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Title: Outcomes for emergency department patients with suspected and confirmed COVID-19: An analysis of the Australian experience in 2020 (COVED-5).
Austin Authors: O'Reilly, G M;Mitchell, R D;Mitra, B;Akhlaghi, H;Tran, V;Buntine, P;Wong, Anselm Y ;Gangathimmaiah, V;Knott, J;Moore, A;Ahn, J;Chan, Q;Wang, A;Goh, H;Loughman, A;Lowry, N;Hackett, L;Sri-Ganeshan, Muhuntha ;Chapman, N;Raos, M;Noonan, M P;Smit, D;Cameron, P A
Affiliation: Trauma Service, Alfred Health, Melbourne, Australia
School of Clinical Sciences at Monash Health, Monash University, Victoria, Australia
Emergency Department, Townsville University Hospital, Townsville, Australia
Emergency Department, Royal Melbourne Hospital, Melbourne, Australia
Emergency Department, Sutherland Hospital, Sydney, Australia
Central Clinical School, Monash University, Melbourne, Australia
Emergency and Trauma Centre, Alfred Health, Melbourne, Australia
School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
National Trauma and Research Institute, Alfred Health, Melbourne, Australia
Emergency Department,, St Vincent's Hospital, Melbourne, Australia
Melbourne Medical School, University of Melbourne, Melbourne, Australia
Emergency Department, Royal Hobart Hospital, Hobart, Australia
Tasmanian School of Medicine, University of Tasmania, Hobart, Australia
Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
Emergency Department, Barwon Health, Geelong, Australia
School of Medicine, Deakin University, Geelong, Australia
Emergency Department, Eastern Health, Melbourne, Australia
Eastern Health Clinical School, Monash University, Melbourne, Australia
Department of Critical Care, University of Melbourne, Melbourne, Australia
Issue Date: Oct-2021
Date: 2021-07-27
Publication information: Emergency Medicine Australasia : EMA 2021; 33(5): 911-921e
Abstract: The aim of this study was to describe the characteristics and outcomes of patients presenting to Australian emergency departments (EDs) with suspected and confirmed COVID-19 during 2020, and to determine the predictors of in-hospital death for SARS-CoV-2 positive patients. This analysis from the COVED Project presents data from twelve 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. 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 9,024 SARS-CoV-2 negative patients (OR 3.5; 95% 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). 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. This article is protected by copyright. All rights reserved.
DOI: 10.1111/1742-6723.13837
ORCID: 0000-0002-1443-557X
Journal: Emergency Medicine Australasia : EMA
PubMed URL: 34312991
Type: Journal Article
Subjects: COVID-19
quality improvement
Appears in Collections:Journal articles

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