SynthesisJournal of the American Geriatrics Society2021
Association of frailty with outcomes in individuals with COVID-19: A living review and meta-analysis.
Synthesis in Journal of the American Geriatrics Society, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 51 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
51 citing papers in PubMed, 5 syntheses or guidelines pooled it, 99 citations in OpenAlex.
- Prognostic Factors of COVID-19: An Umbrella Review Endorsed by the International Society for Pharmacoepidemiology.Clinical pharmacology and therapeutics · 2023Pooled it
- The devastating trio of sarcopenia, frailty, and COVID-19 - A systematic review and meta-analysis.Clinical nutrition ESPEN · 2022Pooled it
- Frailty and risks of all-cause and cause-specific death in community-dwelling adults: a systematic review and meta-analysis.BMC geriatrics · 2022Pooled it
- Frailty and mortality associations in patients with COVID-19: a systematic review and meta-analysis.Internal medicine journal · 2022Pooled it
- Association of frailty with outcomes in individuals with COVID-19: A living review and meta-analysis.Journal of the American Geriatrics Society · 2021Pooled it
- Six Years of COVID-19: Lessons from Epidemiology, Vaccination Campaigns, Clinical Risk Stratification, and Thromboembolic Surveillance.Vaccines · 2026Review
- Emergency hernia hospitalizations in older adults with and without multimorbidity.Hernia : the journal of hernias and abdominal wall surgery · 2026Article
- Cost and Utilization of Ambulance Services Across the United States.Healthcare (Basel, Switzerland) · 2026Article
- Comparing various frailty instruments for predicting adverse outcomes in older patients hospitalized with lower respiratory tract infections.The journal of nutrition, health & aging · 2026Article
- Physical activity during COVID-19 pandemic: A 5-year retrospect.Sports medicine and health science · 2025Review
- No evidence of immune exhaustion after repeated SARS-CoV-2 vaccination in vulnerable and healthy populations.Nature communications · 2025Article
- Impact of Frailty on the Duration and Type of Speech-Language-Hearing Therapy for Patients With COVID-19.Cureus · 2025Article
- Long-term outcomes of older adults with acute COVID-19 following inpatient geriatric rehabilitation: a prospective cohort study from the Republic of Ireland.Irish journal of medical science · 2024Article
- The risk of geriatric syndromes in older COVID-19 survivors among the nonvaccinated population: a real world retrospective cohort study.Age and ageing · 2024Article
- Exploration of the factors affecting different delirium subtypes in hospitalized COVID-19 patients: a multicentre cross-sectional study.Scientific reports · 2024Article
- Limited incremental predictive value of the frailty index and other vulnerability measures from routine care data for mortality risk prediction in older patients with COVID-19 in primary care.BMC primary care · 2024Article
- To Be Frail or Not to Be Frail: This Is the Question-A Critical Narrative Review of Frailty.Journal of clinical medicine · 2024Review
- The association of technology acceptance and physical activity on frailty in older adults during the COVID-19 pandemic period.European review of aging and physical activity : official journal of the European Group for Research into Elderly and Physical Activity · 2023Article
- Comparison of different prognostic scores in estimating short- and long-term mortality in COVID-19 patients above 60 years old in a university hospital in Belgium.European geriatric medicine · 2023Observational
- The Clinical Frailty Scale for mortality prediction of old acutely admitted intensive care patients: a meta-analysis of individual patient-level data.Annals of intensive care · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectivesFrailty leaves older adults vulnerable to adverse health outcomes. Frailty assessment is recommended by multiple COVID-19 guidelines to inform care and resource allocation. We aimed to identify, describe, and synthesize studies reporting the association of frailty with outcomes (informed by the Institute for Healthcare Improvement's Triple Aim [health, resource use, and experience]) in individuals with COVID-19.
designSystematic review and meta-analysis.
settingStudies reporting associations between frailty and outcomes in the setting of COVID-19 diagnosis.
participantsAdults with COVID-19. MEASUREMENTS: Following review of titles, abstracts and full text, we included 52 studies that contained 118,373 participants with COVID-19. Risk of bias was assessed using the Quality in Prognostic studies tool. Our primary outcome was mortality, secondary outcomes included delirium, intensive care unit admission, need for ventilation and discharge location. Where appropriate, random-effects meta-analysis was used to pool adjusted and unadjusted effect measures by frailty instrument.
resultsThe Clinical Frailty Scale (CFS) was the most used frailty instrument. Mortality was reported in 37 studies. After confounder adjustment, frailty identified using the CFS was significantly associated with mortality in COVID-19 positive patients (odds ratio 1.79, 95% confidence interval [CI] 1.49-2.14; hazard ratio 1.87, 95% CI 1.33-2.61). On an unadjusted basis, frailty identified using the CFS was significantly associated with increased odds of delirium and reduced odds of intensive care unit admission. Results were generally consistent using other frailty instruments. Patient-reported, cost and experience outcomes were rarely reported.
conclusionFrailty is associated with a substantial increase in mortality risk in COVID-19 patients, even after adjustment. Delirium risk is also increased. Frailty assessment may help to guide prognosis and individualized care planning, but data relating frailty status to patient-reported outcomes are urgently needed to provide a more comprehensive overview of outcomes relevant to older adults.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.