O'Reilly, GM and Mitchell, RD and Mitra, B and Akhlaghi, H and Tran, V and Furyk, JS and Buntine, P and Wong, A and Gangathimmaiah, V and Knott, J and Moore, A and Ahn, JR and Chan, Q and Wang, A and Goh, H and Loughman, A and Lowry, N and Hackett, L and Sri-Ganeshan, M and Chapman, N and Raos, M and Noonan, MP and Smit, DV and Cameron, PA, Outcomes for emergency department patients with suspected and confirmed COVID-19: An analysis of the Australian experience in 2020 (COVED-5), EMA - Emergency Medicine Australasia, 33, (5) pp. 911-921. ISSN 1742-6731 (2021) [Refereed Article]
Objective: The aim of the present study was to describe the characteristics and outcomes of patients presenting to Australian EDs with suspected and confirmed COVID-19 during 2020, and to determine the predictors of in-hospital death for SARS-CoV-2 positive patients.
Methods: This analysis from the COVED Project presents data from 12 sites across four Australian states for the period from 1 April to 30 November 2020. All adult patients who met local criteria for suspected COVID-19 and underwent testing for SARS-CoV-2 in the ED were eligible for inclusion. Study outcomes were mechanical ventilation and in-hospital mortality.
Results: Among 24 405 eligible ED presentations over the whole study period, 423 tested positive for SARS-CoV-2. During the 'second wave' from 1 July to 30 September 2020, 26 (6%) of 406 SARS-CoV-2 patients received invasive mechanical ventilation, compared to 175 (2%) of the 9024 SARS-CoV-2 negative patients (odds ratio [OR] 3.5; 95% confidence interval [CI] 2.3-5.2, P < 0.001), and 41 (10%) SARS-CoV-2 positive patients died in hospital compared to 312 (3%) SARS-CoV-2 negative patients (OR 3.2; 95% CI 2.2-4.4, P = 0.001). For SARS-CoV-2 positive patients, the strongest independent predictors of hospital death were age (OR 1.1; 95% CI 1.1-1.1, P < 0.001), higher triage category (OR 3.5; 95% CI 1.3-9.4, P = 0.012), obesity (OR 4.2; 95% CI 1.2-14.3, P = 0.024) and receiving immunosuppressive treatment (OR 8.2; 95% CI 1.8-36.7, P = 0.006).
Conclusions: ED patients who tested positive for SARS-CoV-2 had higher odds of mechanical ventilation and death in hospital. The strongest predictors of death were age, a higher triage category, obesity and receiving immunosuppressive treatment.
|Item Type:||Refereed Article|
|Keywords:||COVID-19, emergency, isolation, quality improvement, registry|
|Research Division:||Biomedical and Clinical Sciences|
|Research Group:||Clinical sciences|
|Research Field:||Emergency medicine|
|Objective Group:||Provision of health and support services|
|Objective Field:||Urgent and critical care, and emergency medicine|
|UTAS Author:||Tran, V (Dr Viet Tran)|
|Deposited By:||Menzies Institute for Medical Research|
Repository Staff Only: item control page