Palliative Care and COVID-19 Pandemic: Retrospective Study of Factors Associated With Infection and Death at an Oncological Palliative Care Reference Center.
Livia Costa de Oliveira, Karla Santos da Costa Rosa, Ana Luísa Durante and 7 others
PMID 33455418WHAT IT FOUND
Among advanced cancer patients in a palliative unit, recent chemotherapy and diabetes were linked to confirmed infection.
Among infected patients, poor function and high CRP were linked to dying, but death rates were similar in confirmed and unconfirmed groups.
Key findings
01Chemotherapy within 30 days before admission had an odds ratio of 3.8 for confirmed COVID-19 infection, and diabetes had an odds ratio of 2.2; both were independently associated.
02Among patients with COVID-19, low Karnofsky Performance Status below 30% had an odds ratio of 14.8 for death, and CRP above 21.6mg/L had an odds ratio of 9.3; both were independently associated.
03The hospital death rate did not differ between confirmed and unconfirmed groups.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Single-center retrospective chart review, so associations may reflect the local population and record-keeping rather than a general effect. All patients were advanced cancer inpatients in a palliative unit, many with very low function (median Karnofsky Performance Status 30%), so findings do not apply to earlier-stage cancer or community patients. Recent chemotherapy and diabetes were associated with confirmed infection, but the study did not show they caused infection or that changing them would reduce risk. The death rate was similar in confirmed and unconfirmed groups. Signs of infection overlap with signs of dying, so classification of suspected cases was difficult. Inconclusive RT-PCR results were excluded, which may affect the confirmed group.
Declared interests
The authors declared no conflicts of interest and received no financial support for the research, authorship or publication.
The easy way to misread this
Do not read recent chemotherapy, diabetes, low function or high CRP as proof that a patient will get infected or die. This was a retrospective association study, and the hospital death rate did not differ between confirmed and unconfirmed groups.