Respiratory research and COVID-19

9th April 2020

A research team based at the Cicely Saunders Institute has published an informative guide for respiratory healthcare professionals working on the front line with COVID-19 patients. This has been published this week in the European Respiratory Journal.

Globally the number of people affected by COVID-19 is rapidly increasing. In about 20% of cases, the illness causes respiratory compromise severe enough to require hospital admission. This may include oxygen for ventilation, and management of complications such as bacterial infection and underlyling co-morbidities such as COPD and heart failure.

Patients with severe disease not suitable for intensive care are at very high risk of dying. There is a moral obligation to provide good symptom control to prevent avoidable suffering. So in addition to optimal symptom management for those who will survive, expert symptom management should be offered alongside end of life care for those that are deteriorating and in their last days or hours of life, a parallel approach.

The article includes information on treatments for breathlessness, both pharmalogical and non-pharmalogical, symptom management, parallel planning and how to address information needs, providing psychological support for the patient and their family, and addressing spiritual care needs for each patient, whether religious or non-religious.

The researchers conclude that COVID-19 patients with severe disease/at the end of life have an equal right to care. Receiving adequate symptom control is a basic human right and there is a fundamental duty to relieve suffering and provide the best care with the available resources regardless of the chances of survival.

Bajwah S, Wilcock A, Towers R, Costantini M, Bausewein C, Simon ST, Bendstrup E, Prentice W, Johnson MJ, Currow DC, Kreuter M, Wells AU, Birring SS, Edmonds P, Higginson IJ. Managing the palliative care needs of those affected by COVID-19. European Respiratory Journal 2020; DOI: 10.1183/13993003.00815-2020

Full paper available here: https://erj.ersjournals.com/content/early/2020/04/07/13993003.00815-2020