Clinical characteristics and outcomes of COVID-19 in a low-prevalence, well resourced setting, Sydney, Australia.
Australia
COVID-19
Virtual Hospital risk stratification
low-prevalence
Journal
Internal medicine journal
ISSN: 1445-5994
Titre abrégé: Intern Med J
Pays: Australia
ID NLM: 101092952
Informations de publication
Date de publication:
Oct 2021
Oct 2021
Historique:
revised:
21
06
2021
received:
27
02
2021
accepted:
22
06
2021
pubmed:
7
7
2021
medline:
26
10
2021
entrez:
6
7
2021
Statut:
ppublish
Résumé
The Northern Sydney Local Health District was one of the first health regions to be affected by COVID-19 in Australia. To describe the clinical characteristics, risk factors and outcomes in our low-prevalence Australian population. This is a retrospective analysis of 517 laboratory-confirmed COVID-19 cases between January and June 2020. Patient information was collected as part of routine care within the COVID-19 Virtual Hospital system. Outcomes examined were death, recovery at 30 days and intensive care unit (ICU) admission. The case fatality rate was 1.8%. Multivariate analysis showed factors independently associated with death, composite outcome of death/ICU admission or incomplete recovery at 30 days were age >80 years and presence of two or more comorbidities. Most cases acquired COVID-19 through international (50.9%) or cruise ship travel (9.1%). Healthcare workers comprised 12.8% of the cohort and represented a disproportionately high percentage of the 'unknown' source group (27.6%). The median incubation period was 5 days (interquartile range 3-8); one patient had an incubation period of 15 days. Hospitalisation was required in 11.8%, ICU admission in 2.1% and ventilation in 1.4%. A Radiographic Assessment of Lung Oedema score on chest X-ray of >10 was independently associated with death. In this low prevalence, well resourced Australian setting, we report an overall low mortality. Factors associated with adverse patient outcomes on multivariate analysis were age greater than 80 and the presence of two or more comorbidities. These data can assist in early risk stratification of COVID-19 patients, and in surge capacity planning for hospitals.
Sections du résumé
BACKGROUND
BACKGROUND
The Northern Sydney Local Health District was one of the first health regions to be affected by COVID-19 in Australia.
AIMS
OBJECTIVE
To describe the clinical characteristics, risk factors and outcomes in our low-prevalence Australian population.
METHODS
METHODS
This is a retrospective analysis of 517 laboratory-confirmed COVID-19 cases between January and June 2020. Patient information was collected as part of routine care within the COVID-19 Virtual Hospital system. Outcomes examined were death, recovery at 30 days and intensive care unit (ICU) admission.
RESULTS
RESULTS
The case fatality rate was 1.8%. Multivariate analysis showed factors independently associated with death, composite outcome of death/ICU admission or incomplete recovery at 30 days were age >80 years and presence of two or more comorbidities. Most cases acquired COVID-19 through international (50.9%) or cruise ship travel (9.1%). Healthcare workers comprised 12.8% of the cohort and represented a disproportionately high percentage of the 'unknown' source group (27.6%). The median incubation period was 5 days (interquartile range 3-8); one patient had an incubation period of 15 days. Hospitalisation was required in 11.8%, ICU admission in 2.1% and ventilation in 1.4%. A Radiographic Assessment of Lung Oedema score on chest X-ray of >10 was independently associated with death.
CONCLUSIONS
CONCLUSIONS
In this low prevalence, well resourced Australian setting, we report an overall low mortality. Factors associated with adverse patient outcomes on multivariate analysis were age greater than 80 and the presence of two or more comorbidities. These data can assist in early risk stratification of COVID-19 patients, and in surge capacity planning for hospitals.
Identifiants
pubmed: 34228387
doi: 10.1111/imj.15445
pmc: PMC8447053
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1605-1613Informations de copyright
© 2021 Royal Australasian College of Physicians.
Références
Intern Med J. 2020 Oct;50(10):1271-1273
pubmed: 32945610
Radiol Med. 2020 Aug;125(8):730-737
pubmed: 32519256
Intern Med J. 2020 Sep;50(9):1146-1150
pubmed: 32761863
Intern Med J. 2021 Mar;51(3):334-340
pubmed: 33629801
N Engl J Med. 2020 Jun 11;382(24):2372-2374
pubmed: 32302078
Med J Aust. 2021 Jan;214(1):23-30
pubmed: 33325070
J Med Internet Res. 2021 Mar 9;23(3):e21064
pubmed: 33687341
Int J Infect Dis. 2021 Jan;102:32-36
pubmed: 33039607
Clin Microbiol Infect. 2021 Jan;27(1):19-27
pubmed: 32860962
J Med Virol. 2020 Oct;92(10):1902-1914
pubmed: 32293716
BMJ. 2020 May 22;369:m1985
pubmed: 32444460
Intern Med J. 2021 Feb;51(2):189-198
pubmed: 33631864
BMJ Open. 2020 Aug 16;10(8):e039652
pubmed: 32801208
N Engl J Med. 2021 Feb 25;384(8):693-704
pubmed: 32678530
Med Mal Infect. 2020 Aug;50(5):436-439
pubmed: 32305563
J Gen Intern Med. 2020 May;35(5):1545-1549
pubmed: 32133578
N Engl J Med. 2020 Apr 30;382(18):1708-1720
pubmed: 32109013
Med J Aust. 2021 Apr;214(7):332-332.e1
pubmed: 33713455
JAMA. 2020 May 26;323(20):2052-2059
pubmed: 32320003
Lancet. 2020 Mar 28;395(10229):1054-1062
pubmed: 32171076