed at baseline, according to the Clinical Frailty Scale (CFS), where higher categories indicate worse frailty. Analyses were adjusted for age, sex, deprivation, ethnicity, previous admissions and acute illness severity.ResultsSix hundred and sixty-four patients were classified according to CFS. Two hundred and seventy-one died, during a mean follow-up of 34.3 days. Worse frailty at baseline was associated with increased mortality risk, even after full adjustment (P = 0.004). Patients with CFS 4 and CFS 5 had non-significant increased mortality risks, compared to those with CFS 1-3. Patients with CFS 6 had a 2.13-fold (95% CI 1.34-3.38) and those with CFS 7-9 had a 1.79-fold (95% CI 1.12-2.88) increased mortality risk, compared to those with CFS 1-3 (P = 0.001 and 0.016, respectively). Older age, male sex and acute illness severity were also associated with increased mortality risk.ConclusionsFrailty is associated with all-cause mortality risk in older inpatients with COVID-19.© The Author(s) 2020. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.

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