Multidimensional symptomatology of patients with a COVID-19 infection as comorbidity and hospice care provided, an exploratory study

Introduction. During the first months of the COVID-19 pandemic, most attention is being paid to seriously ill COVID-19 patients in hospitals. However, patients already suffering from life limiting illness and infected with COVID-19 suffer from their illness primarily and COVID-19 as a comorbidity. Hospice care provided to these patients might reveal how a COVID-19 infection affect multidimensional symptomatology during the last weeks of life of hospice patients and the care and treatment provided.
Methods. An exploratory retrospective chart review was performed from patients with a COVID-19 comorbidity admitted to hospices in the Netherlands from March to June 2020. The main outcome of this study was multidimensional symptomatology, assessed by means of the Utrecht Symptom Diary four dimensional, entailing eleven physical and psychological symptoms and five social and spiritual concerns and 1 item wellbeing and value of life questions. All scored on a 11 point numerical scale from no symptom/best possible to most severe/worst possible. Data are analyzed using descriptive statistics and the longitudinal symptom intensity is analyzed using spaghetti plots.
Results. Data from 42 patients are available for the analyses. Preliminary results show that the symptoms sleeping problems and breathlessness are more prevalent in patients with a COVID-19 comorbidity. Delirium is more intense and more eratic in patients with a COVID-19 comorbidity. Careful analyses of symptomatology and possible causes is necessary to select the optimal treatment. Care and treatment were affected by the measures taken to prevent COVID-19 spread specifically for family members. All data will be analyzed in September and presented.
Conclusion. Hospice care, multidimensional symptom management approach can contribute to palliative care for patients with COVID-19 comorbidity and inform COVID-19 care to be sensitive for symptoms and problems not caused but influenced by a COVID-19 infection.