Coronavirus and Palliative Care

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Coronavirus and Palliative Care

Home health care providers are receiving more requests to provide palliative care to patients with lingering effects from the coronavirus disease 2019 (COVID-19). Some companies are expanding their services to meet the growing need.

Since the COVID-19 outbreak began, Dr. Matthew Kestenbaum, chief medical officer for Capital Caring Health, said the organization has seen an increase in the number of requests from hospitals and community agencies for palliative care consultations.

Palliative care focuses on improving the quality of life for people living with chronic and life-threatening illnesses, like cancer and chronic obstructive pulmonary disease.

Palliative care services are delivered by a team of professionals that develop a care plan for the patient, and ways to support the patient’s family members. This team can include:

  • Physicians
  • Surgeons
  • Nurses
  • Home health care agencies
  • Dieticians
  • Social workers
  • Psychiatrists or psychologists

The palliative services, which can include pain management, and physical therapy, vary, depending on the patient’s need. The goal is to do most of the services at home.

Hospice is the most familiar type of palliative care. But, hospice is reserved for people who have six months or less to live. People who expect to recover from a curable illness can also benefit from palliative care.

Are There Long-Term Effects From COVID-19?

COVID-19 is called “novel” because it is a new coronavirus that has not been previously identified, according to the Centers for Disease Control and Prevention (CDC). As a result, scientists have not been able to study the disease’s long-term effects on COVID-19 survivors.

Medical doctors, however, are seeing a variety of lingering symptoms in patients who recovered weeks and months ago from COVID-19. The most commonly reported symptoms include:

  • Cough
  • Difficulty concentrating
  • Extreme Fatigue
  • Headaches
  • Intermittent low-grade fevers
  • Muscle aches
  • Shortness of breath
  • Weakness

Besides lingering symptoms, doctors are also seeing the damage COVID-19 has done that would make patients eligible for palliative care.

Coronavirus Disease Leading to Strokes, Heart Damage

When the coronavirus disease first hit earlier this year, public health officials warned that adults over 65 years old with underlying medical conditions were more at risk than the younger population for developing the virus.

Doctors are now treating blood clots, strokes, lung problems, kidney disease, and other serious conditions in adults under 65 years old who recovered from COVID-19.

A report in the New England Journal of Medicine told of a previously healthy 33-year-old New York woman who had numbness and weakness in her left arm and leg for about 28 hours. She was reluctant to go to the hospital because of COVID-19. By the time she went to the hospital, test results showed the woman had suffered a stroke. The woman also tested positive for COVID-19.

According to the American College of Cardiology, doctors are seeing patients who developed COVID-19 suffering acute-onset heart failure, heart attacks, myocarditis (inflammation of the heart muscle), and cardiac arrest.

Recovered COVID-19 patients are also showing signs of kidney damage. According to the International Society of Nephrology, kidney abnormalities were seen in 25-50 percent of patients who were hospitalized for a severe coronavirus infection.

Some patients had no underlying kidney problems before they were infected with the coronavirus, said Dr. C. John Sperati, an associate professor of medicine at the Johns Hopkins University School of Medicine. In some cases, Sperati said the kidney damage was severe enough for patients to undergo dialysis.

Scientists at Scripps Research Institute reviewed a study of asymptomatic COVID-19 patients from a cruise ship. CT scans conducted on 54 percent of 76 asymptomatic individuals showed “significant subclinical lung abnormalities.” According to scientists, this raises the possibility that COVID-19 infection impacts lung function that might not be immediately apparent. The scientists said further research is needed to confirm the potential significance of this finding. 

Sometimes, the treatment for coronavirus, whether on a ventilator, in the intensive care unit, or with drugs, could possibly cause damage. However, researchers have yet to determine whether COVID-19 treatments actually caused damage.

Doctors Urged to “Embrace” Palliative Care for COVID-19 Patients

The various challenges associated with the coronavirus pandemic has forced surgeons to re-evaluate how patients are treated, according to an article in JAMA (Journal of the American Medical Association) Surgery.

The article further stated that the crisis presents surgeons with an “unprecedented opportunity to embrace palliative care” to face this pandemic.

Home health providers are also taking the COVID-19 pandemic as an opportunity to expand their services to include palliative care.

Links:

https://homehealthcarenews.com/2020/06/coronavirus-may-push-more-home-health-providers-into-palliative-care/
https://www.webmd.com/lung/news/20200513/complications-on-the-road-to-recovery-after-covid
https://www.advisory.com/daily-briefing/2020/06/02/covid-health-effects
https://medlineplus.gov/ency/patientinstructions/000536.htm
https://www.who.int/cancer/palliative/definition/en/
https://www.nejm.org/doi/full/10.1056/NEJMc2009787
https://www.acc.org/~/media/Non-Clinical/Files-PDFs-Excel-MS-Word-etc/2020/02/S20028-ACC-Clinical-Bulletin-Coronavirus.pdf
https://www.theisn.org/covid19/recommendations
https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/coronavirus-kidney-damage-caused-by-covid19
https://www.carecentrix.com/news/carecentrix-acquires-turn-key-health

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