Prevalence, Predictors, and Outcomes of Documented DNR and/or DNI Orders in COVID-19 Patients

The COVID-19 pandemic created complex challenges regarding timing and appropriateness of do not resuscitate (DNR) and/or do not intubate (DNI) orders. This study sought to determine the prevalence, predictors, timing, and outcomes associated with having a documented DNR and/or DNI order in hospitalized patients with COVID-19. Among 1,358 hospitalized patients with COVID-19, 19% (n = 259) had a documented DNR and/or DNI order. Additionally, this study found that DNR and/or DNI orders were utilized at higher rates between patients hospitalized early in the pandemic versus later in the pandemic. Uncertainty in prognosis may have played a role in the frequency and timing of DNR and/or DNI orders early in the pandemic. Additional factors, such as fear of resource shortage and transmission of COVID-19 to healthcare workers may have also played a role.