Respiratory failure, clinical course and community management of COVID-19 patients in a large Australian cohort.

Background: Coronavirus disease 2019 (COVID-19) has wreaked health and economic damage globally. A thorough understanding of the characteristics of COVID-19 patients in Australia plus the strategies that successfully 'flatten the curve' are vitally important to contain this pandemic.

Aim: To describe the clinical characteristics and outcomes of COVID-19 patients in the Sutherland Shire, and the management model adopted to manage these patients.

Methods: A retrospective case series of COVID-19 patients monitored in the Sutherland Shire between 19 March and 15 May 2020 was performed. Demographic, clinical and outcome data of COVID-19 inpatients at the Sutherland Hospital and demographic data of COVID-19 patients in the Sutherland Shire community were obtained. The Sutherland Hospital COVID-19 Management Model involved close collaboration among the Sutherland Fever Clinic, Sutherland COVID-19 community telemonitoring team (CTAC) and Sutherland COVID-19 inpatient team.

Results: Ninety-nine COVID-19 cases (median age, 49 years, 50 (51%) male) were monitored in Sutherland Shire, with 19 cases (median age, 54 years, 10 (53%) male) requiring inpatient management. Common comorbidities included obesity, asthma, hypertension and Type 2 diabetes mellitus. Six (32%) patients required supplemental oxygen and three (16%) patients required intensive care admission. There was one mortality. The CTAC team identified five (5%) patients requiring admission, and three (3%) patients requiring re-admission. The majority of COVID-19 source was from overseas travel (67%), with nine (9%) cases having unknown source.

Conclusion: A comprehensive COVID-19 management model is needed to successfully manage COVID-19 patients in both outpatient and inpatient settings in order to 'squash the curve'.