Frailty was assessed by the CFS, which is a tool initially developed by the Canadian Health Study of Aging based on the Frailty Index (FI) to be used in patients older than 65 years. It was created with the objective of developing a simple instrument to stratify patients according to their degree of vulnerability and to relate it to patients’ needs and prognoses. However, contrary to the FI, that includes comorbidity within its score, which has been independently associated with worse clinical outcomes in COVID-19 patients, the CFS does not take into account comorbidities for its assessment, allowing to focus on the investigation of the accurate relationship between frailty and clinical outcomes (Kow & Hasan, 2020).

The CFS is a practical, efficient tool that assigns a score between 1 and 7 based on activity, functionality and disability (Rockwood et al., 2005). It classifies patients as robust (score 1–3), pre-frail (score 4), and frail (score >5) (Dent et al., 2019). This stratification allowed to identify not only frail individuals, who usually have higher risk of serious health complications and worse prognosis; but pre-frail subjects as well, who have reported an increased risk of negative events, such as an elevated mortality from all causes (Changfeng, Shouyan & Yu, 2019).

The CFS scale was not taken directly from the medical record but involved analyzing family medical history, nursing history, and in some cases interviewing the patient directly. Six doctors spent 15 days collecting this information and classifying patients according to the CFS scale. Parallelly, a group of experts trained in the use of frailty scales classified the same patients according to their level of frailty obtaining a Kappa 0,89 (95% CI [0.82–0.94])

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