Study captures first national picture of COVID-19 patients in Intensive Care Units

Researchers at the School of Public Health and Preventive Medicine have captured the first national snap shot of COVID-19 patients admitted to ICUs around the country since the outbreak hit Australian shores on March 14th. To date, at least 103 patients have been admitted to intensive care units in Australia with either confirmed or strongly suspected COVID-19, while at least 46 more ICU patients await test results. Men were twice as likely to be admitted to ICU than women (67% vs 31%), and people over 60 make up over 69% of admissions.

The data is being collected as part of the Monash University-led SPRINT-SARI Australia study – a major international collaboration with the University of Oxford, and endorsed by the WHO. The study is being administered by the team at the Australian and New Zealand Intensive Care Research Centre (ANZIC-RC). It provides imperative insights into the ability of Australia’s health system to cope with a pandemic – measured in part by the ability of hospital ICU’s to respond to the sickest patients. It also provides a benchmark for global comparison.

Over 76 ICUs are participating in the study nationally, and have recorded 149 ICU admissions as of May 7th. Of those admissions, 85 tested positive to COVID‐19 (57 males, 27 females), 18 were strongly suspected but returned a negative swab test, and 46 with suspected COVID-19 were still awaiting test results. Patients admitted to ICU with COVID-19 symptoms ranged from 39 to 85 years, however the majority of cases occurred in those aged over 60 (69%), with 41% occurring in the 70-79 age group.

Of the 85 confirmed COVID‐19 patients, 12 have died, 31 were discharged home, three were transferred to another hospital/facility, 20 remain in hospital ward care and 19 in ongoing ICU care.

The most common symptoms at time of admission to hospital included fever, cough, shortness of breath, fatigue/malaise and diarrhoea.

Men were twice as likely to be admitted to ICU than women, and patients with comorbidities such as diabetes, chronic cardiac disease and obesity were much more likely to be admitted.

Treatments used in the ICU to stabilise patients and support their recovery included antibiotics, invasive (tube) ventilation, medications to support blood pressure and the heart, high‐flow nasal canula oxygen therapy, and neuromuscular blocking agents, which turn off the body’s muscles to allow mechanical ventilation.

The project, led by Dr Aidan Burrell and Professor Andrew Udy of ANZIC‐RC, is also contributing the data to the University of Oxford, that is managing the global SPRINT-SARI database.

“This is the first time we have data outlining the number of COVID-19 patients requiring ICU, the duration of their care, the type of treatments they’re receiving, and the number that are surviving,” said Professor Udy, Co-Deputy Director of ANZIC-RC and an intensive care clinician and researcher at The Alfred ICU.

“From a broad national perspective, this data gives us important insights into the type of therapy, care, and medical intervention our sickest COVID-19 patients need. It means we can inform clinicians and improve the therapies provided, as well as appraise resourcing, particularly if we experience a sudden spike in cases over the coming months. The ability of our health system to cope with a pandemic may be measured in part by the ability of ICU to respond to the sickest patients.

“We’ve never seen this infectious disease before and as a consequence, a lot of the traditional ways that we manage a patient are being challenged. There are complications that can arise as a consequence of the disease, particularly in younger patients. This helps us to individualise therapy, and nuance the care that’s provided to ensure the best possible patient outcomes.”

To date, state and territory health authorities have reported 6,948 confirmed cases of COVID-19 in Australia, including 97 deaths.

“The COVID-19 viral pandemic may represent an unprecedented challenge to intensive care services throughout Australia and New Zealand. We are fortunate to have world class intensive care services, with a highly trained and professional workforce who are ready and able to serve their communities at this time,” Dr Burrell said.

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