Objective: To describe hospitalisation rates following COVID-19 infection in NSW. Design, setting and participants: Analysis of all confirmed COVID-19 cases diagnosed in NSW from 1 January to 31 May 2020 extracted from the NSW Notifiable Conditions Information Management System and linked to routinely collected hospitalisation data. Outcome measures: In-patient hospitalisations and hospital service utilisation details. Results: There were 3,101 COVID-19 cases diagnosed between 1 January and 31

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... ay 2020 in NSW: mean age 46.7 years, 50.5% were females. Overall, 12.5% (n = 389) had a record of inpatient hospitalisation, 4.2% (n = 130) were admitted to ICU and 1.9% (n = 58) received ventilation. Among adult cases, hospital and ICU admission rates increased with increasing age: 2.9% of those aged 20–29 years were hospitalised, increasing to 46.6% of those aged 80–89 years; 0.6% of those aged 20–29 years were admitted to ICU, increasing to 11.2% of those aged 70–79 years. The median time from symptoms to hospitalisation was seven days (IQR 4–11). The median time in hospital was nine days (IQR 4–20), and in ICU six days (IQR 2–15); the median time in hospital increased with older age. Almost half (49.4%) of those hospitalised with a diagnostic code had pneumonia/lower respiratory tract infection and another 36.6% had an upper respiratory tract infection or other known COVID-19 symptoms. Conclusion: COVID-19 is a serious infection particularly in older adults. During January to May of 2020, 1 in 8 of those diagnosed in NSW were hospitalised. While this partly reflects the cautious approach to case management in the initial phase of the pandemic, it also demonstrates the large potential impact of COVID-19 on Australian health services and need for continuing mitigation strategies.