Ect in Two Elderly Patients with Covid-19: Weighing Up Unknown Risks in Unprecedented Times

The COVID-19 pandemic has created an unprecedented situation demanding a rapid response to a barrage of unknown risks. Issues around infection control, resource allocation and treatment delivery have threatened the viability and accessibility of Electroconvulsive Therapy (ECT) services. Additionally, there are unquantified risks around the delivery and effect of ECT in patients who have had COVID-19. We discuss two cases where ECT was restarted in older-adults who had had symptomatic COVID-19. We consider the importance of clinical assessment, multi-speciality team involvement, and comprehensive risk assessment in making high stakes treatment decisions around ECT in patients with COVID-19. Although more research and international multi-speciality collaboration is required to develop evidence-based guidance, it is vital that we maintain equitable access to safe, effective and potentially life-saving ECT during this pandemic.