Hospital-Based Palliative and End-of-Life Care in the COVID-19 Pandemic: A Scoping Review.
Michael Connolly, Mary Bell, Fiona Lawler and 2 others
PMID 34894772WHAT IT FOUND
Hospital palliative care services reported more consults during the pandemic surge, mostly for goals-of-care and advance care planning.
Breathlessness and agitation were common, dying phases were often shorter, and visiting restrictions left patients isolated and clinicians distressed.
Key findings
01New palliative care consults increased significantly, and 75% of referrals in one hospital palliative care service were for goals of care or advance care planning, while fewer than 10% were for symptom management.
02Breathlessness and agitation were the two most commonly reported symptoms in three included studies, although one Italian study found restlessness or agitation more common than breathlessness.
03Time from palliative care referral to death was shorter for patients with COVID-19 than for patients without, reported as 2 days versus 5 days in one service and an average dying phase of 38.25 hours versus 74 hours in another.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This is a scoping review, so it maps what was reported rather than testing whether hospital palliative care changed patient outcomes. Most included studies were small, single-centre retrospective chart reviews or discussion papers, and only 6 had more than 100 participants. The search was limited to English publications and did not include grey literature or reference checking, so relevant local reports may be missing. No studies from South America, Asia or Africa were included, despite some countries having high COVID-19 death rates. Included studies used different populations, outcomes and methods, so the findings cannot be pooled or compared directly.
The easy way to misread this
Do not read this as proof that hospital palliative care improved patient outcomes. It is a scoping review of mostly small retrospective chart reviews and discussion papers, so it describes what services reported, not whether the care worked.