Code status documentation during the COVID-19 pandemic 113 5 We believe our results are an important first step to understand the how the COVID-19 pandemic impacted code status documentation, discussion and content. Future research should focus on further distinguishing what might explain the increase in limitations and especially ‘no intubation’ and ‘no ICU admission’. This might also help us how to improve code status documentation and discussion. 5. Conclusion and recommendation We have seen that frequency of code status documentation or discussion did not differ between patients with infections prior to the pandemic and COVID-19 patients. Yet, in COVID-19 patients treatment limitations were more prevalent and within these limitations, ‘no intubation’ and ‘no ICU admission’ were more often reported. This suggest a more limitation-directed approach during the COVID-19 pandemic. Our results support the notion that the COVID-19 pandemic influenced code status, although more extensive research is needed to verify these changes and to determine what causes this effect. Acknowledgments We would like to thank Dr. CH van Werkhoven, assistant professor at the Department of Epidemiology of the Julius Centre (Research Programme Infectious Diseases), for his advice on the design and methodology of our study.
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