Multicenter Evaluation of 434 Hospital Deaths From COVID-19: How Can We Improve End-of-Life Care During a Pandemic?

Abstract

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Symptom Control and Survival for People Severely ill With COVID: A Multicentre Cohort Study (CovPall-Symptom)

“…Analysis of cohorts of patients indicates that the usual course for individuals severely ill or dying with COVID results in increasing symptom severity and suffering over time. 2,33,34 Therefore, our findings of symptom improvements during palliative care for these nine symptoms are very encouraging and suggest that symptoms can be ameliorated. Little is known about effectiveness of therapeutics for symptoms in COVID, 34,35 so this is an important contribution for the many clinicians who care for patients with COVID, both within, and perhaps even more crucially outwith specialist palliative care.…”

Identifying barriers and facilitators to palliative care integration in the management of hospitalized patients with COVID-19: A qualitative study

“…Palliative care participants identified a misperception of the need to choose between supporting length of life versus quality of life in the management of patients with COVID-19. Due to the nature of severe COVID-19, including the risk of respiratory failure, 9 , 27 clinicians felt that to optimize treatment for refractory dyspnea with opioids could negatively impact survival. These concerns and fears over the use of opioids for dyspnea have been outlined previously in patient populations with respiratory disease, 28 – 30 despite evidence that management of refractory dyspnea with opioids is safe and effective in alleviating discomfort from refractory dyspnea.…”

Implications of end‐of‐life home care compared with hospital‐based care during the COVID‐19 pandemic: A case report

“… 9 Besides the potential risk of nosocomial infection, work overload, logistic, and staff shortages are also an issue in hospitals during this pandemic. 9 Given these reasons, home care could be considered as a viable option, at least until the pandemic subsides. Further research is needed to determine the impact of home‐based care on outcomes for patients and their families.…”

“…End‐of‐life patients are a vulnerable population who are more likely to experience serious consequences if infected with COVID‐19 9 . Besides the potential risk of nosocomial infection, work overload, logistic, and staff shortages are also an issue in hospitals during this pandemic 9 . Given these reasons, home care could be considered as a viable option, at least until the pandemic subsides.…”

“…Second, home care would potentially reduce the burden of COVID‐19 on our healthcare system. End‐of‐life patients are a vulnerable population who are more likely to experience serious consequences if infected with COVID‐19 9 . Besides the potential risk of nosocomial infection, work overload, logistic, and staff shortages are also an issue in hospitals during this pandemic 9 .…”