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. 2022 Jul 29;17(7):e0271822.
doi: 10.1371/journal.pone.0271822. eCollection 2022.

Hospitalized patients dying with SARS-CoV-2 infection-An analysis of patient characteristics and management in ICU and general ward of the LEOSS registry

Claudia Raichle  1 , Stefan Borgmann  2 , Claudia Bausewein  3 , Siegbert Rieg  4 , Carolin E M Jakob  5 , Steffen T Simon  6 , Lukas Tometten  5 , Jörg Janne Vehreschild  5   7   8 , Charlotte Leisse  5 , Johanna Erber  9 , Melanie Stecher  5   8 , Berenike Pauli  6 , Maria Madeleine Rüthrich  10 , Lisa Pilgram  7 , Frank Hanses  11   12 , Nora Isberner  13 , Martin Hower  14 , Christian Degenhardt  15 , Bernd Hertenstein  16 , Maria J G T Vehreschild  17 , Christoph Römmele  18 , Norma Jung  5 ; LEOSS Study Group
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Hospitalized patients dying with SARS-CoV-2 infection-An analysis of patient characteristics and management in ICU and general ward of the LEOSS registry

Claudia Raichle et al. PLoS One. .

Abstract

Background: COVID-19 is a severe disease with a high need for intensive care treatment and a high mortality rate in hospitalized patients. The objective of this study was to describe and compare the clinical characteristics and the management of patients dying with SARS-CoV-2 infection in the acute medical and intensive care setting.

Methods: Descriptive analysis of dying patients enrolled in the Lean European Open Survey on SARS-CoV-2 Infected Patients (LEOSS), a non-interventional cohort study, between March 18 and November 18, 2020. Symptoms, comorbidities and management of patients, including palliative care involvement, were compared between general ward and intensive care unit (ICU) by univariate analysis.

Results: 580/4310 (13%) SARS-CoV-2 infected patients died. Among 580 patients 67% were treated on ICU and 33% on a general ward. The spectrum of comorbidities and symptoms was broad with more comorbidities (≥ four comorbidities: 52% versus 25%) and a higher age distribution (>65 years: 98% versus 70%) in patients on the general ward. 69% of patients were in an at least complicated phase at diagnosis of the SARS-CoV-2 infection with a higher proportion of patients in a critical phase or dying the day of diagnosis treated on ICU (36% versus 11%). While most patients admitted to ICU came from home (71%), patients treated on the general ward came likewise from home and nursing home (44% respectively) and were more frequently on palliative care before admission (29% versus 7%). A palliative care team was involved in dying patients in 15%. Personal contacts were limited but more often documented in patients treated on ICU (68% versus 47%).

Conclusion: Patients dying with SARS-CoV-2 infection suffer from high symptom burden and often deteriorate early with a demand for ICU treatment. Therefor a demand for palliative care expertise with early involvement seems to exist.

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Conflict of interest statement

The authors have declared that no competing interests exist.

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Fig 1. Patient cohort.
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