COVID-19 in Australia: our national response to the first cases of SARS-CoV-2 infection during the early biocontainment phase

Abstract

Background: On 31 December 2019, the World Health Organization recognised clusters of pneumonia-like cases due to a novel coronavirus disease (COVID-19). COVID-19 became a pandemic 71 days later.

Aim: To report the clinical and epidemiological features, laboratory data and outcomes of the first group of 11 returned travellers with COVID-19 in Australia.

Methods: This is a retrospective, multi-centre case series. All patients with confirmed COVID-19 infection were admitted to tertiary referral hospitals in New South Wales, Queensland, Victoria and South Australia.

Results: The median age of the patient cohort was 42 years (interquartile range (IQR), 24-53 years) with six men and five women. Eight (72.7%) patients had returned from Wuhan, one from Shenzhen, one from Japan and one from Europe. Possible human-to-human transmission from close family contacts in gatherings overseas occurred in two cases. Symptoms on admission were fever, cough and sore throat (n = 9, 81.8%). Co-morbidities included hypertension (n = 3, 27.3%) and hypercholesterolaemia (n = 2, 18.2%). No patients developed severe acute respiratory distress nor required intensive care unit admission or mechanical ventilation. After a median hospital stay of 14.5 days (IQR, 6.75-21), all patients were discharged.

Conclusions: This is a historical record of the first COVID-19 cases in Australia during the early biocontainment phase of the national response. These findings were invaluable for establishing early inpatient and outpatient COVID-19 models of care and informing the management of COVID-19 over time as the outbreak evolved. Future research should extend this Australian case series to examine global epidemiological variation of this novel infection.

Keywords: COVID-19; SARS-CoV-2; clinical characteristics; models of care; pandemic.

Figure 1

Chest radiographs and computed tomography (CT) images of the two patients from Victoria (VIC‐5 and VIC‐6) with COVID‐19. (A): (i) Chest radiograph on admission demonstrating subtle ill‐defined opacities within the mid zones bilaterally and left lower zone; (ii) Day 4 chest CT (coronal maximum intensity projection, MIP); and (iii) Day 4 chest CT axial demonstrating extensive ground‐glass opacities in a peribronchovascular and peripheral distribution favouring mid to upper zones of the lungs. (B): (i) Chest radiograph on Day 6 demonstrating patchy opacity within the lateral aspect of the right upper lobe; (ii) Day 11 chest CT (coronal MIP); and (iii) Day 11 chest CT axial images demonstrating bilateral peripheral upper zone predominant ground‐glass opacities (more on the right).