The COVID-19 pandemic provided an ideal scenario for studying the care of the elderly population, we implemented a tool named the Geriatric Measure (GM) tool to determine the severity and need for hospitalization. The objective of the study is to evaluate if the results of a brief Geriatric Measure tool are associated with mortality and other outcomes among older adults with COVID-19 treated in the emergency department. Retrospective observational cohort study. Participants were older adults (65 years and over) who required hospitalization for SARS CoV2 pneumonia. Patients were evaluated with the GM tool and were followed-up until death or discharge and associations between GM tool scores and mortality and other outcomes were assessed. A total of 275 patients were included. The proportion of patients who died increased with every category of the GM tool. Patients in category 1 (fit with good functional status) had a mortality of 24.7% versus those in category 4 (frail with poor functional status) who had a mortality of 51%. Our results show an association between our GM tool and mortality among older adults with pneumonia caused by SARS CoV2 and treated in the emergency department, and highlight the need of individualizing care for older patients.© 2025. The Author(s), under exclusive licence to Società Italiana di Medicina Interna (SIMI).