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.
【저자키워드】 COVID-19, frailty, hospital-related mortality, systematic review, older people, 【초록키워드】 Brazil, Meta-analysis, Europe, Mortality, Prognosis, frailty, risk, outcome, Screening, clinical, female, death, Hospitalised patients, association, COVID-19 mortality, Grey literature, Older, Web of Science, Sample size, overall mortality, caution, median age, Descriptive statistics, data extraction, COVID-19 illness, COVID-19-related death, inception, positive, MOST, Result, greater, shown, resulting, reported, indicated, screened, majority, searched, suggested, ranged, people with COVID-19, the median, 【제목키워드】 Mortality, hospital, with COVID-19,