Hetherington 2020.

Study characteristics
Methods	Study design: retrospective cohort study Type of publication: journal publication Setting and dates: hospital palliative care, 30 March to 26 April 2020 Country: United Kingdom Language: English Inclusion/exclusion criteria: COVID‐19‐positive patients referred to palliative care
Participants	Age: median age 76 (IQR 71 to 84) years Gender: 98 men/88 women Ethnicity: NR Number of participants (recruited/allocated/evaluated): 186 evaluated Symptoms at baseline: dyspnea (116), agitation (82), pain (35), delirium (18), cough (15), anxiety (12), fever (11), secretions (10), nausea and vomiting (11), fatigue (6), and drowsiness (4) Comorbidities: hypertension 58 (31.2%), diabetes mellitus 52 (28%), chronic obstructive pulmonary disease 50 (26.9%), ischemic heart disease 45 (24.2%), dementia 41 (22%), chronic kidney disease 34 (18.3%), cerebrovascular disease 29 (15.6%), solid tumor—localized 28 (15.1%), congestive heart failure 19 (10.2%), myocardial infarction 17 (9.1%), connective tissue disease 13 (7%), degenerative neurological condition 9 (4.8%), hematological malignancy 8 (4.3%), solid tumor—metastatic 7 (3.8%), peptic ulcer disease 7 (3.8%), and liver disease 6 (3.2%)
Interventions	Pharmacological intervention(s); median, (range) (IQR) of drug dose in 24 hours: all opiates in sub cut morphine equivalent (n = 133) 15 mg (5 to 90) (10 to 20); morphine (n = 87) 15 mg (5 to 90) (10 to 20); oxycodone (n = 15) 10 mg (5 to 40) (8 to 17.5); alfentanil (n = 33) 900 μg (300 to 4000) (500 to 1000); midazolam (n = 125) 10 mg (2.5 to 60) (10 to 20); haloperidol (n = 4) 1.75 mg (1 to 2); hyoscine butylbromide (n = 21) 60 mg (40 to 120); levomepromazine (n = 16) 15 (100*). Mode of drug‐delivery: CSCI Non‐pharmacological intervention(s): none *IQR not reported
Outcomes	Primary review outcomes Symptom relief, assessed through clinical impression of efficacy Secondary review outcomes None reported  Additional outcomes reported Length of hospital stay Death rate
Notes	Sponsor/funding: the author(s) received no financial support for the research, authorship, and/or publication of this article. COIs: the author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Risk of bias
Bias	Authors' judgement	Support for judgement
Selection bias (unrepresentative study group) All outcomes	Low risk	Overall, data from 186 participants were captured. Clear inclusion criteria
Attrition bias (incomplete outcome assessment/follow up) All outcomes	Low risk	Reported until death or discharge
Detection bias (outcome detectors blinded to intervention) All outcomes	High risk	Not blinded
Confounding (important prognostic factors or follow‐up not taken adequately into account) All outcomes	High risk	Not adjusted for confounding factors
Reporting bias (poorly defined study group) All outcomes	Low risk	Study population well described, clear inclusion criteria.
Reporting bias (poorly defined follow up) All outcomes	High risk	Follow‐up period not defined.
Reporting bias (poorly defined outcome) All outcomes	High risk	Outcome was subjective and was not defined. Data collected retrospectively. Outcome assessment has not been validated.