An Australian COVID‐19 respiratory care unit experience

• Published in: Internal medicine journal Vol. 53; no. 7; pp. 1115 - 1120
• Main Authors: Ward‐Ambler, Emily, Wallbridge, Peter, Singh, Kasha, Miller, Alistair, Irving, Louis B., Manser, Renee, Goldin, Jeremy, Hii, Su, Hammerschlag, Gary, Rees, Megan
• Format: Journal Article
• Language: English
• Published: Melbourne John Wiley & Sons Australia, Ltd 01.07.2023; Wiley Subscription Services, Inc
• Subjects: Age; Aged; Asymptomatic infection; Australia - epidemiology; Child, Preschool; Comorbidity; continuous positive airway pressure; Coronaviruses; COVID-19; COVID-19 - therapy; Feasibility studies; Female; Hospitals; Humans; Infectious diseases; Intensive Care Units; Intubation; Lung diseases; Male; Mechanical ventilation; Medical treatment; Mortality; non‐invasive ventilation; Obstructive lung disease; Patients; Pneumonitis; Respiratory Care Units; Retrospective Studies; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; Australia; COVID-19; SARS-CoV-2; non-invasive ventilation; continuous positive airway pressure
• ISSN: 1444-0903; 1445-5994
• DOI: 10.1111/imj.16125

Background Coronavirus disease (COVID‐19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) with a heterogeneous presentation ranging from severe pneumonitis to asymptomatic infection. International studies have demonstrated the utility of respiratory care units (RCUs) to facilitate the delivery of non‐invasive ventilation techniques to patients with COVID‐19 pneumonitis. Aims This study aims to describe the patient characteristics, flow and outcomes of admissions to the Royal Melbourne Hospital (RMH) COVID‐19 RCU (CRCU) during its initial period of operation. Methods Single‐centre retrospective cohort study, all patients admitted to CRCU between 17 September and 10 December 2021 were included in this study. Patient demographics, including comorbidities and limitations of medical treatment, were analysed. Admission source and discharge destination were reviewed. Length of stay was recorded. Finally, in‐hospital and CRCU mortality were analysed. Results Ninety‐seven patients, comprising 111 admissions, occurred during the study period with median age of 65 years (48% female). Most patients were admitted from and discharged to the ward. Twenty patients died in hospital (21%), with age, 4C score, comorbidity and presence of obstructive lung disease predicting mortality (area under the curve (AUC) 0.85, P < 0.001). Mortality was significantly higher in those over 65 years of age compared to those under 65 (P < 0.001), or those deemed not for intubation compared to those for intubation (P = 0.0019). Conclusions This study demonstrates the feasibility of operating a CRCU within an Australian tertiary healthcare setting.