G M O'Reilly1,2,3, R D Mitchell1,2, B Mitra1,2,3, H Akhlaghi4,5, V Tran6,7,8, J Furyk9,10, P Buntine11,12, A Wong13,14,15, V Gangathimmaiah16, J Knott14,17, M Raos18, E Chatterton1,19,20, C Sevior1, S Parker1,21, S Baker4, A Loughman6, N Lowry9, D Freeman11, M Sri-Ganeshan13, Nicole Chapman16, S Siu18, M P Noonan1,3,22, D Smit1,2,3, P A Cameron1,2. 1. Emergency and Trauma Centre, Alfred Health, Melbourne, Australia. 2. School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia. 3. National Trauma and Research Institute, Alfred Health, Melbourne, Australia. 4. Emergency Department, St Vincent's Hospital, Melbourne, Australia. 5. Melbourne Medical School, University of Melbourne, Melbourne, Australia. 6. Emergency Department, Royal Hobart Hospital, Hobart, Australia. 7. Tasmanian School of Medicine, University of Tasmania, Hobart, Australia. 8. Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia. 9. Emergency Department, Barwon Health, Geelong, Australia. 10. School of Medicine, Deakin University, Geelong, Australia. 11. Emergency Department, Eastern Health, Melbourne, Australia. 12. Eastern Health Clinical School, Monash University, Melbourne, Australia. 13. Emergency Department, Austin Hospital, Melbourne, Australia. 14. Centre for Integrated Critical Care, University of Melbourne, Melbourne, Australia. 15. School of Clinical Sciences, Monash University, Victoria, Australia. 16. Emergency Department, Townsville University Hospital, Townsville, Australia. 17. Emergency Department, Royal Melbourne Hospital, Melbourne, Australia. 18. Emergency Department, Sutherland Hospital, Sydney, Australia. 19. School of Nursing and Midwifery, La Trobe University, Melbourne, Australia. 20. School of Nursing and Midwifery, Deakin University, Melbourne, Australia. 21. Peter MacCallum Hospital, Melbourne, Australia. 22. Trauma Service, Alfred Health, Melbourne, Australia.
Abstract
OBJECTIVE: The aim of this study was to describe the epidemiology and clinical features of patients presenting to the emergency department (ED) with suspected and confirmed COVID-19 during Australia's 'second wave'. METHODS: The COVID-19 Emergency Department (COVED) Project is an ongoing prospective cohort study in Australian EDs. This analysis presents data from twelve sites across four Australian states for the period from 1 July to 31 August 2020. All adult patients who met criteria for 'suspected COVID-19' and underwent testing for SARS-CoV-2 in the ED were eligible for inclusion. Study outcomes included a positive SARS-CoV-2 test result, mechanical ventilation and in-hospital mortality. RESULTS: There were 106,136 presentations to the participating EDs and 12,055 (11.4%; 95% CI: 11.2-11.6) underwent testing for SARS-CoV-2. Of these, 255 (2%) patients returned a positive result. Among positive cases, 13 (5%) received mechanical ventilation during their hospital admission compared to 122 (2%) of the SARS-CoV-2 negative patients (OR 2.7; 95% CI: 1.5-4.9, p=0.001). Nineteen (7%) SARS-CoV-2 positive patients died in hospital compared to 212 (3%) of the SARS-CoV-2 negative patients (OR 2.3; 95% CI: 1.4-3.7, p=0.001). Strong clinical predictors of the SARS-CoV-2 test result included self-reported fever, sore throat, bilateral infiltrates on CXR, and absence of a leucocytosis on first ED blood tests (p<0.05). CONCLUSIONS: In this prospective multi-site study during Australia's 'second wave', a substantial proportion of ED presentations required SARS-CoV-2 testing and isolation. Presence of SARS-CoV-2 on nasopharyngeal swab was associated with an increase in the odds of death and mechanical ventilation in hospital. This article is protected by copyright. All rights reserved.
OBJECTIVE: The aim of this study was to describe the epidemiology and clinical features of patients presenting to the emergency department (ED) with suspected and confirmed COVID-19 during Australia's 'second wave'. METHODS: The COVID-19 Emergency Department (COVED) Project is an ongoing prospective cohort study in Australian EDs. This analysis presents data from twelve sites across four Australian states for the period from 1 July to 31 August 2020. All adult patients who met criteria for 'suspected COVID-19' and underwent testing for SARS-CoV-2 in the ED were eligible for inclusion. Study outcomes included a positive SARS-CoV-2 test result, mechanical ventilation and in-hospital mortality. RESULTS: There were 106,136 presentations to the participating EDs and 12,055 (11.4%; 95% CI: 11.2-11.6) underwent testing for SARS-CoV-2. Of these, 255 (2%) patients returned a positive result. Among positive cases, 13 (5%) received mechanical ventilation during their hospital admission compared to 122 (2%) of the SARS-CoV-2 negative patients (OR 2.7; 95% CI: 1.5-4.9, p=0.001). Nineteen (7%) SARS-CoV-2 positive patients died in hospital compared to 212 (3%) of the SARS-CoV-2 negative patients (OR 2.3; 95% CI: 1.4-3.7, p=0.001). Strong clinical predictors of the SARS-CoV-2 test result included self-reported fever, sore throat, bilateral infiltrates on CXR, and absence of a leucocytosis on first ED blood tests (p<0.05). CONCLUSIONS: In this prospective multi-site study during Australia's 'second wave', a substantial proportion of ED presentations required SARS-CoV-2 testing and isolation. Presence of SARS-CoV-2 on nasopharyngeal swab was associated with an increase in the odds of death and mechanical ventilation in hospital. This article is protected by copyright. All rights reserved.
Authors: Peter Del Mar; Min Joung Kim; Nathan J Brown; Joon Min Park; Kevin Chu; John Burke Journal: Emerg Med Australas Date: 2022-08-23 Impact factor: 2.279
Authors: Paul Buntine; Emogene S Aldridge; Simon Craig; Dianne Crellin; Julian Stella; Stephen D Gill; Breanna Wright; Rob D Mitchell; Glenn Arendts; Helen Rawson; Amanda M Rojek Journal: Emerg Med Australas Date: 2022-05-27 Impact factor: 2.279
Authors: Gerard M O'Reilly; Rob D Mitchell; Biswadev Mitra; Hamed Akhlaghi; Viet Tran; Jeremy S Furyk; Paul Buntine; Anselm Wong; Vinay Gangathimmaiah; Jonathan Knott; Allison Moore; Jung Ro Ahn; Quillan Chan; Andrew Wang; Han Goh; Ashley Loughman; Nicole Lowry; Liam Hackett; Muhuntha Sri-Ganeshan; Nicole Chapman; Maximilian Raos; Michael P Noonan; De Villiers Smit; Peter A Cameron Journal: Emerg Med Australas Date: 2021-08-13 Impact factor: 2.279