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Identification of patients at increased risk of death following hospital discharge is needed to guide clinical monitoring and early intervention. Herein, we aimed to identify predictors of early vs. late mortality in COVID\u201019 patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 471 patients with polymerase chain reaction\u2010confirmed COVID\u201019 were followed up for 9\u00a0months [median (inter\u2010quartile range) of follow\u2010up time: 271 (14) days] after hospital admission. COVID\u201019\u2010related signs and symptoms, laboratory features, co\u2010morbidities, Coronavirus Clinical Characterisation Consortium (4C) mortality and Clinical Frailty Scale (CFS) scores were analysed by logistic regression for association with early (28\u00a0day) vs. late mortality. Receiver operating characteristic (ROC) analysis was used to determine the discriminative value of 4C and CFS scores for early vs. late mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 120 patients died within 28\u00a0days from hospital admission. Of the remaining 351 patients, 41 died within the next 8\u00a0months. Respiratory failure, systemic inflammation, and renal impairment were associated with early mortality, while active cancer and dementia were associated with late mortality, after adjustment for age and sex. 4C mortality score and CFS were associated with both early [odds ratio (OR) (95% confidence interval\u2014CI): <jats:italic>4C<\/jats:italic>: 1.34 (1.25\u20131.45); <jats:italic>CFS<\/jats:italic>: 1.49 (1.33\u20131.66)] and late [OR (95% CI): <jats:italic>4C<\/jats:italic>: 1.23 (1.12\u20131.36); <jats:italic>CFS<\/jats:italic>: 2.04 (1.62\u20132.56)] mortality. After adjustment for CFS, the association between 4C and late mortality was lost. By ROC analysis, 4C mortality score was superior to CFS for 28\u00a0day mortality [area under the curve (AUC) (95% CI): 0.779 (0.732\u20130.825) vs. 0.723 (0.673\u20130.773), respectively; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.039]. In contrast, CFS had higher predictive value for late mortality compared with 4C mortality score [AUC (95% CI): 0.830 (0.776\u20130.883) vs. 0.724 (0.650\u20130.798), respectively; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.007].<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In our cohort, late mortality in COVID\u201019 patients is more strongly associated with premorbid clinical frailty than with severity of the acute infection phase.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jcsm.12966","type":"journal-article","created":{"date-parts":[[2022,3,8]],"date-time":"2022-03-08T04:45:20Z","timestamp":1646714720000},"page":"1502-1513","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Clinical frailty, and not features of acute infection, is associated with late mortality in COVID\u201019: a retrospective cohort study"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7878-8078","authenticated-orcid":false,"given":"Nikolaos I.","family":"Vlachogiannis","sequence":"first","affiliation":[{"name":"Biosciences Institute, Vascular Biology and Medicine Theme, Faculty of Medical Sciences Newcastle University  Newcastle Upon Tyne UK"},{"name":"RVI and Freeman Hospitals Newcastle upon Tyne Hospitals NHS Foundation Trust  Newcastle Upon Tyne UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenneth F.","family":"Baker","sequence":"additional","affiliation":[{"name":"RVI and Freeman Hospitals Newcastle upon Tyne Hospitals NHS Foundation Trust  Newcastle Upon Tyne UK"},{"name":"Translational and Clinical Research Institute Newcastle University  Newcastle Upon Tyne UK"},{"name":"NIHR Newcastle Biomedical Research Centre Newcastle University and Newcastle upon Tyne Hospitals NHS Foundation Trust  Newcastle Upon Tyne UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Georgios","family":"Georgiopoulos","sequence":"additional","affiliation":[{"name":"Biosciences Institute, Vascular Biology and Medicine Theme, Faculty of Medical Sciences Newcastle University  Newcastle Upon Tyne UK"},{"name":"Department of Clinical Therapeutics National and Kapodistrian University of Athens Medical School  Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charalampos","family":"Lazaridis","sequence":"additional","affiliation":[{"name":"RVI and Freeman Hospitals Newcastle upon Tyne Hospitals NHS Foundation Trust  Newcastle Upon Tyne UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ina","family":"Schim van der Loeff","sequence":"additional","affiliation":[{"name":"Translational and Clinical Research Institute Newcastle University  Newcastle Upon Tyne UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aidan T.","family":"Hanrath","sequence":"additional","affiliation":[{"name":"Translational and Clinical Research Institute Newcastle University  Newcastle Upon Tyne UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kateryna","family":"Sopova","sequence":"additional","affiliation":[{"name":"RVI and Freeman Hospitals Newcastle upon Tyne Hospitals NHS Foundation Trust  Newcastle Upon Tyne UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon","family":"Tual\u2010Chalot","sequence":"additional","affiliation":[{"name":"Biosciences Institute, Vascular Biology and Medicine Theme, Faculty of Medical Sciences Newcastle University  Newcastle Upon Tyne UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aikaterini","family":"Gatsiou","sequence":"additional","affiliation":[{"name":"Biosciences Institute, Vascular Biology and Medicine Theme, Faculty of Medical Sciences Newcastle University  Newcastle Upon Tyne 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