Pharmacological strategies used to manage symptoms of patients dying of COVID-19: A rapid systematic review

SAGE Palliative Medicine & Chronic Care

This episode features Laura Health (Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK). COVID-19 has a mortality of between 1% and 2% and is the deadliest pandemic in living memory. The elderly, and those with pre-existing conditions tend to be most vulnerable to severe disease and death. Common symptoms experienced at the end of life include breathlessness and agitation/delirium. Care of those dying of COVID-19 is an understudied aspect of the pandemic. This paper is the first review of international studies describing pharmacological symptom management of adult patients dying of COVID-19. Our thorough search found only seven papers that documented pharmacological symptom management of this patient cohort, highlighting the lack of research in this area. A higher proportion of patients required continuous subcutaneous infusions for medication delivery than is typically seen at the end of life. Modest doses of commonly used end of life medications were required for symptom control. There was a lack of information about how effectiveness was measured, and whether medications used effectively alleviated symptoms.