Death among patients hospitalized with symptomatic COVID‐19: Implications for high‐risk patients. Issue 4 (16th March 2022)

• Record Type: Journal Article
• Authors: Stefan, Mihaela S.; Eltanbedawi, Ahmed; Devoe, Neil C.; Khan, Sabiha; Zhou, Ya; Latef, Taroob; Esposito, Anthony; Fatima, Anum; Knee, Alexander B.; Lagu, Tara C.
• Is Part Of: Journal of hospital medicine. Volume 17:Issue 4(2022)
• Page Start: 252
• Page End: 258
• Publication Date: 2022-03-16
• Subjects: Hospital care -- Periodicals; Clinical medicine -- Periodicals; 610
• DOI: 10.1002/jhm.12805
• Languages: English
• ISSNs: 1553-5592

Abstract

Abstract: Background: We aimed to examine the role played by the COVID‐19 infection in patients' death and to determine the proportion of patients for whom it was a major contributor to death. Methods: We included patients ≥50 years old who were hospitalized with COVID‐19 infection and died between March 1, 2020 and September 30, 2020 in a tertiary medical center. We considered COVID‐19 infection to be a major cause for death if the patient had well‐controlled medical conditions and death was improbable without coronavirus infection, and a minor cause for death if the patient had serious illnesses and had an indication for palliative care. Results: Among 243 patients, median age was 80 (interquartile intervals: 72–86) and 40% were female. One in two had moderate or severe frailty and 41% had dementia. Nearly 60% of the patients were classified as having advanced, serious illnesses present prior to the hospitalization, with death being expected within 12 months, and among this group 39% were full code at admission. In the remaining 40% of patients, deaths were classified as unexpected based on patients' prior conditions, suggesting that COVID‐19 infection complications were the primary contributor to death. Conclusions: For slightly less than half (40%) of patients who died of complications of COVID‐19, death was an unexpected event. Among the 60% of patients for whom death was not a surprise, our findings identify opportunities to improve end‐of‐life discussions and implement shared decision‐making in high‐risk patients early on or prior to hospitalization.