Palliative Care Utilization among Patients with COVID-19 in an Underserved Population: A Single-Center Retrospective Study

Haydar, Ali; Lo, Kevin Bryan; Goyal, Abhinav; Gul, Fahad; Peterson, Eric; Bhargav, Ruchika; DeJoy, Robert; Salacup, Grace; Pelayo, Jerald; Albano, Jeri; Azmaiparashvili, Zurab; Ansari, Huma; Aponte, Gabriel Patarroyo

BACKGROUND: As healthcare institutions mobilize resources to address the coronavirus disease 2019 (COVID-19) pandemic, palliative care may potentially be underutilized. It is important to assess the use of palliative care in response to the COVID-19 pandemic. METHODS: This is a retrospective single center study of patients with COVID-19 diagnosed via reverse transcriptase–polymerase chain reaction assay (RT-PCR) admitted between 3/1/2020 and 4/24/2020. An analysis of the utilization of palliative care in accordance with patient comorbidities and other characteristics was performed while considering clinical outcomes. Chi square test was used to determine associations between categorical variables while T tests were used to compare continuous variables. RESULTS: The overall mortality rate was 21.5% (n=52) and in 48% (n=25) of these patients, palliative care was not involved. Fifty nine percent (n=24) of those who had palliative consults eventually elected for comfort measures and transitioned to hospice care. Among those classified as having severe COVID-19, only 40% (n=31) had palliative care involvement. Of these patients with severe COVID-19, 68% (n=52) died. Patients who got palliative care consults were of older age, had higher rates of intubation, need for vasopressors, and death. CONCLUSION: There was a low utilization rate of palliative care in patients with COVID-19. Conscious utilization of palliative care is needed at the time of COVID-19.