• Rebecca Davis, Kendall Bein, Jamie Burrows, Bashir Chakar, Saartje Berendsen Russell, Owen Hutchings, Cassandra Dearing, Dianna Jagers, James Edwards, Dane Chalkley, Miranda Shaw, Lucy McKenzie, Helen Goldmith, and Michael Dinh.
• Royal Prince Alfred Virtual Hospital, Sydney, New South Wales, Australia.
• Emerg Med Australas. 2023 Feb 1; 35 (1): 344034-40.

ObjectivesThe COVID-19 Delta variant of concern continues to pose significant challenges to health systems globally, with increased transmissibility and different patient populations affected. In Sydney, a virtual model of care was implemented in response to the COVID-19 pandemic and Special Health Accommodation (SHA) was made available for community patients with COVID-19 who could not isolate at home or needed health support.MethodsThis retrospective observational cohort study of all patients with COVID-19 Delta variant in SHA during the initial phases of the Delta variant outbreak in Sydney describes the demographic and clinical characteristics of patients with Delta variant COVID-19 and determines predictors of need for in-patient hospital admission.ResultsData from 794 patients were analysed. One hundred and fifty-seven patients (19.8%) were transferred to ED. Of those, 125 were admitted to an in-patient unit (admission rate from ED 79.6%), and of these 30 (24%) went to ICU and seven were intubated. Two patients died within the follow-up period. Age >40 years, obesity, and presence of fever (temperature >37.5°C), hypoxia (oxygen saturation <95%), tachycardia or gastrointestinal symptoms on initial assessment in SHA were independent predictors of in-patient admission with an AUROC of 0.78 (95% confidence interval 0.73, 0.82).ConclusionsInitial symptoms and vital signs were just as predictive for short-term deterioration as age and pre-existing comorbidities and should be included in future risk prediction models for COVID-19. Based on this, we derive a proposed risk prediction score that incorporates these predictors with further validation required.© 2022 Australasian College for Emergency Medicine.

11 keywords...

hide…