Code status documentation during the COVID-19 pandemic 109 5 Table 1 Characteristics of patients admitted before the COVID-19 pandemic and admitted with COVID-19. COVID-19 (N= 129) Before COVID-19 (N= 1586) Age (median (IQR)) 66 (55-76) 64 (52-72) Male (N(%)) 71 (55%) 873 (55%) Dementia (N(%)) 6 (5%) 26 (2%) Malignancy (N(%)) 12 (9%) 665 (42%) Charlson comorbidity index (median (IQR)) 1 (0-2) 2 (1-4) Modified early warning scorea (median (IQR)) 3 (1-4) 3 (1-4) Housing situation (N (%)) Own house 118 (92%) 1484 (94%) Nursing home or long term facility 6 (5%) 88 (6%) Other/unknown 5 (4%) 14 (1%) Transferred from other hospital (N (%)) 32 (25%) 13 (1%) Type of infection (N(%)) Respiratory - 555 (35%) Gastrointestinal - 240 (15%) Urinary tract - 285 (18%) Skin - 115 (7%) COVID-19 129 (100%) - Other - 391 (25%) All variables had <1% missing values, except for MEWS (12% missing values). Patients admitted with COVID-19 had a notably lower prevalence of malignancy (9% vs 42%) and more were transferred from another hospital (25% vs 1%). Additionally, patients with COVID-19 were slightly older, had more dementia, lower CCI scores and in more people housing situation was unknown. No difference was found for gender and MEWS score between both groups. The most prevalent type of infection of admitted patients in the SPACE cohort was respiratory (35%). 3.3 Code status content Subsequently to comparing the documentation and discussion of code status, we compared the content of these code status in both patient groups on limitations or not and type of limitations. In the COVID-19 cohort, there was a higher frequency of any treatment limitation than in the before COVID-19 cohort (40% (36/90) vs 25% (283/1153) of patients with documented code status, respectively). Figure 1 shows the types of limitations in patients with any limitation in both cohorts. Patients in the COVID-19 cohort had a higher frequency of ‘no intubation’ (81% vs 51%),‘no ICU admission’ (69% vs 40%) and, to a lesser
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