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. 2021 Apr:105:141-143.
doi: 10.1016/j.ijid.2021.02.053. Epub 2021 Feb 16.

Palliative care in a COVID-19 Internal Medicine ward: A preliminary report

Nicola Mumoli  1 , Clarissa Florian  2 , Marco Cei  3 , Isabella Evangelista  4 , Alessandra Colombo  4 , Giancarlo Razionale  5 , Luca Moroni  2 , Antonino Mazzone  6
Affiliations

Palliative care in a COVID-19 Internal Medicine ward: A preliminary report

Nicola Mumoli et al. Int J Infect Dis. 2021 Apr.

Abstract

Background: in the current pandemic emergency, increased attention has given to treating symptoms that cause suffering in patients with COVID-19. This study aims to describe the role of palliative care in the management of these patients.

Methods: palliative consultation was requested by the staff as per protocol. In brief, the criteria for referring patients to a palliative care physician or to undergo palliative care were left to the discretion of the physician in charge. We recorded data regarding age, gender, length of stay, type of discharge (dead or alive, and transfer to long-term or hospice facilities).

Results: Between March 18 to May 8, 2020, 412 patients with COVID-19 were admitted to the Internal Medicine wards of Magenta Hospital, Italy. The palliative care physician was directly involved in 105 cases (25.5%) and performed 236 consultations. Of the 105 patients who received palliative care counselling, 66 (63%) died. The average number of days in care was 2.26 days. The principal reason for counseling was controlling symptoms (54%) and 12% deal with the end of life management. The prevalent symptom, among those which led to the counseling, was restlessness/agitation (41%), followed by emotional issues (26%) such as anxiety, fear, and demoralization. In only 20% of cases, dyspnoea was the reason for symptomatic treatment.

Conclusions: A large number of hospitalized Covid-19 patients are at high risk of clinical deterioration and death. This leads to the opportunity to integrate a palliative physician into the staff, who treat these patients. There is an urgent need for protocol standardization and formal trials to verify the effectiveness of this approach.

Keywords: COVID-19; Palliative care; SARS-CoV-2.

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References

    1. Grasselli G., Zangrillo A., Zanella A., Antonelli M., Cabrini L., Castelli A. Baseline characteristics and outcomes of 1591 patients infected with SARS-CoV-2 admitted to ICUs of the Lombardy Region, Italy. JAMA. 2020;323(16):1574–1581. - PMC - PubMed
    1. Radbruch L., Knaul F.M., de Lima L., de Joncheere C., Bhadelia A. The key role of palliative care in response to the COVID-19 tsunami of suffering. Lancet. 2020;395(10235):1467–1469. - PMC - PubMed
    1. Zhou F., Yu T., Du R., Fan G., Liu Y., Liu Z. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395(10229):1054–1062. - PMC - PubMed
    1. Price-Haywood E.G., Burton J., Fort D., Seoane L. Hospitalization and mortality among black patients and white patients with Covid-19. N Engl J Med. 2020;382(26):2534–2543. - PMC - PubMed
    1. Wang L., He W., Yu X., Hu D., Bao M., Liu H. Coronavirus disease 2019 in elderly patients: characteristics and prognostic factors based on 4-week follow-up. J Infect. 2020;80(6):639–645. - PMC - PubMed