• 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, SmitDe VilliersVEmergency and Trauma Centre, Alfred Health, Melbourne, Victoria, Australia.School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.National Trauma Research Institute, Alfred Health, Melbourne, Vic, Peter A Cameron, and COVED Project Team.
• Emergency and Trauma Centre, Alfred Health, Melbourne, Victoria, Australia.
• Emerg Med Australas. 2021 Oct 1; 33 (5): 911-921.

ObjectiveThe 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.MethodsThis 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.ResultsAmong 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).ConclusionsED 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.© 2021 Australasian College for Emergency Medicine.

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