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Symptoms, symptom relief and support in COVID-19 patients dying in hospitals during the first pandemic wave
Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.ORCID iD: 0000-0003-4126-2675
Palliative Care Unit, Stockholms Sjukhem Foundation, Stockholm, Sweden.
R & D Department, Stockholms Sjukhem Foundation, Stockholm, Sweden; Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
R & D Department, Stockholms Sjukhem Foundation, Stockholm, Sweden; Department of Oncology–Pathology, Karolinska Institutet, Stockholm, Sweden.
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2021 (English)In: BMC Palliative Care, E-ISSN 1472-684X, Vol. 20, no 1, article id 102Article in journal (Refereed) Published
Abstract [en]

Background: At the time of the first wave of the COVID-19 pandemic in Sweden, little was known about how effective our regular end-of-life care strategies would be for patients dying from COVID-19 in hospitals. The aim of the study was to describe and evaluate end-of-life care for patients dying from COVID-19 in hospitals in Sweden up until up until 12 November 2020.

Methods: Data were collected from the Swedish Register of Palliative Care. Hospital deaths during 2020 for patients with COVID-19 were included and compared to a reference cohort of hospital patients who died during 2019. Logistic regression was used to compare the groups and to control for impact of sex, age and a diagnosis of dementia.

Results: The COVID-19 group (1476 individuals) had a lower proportion of women and was older compared to the reference cohort (13,158 individuals), 81.8 versus 80.6 years (p <.001). Breathlessness was more commonly reported in the COVID-19 group compared to the reference cohort (72% vs 43%, p <.001). Furthermore, anxiety and delirium were more commonly and respiratory secretions, nausea and pain were less commonly reported during the last week in life in the COVID-19 group (p <.001 for all five symptoms). When present, complete relief of anxiety (p =.021), pain (p =.025) and respiratory secretions (p =.037) was more often achieved in the COVID-19 group. In the COVID-19 group, 57% had someone present at the time of death compared to 77% in the reference cohort (p <.001).

Conclusions: The standard medical strategies for symptom relief and end-of-life care in hospitals seemed to be acceptable. Symptoms in COVID-19 deaths in hospitals were relieved as much as or even to a higher degree than in hospitals in 2019. Importantly, though, as a result of closing the hospitals to relatives and visitors, patients dying from COVID-19 more frequently died alone, and healthcare providers were not able to substitute for absent relatives.

Place, publisher, year, edition, pages
BioMed Central, 2021. Vol. 20, no 1, article id 102
Keywords [en]
COVID-19, Dementia, End-of-life care, Hospitals, Palliative care, Pandemic
National Category
Public Health, Global Health, Social Medicine and Epidemiology Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
URN: urn:nbn:se:umu:diva-185898DOI: 10.1186/s12904-021-00785-4ISI: 000668888400001PubMedID: 34210312Scopus ID: 2-s2.0-85109107932OAI: oai:DiVA.org:umu-185898DiVA, id: diva2:1579898
Funder
Region Västerbotten, 20200472Region StockholmAvailable from: 2021-07-12 Created: 2021-07-12 Last updated: 2024-01-17Bibliographically approved

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Martinsson, Lisa

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