Specialist palliative care consultations in covid-19 patients in the ICU : a retrospective analysis of patient characteristics and symptoms at a German university hospital

Article

TENGE, Theresa | BRIMAH, Sebastian | SCHLIEPER, Daniel | ROESEL, Antje | SCHWARTZ, Jacqueline | SCHALLENBURGER, Manuela | MEIER, Stefan | BRANDENBURGER, Timo | KINDGEN-MILLES, Detlef | KIENBAUM, Peter | NEUKIRCHEN, Martin

COVID-19 patients who may require invasive therapeutic procedures such as extracorporeal membrane oxygenation (ECMO) have high symptom burden and in-hospital mortality. In addition, awake patients on ECMO are new in the intensive care unit (ICU) setting. Inpatient specialist palliative care (sPC) provides support such as symptom control on a physical, psychosocial and spiritual level. The field of sPC in COVID-19 patients is still new and important to investigate. We aim to analyze sPC of COVID-19 patients in the ICU with regard to patient characteristics and symptoms from a palliative care perspective. We conducted a retrospective analysis (03/2020-04/2021) and identified 51 ICU patients receiving sPC. The statistical analysis included descriptive statistics and comparisons of symptoms. The first sPC contact of patients (mean age 69.5 years, 62.7% male) was around 14 days after COVID-19 confirmation, and 43% were treated with ECMO therapy. The baseline symptom burden was high with a focus on weakness (100%), tiredness (98%), dyspnea (96%) and family burden (92%). The symptom intensity significantly decreased during the time period of sPC and COVID-19 treatment (t(99) = 3.119, p = 0.003, d = 0.437). These results help intensivists and sPC clinicians to identify symptoms and the need for sPC in COVID-19 patients. However, studies with prospective and controlled designs need to follow.

http://dx.doi.org/10.3390/jcm11195925

Voir la revue «Journal of clinical medicine, 11»

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