Impact of the COVID-19 pandemic on palliative care in cancer patients in Spain

Abstract

Background: The COVID-19 pandemic outbreak has severely affected healthcare organi-zations worldwide, and the provision of palliative care (PC) to cancer patients has been no excep-tion. 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. Con-clusion: The COVID-19 pandemic has presented a challenge in the management of patients requir-ing 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.