
| 10.1186/s12904-021-00785-4
http://scihub22266oqcxt.onion/10.1186/s12904-021-00785-4
 34210312!8247619!34210312
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BMC+Palliat+Care 2021 ; 20 (1): 102 Nephropedia Template TP
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Symptoms, symptom relief and support in COVID-19 patients dying in hospitals during the first pandemic wave #MMPMID34210312Martinsson L; Bergstrom J; Hedman C; Strang P; Lundstrom SBMC Palliat Care 2021[Jul]; 20 (1): 102 PMID34210312show ga
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.|*Palliative Care[MESH]|*Terminal Care[MESH]|Adolescent[MESH]|Adult[MESH]|Aged[MESH]|Aged, 80 and over[MESH]|Anxiety/epidemiology/virology[MESH]|COVID-19/*complications/*epidemiology/psychology[MESH]|Cohort Studies[MESH]|Delirium/epidemiology/virology[MESH]|Dyspnea/epidemiology/virology[MESH]|Female[MESH]|Hospital Mortality[MESH]|Hospitalization[MESH]|Humans[MESH]|Male[MESH]|Middle Aged[MESH]|Nausea/epidemiology/virology[MESH]|Pain/epidemiology/virology[MESH]|Registries[MESH]|Sweden/epidemiology[MESH]|Symptom Assessment[MESH]
  
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