Outcomes for emergency department patients with suspected and confirmed COVID‐19: An analysis of the Australian experience in 2020 (COVED‐5)

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.

Telehealth consultation before inter‐hospital transfer after falls in a subacute hospital (the PREVENT‐2 study)

“…During this time, there was a substantial burden to worldwide health systems due to the COVID-19 pandemic and telehealth was increasingly used and improved the provision of health services. 15,16…”

“…This was an observational pre‐ and post‐intervention study over a 12‐month period from 1 October 2020 to 30 September 2021. During this time, there was a substantial burden to worldwide health systems due to the COVID‐19 pandemic and telehealth was increasingly used and improved the provision of health services 15,16 …”