COVID-19 continues to stalk the world, ravaging those most vulnerable from age, disease, race, living environments, and a host of social determinants of illness. There is no end in sight so we hope to learn from the success and failures of the past few months in health care and we look for the silver linings that always exist.

Frailty continues to be validated as an indicator for survival from COVID-19. In a recently published paper, patients who were considered to be severely frail were 2.4 times more likely to die from COVID-19. The authors continue: “Frailty is as important as age or underlying health issues in determining whether someone may die from COVID-19.” They recommend using Frailty rather than age or underlying condition “to make sure patients are receiving the appropriate, targeted treatment.” To this we would add that patient-centered decisions, informed by frailty, must also be communicated to families. This information on risk and realities for recovery will help to align their expectations with a more accurate, realistic picture of their loved one’s potential for recovery.

The tool used for assessing frailty in this study is the Clinical Frailty Scale, a brief bedside, screening tool, validated for decades and recommended by NICE Guidelines for assessment of frailty in rapidly changing circumstances, such as illness with COVID-19. With isolation and/or cohorting often not possible or feasible and as some facilities are easing off on restrictions, it is valuable to have a measure to inform decisions about care management and who should be isolated in the future.

The full article, The effect of frailty on survival in patients with COVID-19, is available at