Impact of the COVID-19 Pandemic on Palliative Care in Cancer Patients in Spain

Int J Environ Res Public Health. 2021 Nov 15;18(22):11992. doi: 10.3390/ijerph182211992.

Abstract

Background: The COVID-19 pandemic outbreak has severely affected healthcare organizations worldwide, and the provision of palliative care (PC) to cancer patients has been no exception. The aim of this paper was to analyse the levels of health care provided by the Clinical Management Unit for PC in Córdoba (Spain) for cancer patients.

Method: a retrospective cohort study was conducted. It analyzed the PC internal management database including all cancer patients treated in the period of 2018-2021.

Results: 1967 cases were studied. There was a drop in cancer cases (p = 0.008), deaths at the PC hospital (p < 0.001), and referrals from primary care (p < 0.001). However, there was a rise in highly complex clinical situations (p = 0.020) and in ECOG performance status scores of 3-4 (p < 0.001). The pandemic was not shown to be a risk factor for survival in the PC program (0.99 [0.82-1.20]; p = 0.931). However, being female (p = 0.005), being older and having a high Karnofsky Performance Status (KPS) score (p < 0.001) could be indicators of a longer stay.

Conclusion: The COVID-19 pandemic has presented a challenge in the management of patients requiring PC and has highlighted the urgent needs of the healthcare system if it is to continue providing a level of care which meets the needs of patients and their families.

Keywords: COVID-19; cancer; ethical issues; legal medicine; palliative care; pandemic.

MeSH terms

  • COVID-19*
  • Female
  • Humans
  • Neoplasms* / epidemiology
  • Neoplasms* / therapy
  • Palliative Care
  • Pandemics
  • Retrospective Studies
  • SARS-CoV-2
  • Spain / epidemiology