Emergency department adult presentations from the COVID-19 hotel quarantine program in Victoria, Australia: A retrospective cohort study of admissions and presenting complaints

Abstract

Objective: The present study aims to describe presentations to the designated ED from the Victorian COVID-19 hotel quarantine program. Methods: A retrospective cohort study was conducted between 7 December 2020 and 6 June 2021 at The Alfred Emergency and Trauma Centre, a major adult quaternary referral teaching hospital. Participants included adult patients (>18 years old) who were quarantining as part of Victoria's COVID-19 quarantine program. The primary outcome was discharge destination from the ED (admission to hospital vs discharge from ED). Results: Notably, 164 patients presented to The Alfred Emergency and Trauma Centre during the study period. The mean (SD) age was 50.9, with most patients being male (n = 96 [58.5%]). Most patients were referred from a quarantine hotel (n = 83 [50%]). Thirty-four percent (n = 56) of ED presentations were admitted to hospital (31.5% to a ward, 2.5% to intensive care unit). Forty-six percent (n = 75) were discharged to the complex care hotel to be looked after by Alfred Health, with only 16% (n = 26) being discharged to a standard quarantine hotel. The most common presenting complaint categories were: cardiovascular (n = 33 [20%]), miscellaneous (n = 25 [25%]), gastrointestinal (n = 19 [11.5%]) and mental health (n = 18 [11%]). Conclusion: The study demonstrates that the number of ED presentations from quarantine was low (<1 presentation/day). COVID Quarantine Victoria and Alfred Health put significant resources into the program to allow most returned international travellers to be safely cared for within a hotel and thus reduce the burden on the public hospital system.