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Journal article

Palliative care during COVID-19: Data and visits from loved ones

Abstract:
Objectives: A vital component of the coronavirus response is care of the dying COVID-19 patient. We document the demographics, symptoms experienced, medications required, effectiveness observed, and challenges to high-quality holistic palliative care in 31 patients. This will aid colleagues in primary and secondary care settings anticipate common symptoms and formulate management plans.
Methods: A retrospective survey was conducted of patients referred to the hospital palliative care service in a tertiary hospital, south east of England between March 21 and April 26, 2020. Patients included had a confirmed laboratory diagnosis of COVID-19 via reverse transcription polymerase chain reaction nasopharyngeal swab for SARS-Cov-2 or radiological evidence of COVID-19.
Results: The thirty-one patients included were predominantly male (77%), elderly (median [interquartile range]: 84 [76-89]), and had multiple (4 [3-5]) comorbidities. Referral was made in the last 2 [1-3] days of life. Common symptoms were breathlessness (84%) and delirium (77%). Fifty-eight percent of patients received at least 1 “as required” dose of an opioid or midazolam in the 24 hours before death. Sixty percent of patients needed a continuous subcutaneous infusion and the median morphine dose was 10 mg S/C per 24 hours and midazolam 10 mg S/C per 24 hours. Nineteen percent of our cohort had a loved one or relative present when dying.
Conclusion: We provide additional data to the internationally reported pool examining death arising from infection with SARS-CoV-19. The majority of patients had symptoms controlled with low doses of morphine and midazolam, and death was rapid. The impact of low visitation during dying needs exploring.
Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1177/1049909120943577

Authors


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Institution:
University of Oxford
Division:
MSD
Department:
Primary Care Health Sciences
Oxford college:
Jesus College
Role:
Author
ORCID:
0000-0002-1628-1981


Publisher:
SAGE Publications
Journal:
American Journal of Hospice and Palliative Medicine More from this journal
Volume:
37
Issue:
11
Pages:
988-991
Place of publication:
United States
Publication date:
2020-07-24
Acceptance date:
2020-06-29
DOI:
EISSN:
1938-2715
ISSN:
1049-9091
Pmid:
32705889


Language:
English
Keywords:
Pubs id:
1135697
Local pid:
pubs:1135697
Deposit date:
2022-07-04

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