Abstract
Background:Little is known about end-of-life care among Muslim patients, particularly during Coronavirus disease 2019 (COVID) pandemic, which we report here.Methods:The clinical characteristics, end-of-life care and resuscitation status of Muslim patients who died in the ICU of our tertiary care hospital in year 2020 from COVID were compared to Non-COVID patients.Results:There were 32 patients in COVID and 64 in the Non-COVID group. A major proportion, mainly of Non-COVID patients, already had a hospice eligible terminal disease at baseline (p=.002). COVID patients were admitted to the ICU sooner after hospitalization (2.2 vs. 17 days), had prolonged duration of mechanical ventilation (18.5 vs. 6 days) and longer ICU stay (24 vs. 8 days) than non-COVID patients, respectively (p<.001). Almost all patients were “Full Code” initially. However, status was eventually changed to ‘do-not-attempt resuscitation’ (DNAR) in about 60% of the cohort. COVID patients were made DNAR late in their ICU stay, predominantly in the last 24 hours of life (p=.04). Until the very end, patients in both groups were on tube feeds, underwent blood draws and imaging, required high dose vasopressors, with few limitations or withdrawal of therapies. Family members were usually not present at bedside at time of death. There was minimal involvement of chaplain and palliative care services.Conclusions:Muslim COVID-19 patients had prolonged mechanical ventilation and ICU stay and a delayed decision to DNAR status than non-COVID Muslim patients. Limitation or withdrawal of therapy occurred infrequently. The utilization of chaplain and palliative care service needs improvement.
Highlights
Coronavirus disease 2019 (COVID-19) has wreaked havoc across the globe and stretched the healthcare systems to the limits
Despite improvement in mortality with time among the COVID-19 patients admitted to the intensive care unit (ICU), still on average one out of four patients die from the disease.[3]
This has been deficient during the COVID-19 pandemic for obvious reasons and discussions regarding goals of care have been fewer with less utilization of palliative care services in patients admitted to the ICU.[5,6]
Summary
Coronavirus disease 2019 (COVID-19) has wreaked havoc across the globe and stretched the healthcare systems to the limits. As of April 2021, 140 million cases of COVID-19 have been documented in the world with over 3 million deaths.[1] Many of these patients who become critically ill require ventilatory and hemodynamic support, including those who do not survive.[2] Despite improvement in mortality with time among the COVID-19 patients admitted to the intensive care unit (ICU), still on average one out of four patients die from the disease.[3] Most of them, already have multiple comorbidities which contribute to their poor outcome.[4] Under normal circumstances, goals of care and limitations of therapy are discussed in such patients early in the hospitalization. The utilization of chaplain and palliative care service needs improvement
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
