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Outcomes for emergency department patients with suspected and confirmed COVID-19: An analysis of the Australian experience in 2020 (COVED-5).
O'Reilly, Gerard M; Mitchell, Rob D; Mitra, Biswadev; Akhlaghi, Hamed; Tran, Viet; Furyk, Jeremy S; Buntine, Paul; Wong, Anselm; Gangathimmaiah, Vinay; Knott, Jonathan; Moore, Allison; Ahn, Jung Ro; Chan, Quillan; Wang, Andrew; Goh, Han; Loughman, Ashley; Lowry, Nicole; Hackett, Liam; Sri-Ganeshan, Muhuntha; Chapman, Nicole; Raos, Maximilian; Noonan, Michael P; Smit, De Villiers; Cameron, Peter A.
  • O'Reilly GM; Emergency and Trauma Centre, Alfred Health, Melbourne, Victoria, Australia.
  • Mitchell RD; School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
  • Mitra B; National Trauma Research Institute, Alfred Health, Melbourne, Victoria, Australia.
  • Akhlaghi H; Emergency and Trauma Centre, Alfred Health, Melbourne, Victoria, Australia.
  • Tran V; School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
  • Furyk JS; Emergency and Trauma Centre, Alfred Health, Melbourne, Victoria, Australia.
  • Buntine P; School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
  • Wong A; National Trauma Research Institute, Alfred Health, Melbourne, Victoria, Australia.
  • Gangathimmaiah V; Emergency Department, St Vincent's Hospital, Melbourne, Victoria, Australia.
  • Knott J; Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia.
  • Moore A; Emergency Department, Royal Hobart Hospital, Hobart, Tasmania, Australia.
  • Ahn JR; Tasmanian School of Medicine, University of Tasmania, Hobart, Tasmania, Australia.
  • Chan Q; Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.
  • Wang A; Emergency Department, Barwon Health, Geelong, Victoria, Australia.
  • Goh H; School of Medicine, Deakin University, Geelong, Victoria, Australia.
  • Loughman A; Emergency Department, Eastern Health, Melbourne, Victoria, Australia.
  • Lowry N; Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia.
  • Hackett L; Emergency Department, Austin Hospital, Melbourne, Victoria, Australia.
  • Sri-Ganeshan M; Department of Critical Care, The University of Melbourne, Melbourne, Victoria, Australia.
  • Chapman N; School of Clinical Sciences, Monash University, Melbourne, Victoria, Australia.
  • Raos M; Emergency Department, Townsville University Hospital, Townsville, Queensland, Australia.
  • Noonan MP; Department of Critical Care, The University of Melbourne, Melbourne, Victoria, Australia.
  • Smit V; Emergency Department, The Royal Melbourne Hospital, Melbourne, Victoria, Australia.
  • Cameron PA; Emergency Department, Sutherland Hospital, Sydney, New South Wales, Australia.
Emerg Med Australas ; 33(5): 911-921, 2021 10.
Article in English | MEDLINE | ID: covidwho-1324954
ABSTRACT

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.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Observational study / Prognostic study Limits: Adult / Humans Country/Region as subject: Oceania Language: English Journal: Emerg Med Australas Journal subject: Emergency Medicine Year: 2021 Document Type: Article Affiliation country: 1742-6723.13837

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Observational study / Prognostic study Limits: Adult / Humans Country/Region as subject: Oceania Language: English Journal: Emerg Med Australas Journal subject: Emergency Medicine Year: 2021 Document Type: Article Affiliation country: 1742-6723.13837