Clinical Characteristics and Outcomes of COVID‐19 in a low‐prevalence, well‐resourced setting, Sydney, Australia

Shiel, Emily; Miyakis, Spiros; Tennant, Elaine; Fernando, Shelanah; Kizny‐Gordon, Alice; Koh, Bryant; Findlay, Michael; Garnham, Katherine; Pilli, Shravya; Segboer, Hayden; Tallon, Jo; Kao, Joanna; Miller, Anne; Shore, Tim; Maher, Richard; Telford, Mark; Barclay, Kate; Harris, Ben; Newcombe, James; Hudson, Bernie; Figtree, Mel

BACKGROUND: The Northern Sydney Local Health District was one of the first health regions to be affected by COVID‐19 in Australia. AIM: To describe the clinical characteristics, risk factors and outcomes in our low‐prevalence Australian population. METHODS: 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: 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 and presence of 2 or more comorbidities. Most cases acquired COVID‐19 through international (50.9%) or cruise ship travel (9.1%). Health care 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 (IQR 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 RALE score on CXR of >10 was independently associated with death. 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 2 or more comorbidities. This data can assist in early risk stratification of COVID‐19 patients, and in surge capacity planning for hospitals. This article is protected by copyright. All rights reserved.