There was little proof that severe COVID results in symptom management. Therefore, for a study, researchers sought to identify changes in symptoms, relationships to therapies, and survival rates among COVID patients who were terminally ill or receiving palliative care.

During the pandemic in 2020 and 2021, a multicenter cohort study of individuals with COVID in England and Wales was supported by palliative care services. They used the Integrated Palliative Care Outcome Scale – COVID version to analyze clinical, demographic, and survival data as well as symptom severity at three follow-up evaluations and baseline (referred to as palliative care, first COVID assessment).

Among the 572 patients we included, 496 (87%) were newly referred to palliative care with COVID, and 75 (13%) were already receiving assistance from palliative care when they contracted COVID. These patients came from 25 services, primarily hospital support teams. Patients were typically in bed or in a semiconscious state at baseline, with a mean of 2.4 co-morbidities, a mean age of 77 years, and a mean of five symptoms. Breathlessness, weakness/lack of energy, sleepiness, anxiety, agitation, confusion/delirium, and pain were the most frequent symptoms. 77% of patients passed away during their median 46-hour stay in palliative care. Breathlessness, agitation, anxiety, delirium, cough, fever, pain, sore/dry mouth, and nausea improved under palliative care; sleepiness worsened. Midazolam and low-dose morphine were typical treatments. Agitation, multimorbidity, and moderate to severe dyspnea were linked to a lower survival time.

The COVID symptoms responded favorably to palliative treatment. Breathlessness, agitation, and multimorbidity may serve as indicators for prompt referral, and symptom counseling for other specialties should draw on the interventions found in the study.

Reference: jpsmjournal.com/article/S0885-3924(22)00785-0/fulltext