Abstract
Context: In spring 2020, New York experienced a surge of patients hospitalized with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 or COVID-19) disease, as part of a global pandemic. There are limited data on populations of COVID-19-infected patients seen by palliative care services.
Objective: To describe a palliative care population at one New York hospital system during the initial pandemic surge.
Methods: This repeated cross-sectional, observational study collected data on palliative care patients in a large health system seen during the COVID-19 outbreak and compared it with pre-COVID data.
Results: Palliative service volume surged from 678 (4% of total admissions) before COVID-19 to 1071 (10% of total admissions) during the COVID-19 outbreak. During the outbreak, 695 (64.9%) of the total palliative patients tested positive for the virus. Compared with a preoutbreak group, this COVID-19-positive group had higher rates of male (60.7% vs. 48.6%, P < 0.01) and Latino (21.3% vs. 13.3%; P < 0.01) patients and less white patients (21.3% vs. 13.3%; P < 0.01). Our patients with COVID-19 also had greater prevalence of obesity and diabetes and lower rates of end-stage organ disease and cancers. The COVID-19-positive group had a higher rate of intensive care unit admissions (58.9% vs. 33.9%; P < 0.01) and in-hospital mortality rate (57.4% vs. 13.1%; P < 0.01) than the preoutbreak group. There was increased odds of mortality in palliative care patients who were COVID-19 positive (odds ratio = 3.21; 95% confidence interval = 2.43-4.24) and those admitted to the intensive care unit (odds ratio = 1.45; 95% confidence interval = 1.11-1.9).
Conclusion: During the initial surge of the COVID-19 pandemic in New York, palliative care services experienced a large surge of patients who tended to be healthier at baseline and more acutely ill at the time of admission than pre-COVID-19 palliative patients.
Keywords: COVID-19; Palliative care; hospital-based palliative care; supportive care.
【저자키워드】 COVID-19, Palliative care, supportive care, hospital-based palliative care, 【초록키워드】 SARS-CoV-2, coronavirus, pandemic, Mortality, intensive care, cross-sectional, COVID-19 pandemic, obesity, hospital, virus, Population, global pandemic, Prevalence, COVID-19 outbreak, outbreak, cancers, male, Patient, health system, New York, disease, Admission, patients, supportive care, Odds ratio, Volume, Latino, Admissions, acute respiratory syndrome, 95% confidence interval, in-hospital mortality rate, collected data, positive, organ, repeated, palliative, initial, greater, tested, less, diabete, baseline, patients hospitalized, patients with COVID-19, was increased, 【제목키워드】 clinical, Impact, New York, palliative, System,