1
|
Ngiam JN, Liong TS, Poh KK. Response to comments on: Silent hypoxia: pulse oximetry and its relation to COVID-19 in Singapore. Singapore Med J 2023; 64:476. [PMID: 37459002 PMCID: PMC10395804 DOI: 10.4103/singaporemedj.smj-2023-112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 05/26/2023] [Indexed: 07/20/2023]
Affiliation(s)
- Jinghao Nicholas Ngiam
- Division of Infectious Diseases, Department of Medicine, National University Health System, Singapore
| | - Tze Sian Liong
- Department of Medicine, National University Health System, Singapore
| | - Kian Keong Poh
- Department of Cardiology, National University Heart Centre Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore E-mail:
| |
Collapse
|
2
|
Ngiam JN, Chew NWS, Sia CH, Kong WKF, Poh KK. Silent hypoxia: pulse oximetry and its relation to COVID-19 in Singapore. Singapore Med J 2023; 64:222-225. [PMID: 34581542 PMCID: PMC10144454 DOI: 10.11622/smedj.2021134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 09/20/2021] [Indexed: 11/18/2022]
Affiliation(s)
- Jinghao Nicholas Ngiam
- Division of Infectious Diseases, Department of Medicine, National University Health System, Singapore
| | | | - Ching-Hui Sia
- Department of Cardiology, National University Heart Centre Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | - Kian Keong Poh
- Department of Cardiology, National University Heart Centre Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| |
Collapse
|
3
|
Chew NW, Ngiam JN, Tham SM, Lim ZY, Li TYW, Cen S, Yap ES, Tambyah PA, Santosa A, Cross GB, Sia CH. Fever as a predictor of adverse outcomes in COVID-19. QJM 2021; 114:706-714. [PMID: 33533902 PMCID: PMC7928573 DOI: 10.1093/qjmed/hcab023] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 01/22/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND/INTRODUCTION There are little data on outcomes of COVID-19 patients with the presence of fever compared to the presence of symptoms. AIM We examined the associations between symptomology, presence of fever and outcomes of a COVID-19 cohort. DESIGN AND METHODS Between 23 January and 30 April 2020, 554 COVID-19 patients were admitted to a tertiary hospital in Singapore. They were allocated into four groups based on symptomology and fever-Group 1: asymptomatic and afebrile, Group 2: symptomatic but afebrile, Group 3: febrile but asymptomatic and Group 4: symptomatic and febrile. The primary outcomes were intensive care unit (ICU) admissions and mortality. The composite end-point included ICU admissions, mortality or any COVID-19 related end-organ involvement. RESULTS There were differences in ferritin (P=0.003), C-reactive protein (CRP) levels (P<0.001) and lymphopenia (P=0.033) across all groups, with the most favourable biochemical profile in Group 1, and the least in Group 4. Symptomatic groups (Groups 2 and 4) had higher ICU admissions (1.9% and 6.0%, respectively, P=0.003) than asymptomatic groups (Groups 1 and 3). Composite end-point was highest in Group 4 (24.0%), followed by Group 3 (8.6%), Group 2 (4.8%) and Group 1 (2.4%) (P<0.001). The presence of fever (OR 4.096, 95% CI 1.737-9.656, P=0.001) was associated with the composite end-point after adjusting for age, pulse rate, comorbidities, lymphocyte, ferritin and CRP. Presence of symptoms was not associated with the composite end-point. DISCUSSION/CONCLUSION In this COVID-19 cohort, presence of fever was a predictor of adverse outcomes. This has implications on the management of febrile but asymptomatic COVID-19 patients.
Collapse
Affiliation(s)
- N W Chew
- Department of Cardiology, National University Heart Centre Singapore, Singapore
- Address correspondence to Dr C.-H. Sia, c/o Department of Cardiology, National University Heart Centre Singapore, 1E Kent Ridge Rd, NUHS Tower Block, Level 9, Singapore 119228.
| | - J N Ngiam
- Department of Medicine, National University Health System, Singapore
| | - S M Tham
- Division of Infectious Diseases, University Medicine Cluster, National University Health System, 1E Kent Ridge Rd, NUHS Tower Block, Level 10, Singapore 119228, Singapore
| | - Z Y Lim
- Department of Medicine, National University Health System, Singapore
| | - T Y W Li
- Department of Medicine, National University Health System, Singapore
| | - S Cen
- Department of Medicine, National University Health System, Singapore
| | - E S Yap
- Department of Haematology, National Cancer Institute Singapore, National University Health System, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - P A Tambyah
- Division of Infectious Diseases, University Medicine Cluster, National University Health System, 1E Kent Ridge Rd, NUHS Tower Block, Level 10, Singapore 119228, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - A Santosa
- Division of Rheumatology, University Medicine Cluster, National University Health System, 1E Kent Ridge Rd, NUHS Tower Block, Level 10, Singapore 119228, Singapore
| | - G B Cross
- Division of Infectious Diseases, University Medicine Cluster, National University Health System, 1E Kent Ridge Rd, NUHS Tower Block, Level 10, Singapore 119228, Singapore
| | - C -H Sia
- Department of Cardiology, National University Heart Centre Singapore, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| |
Collapse
|
4
|
Anand SV, Shuy YK, Lee PSS, Lee ES. One Year on: An Overview of Singapore's Response to COVID-19-What We Did, How We Fared, How We Can Move Forward. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179125. [PMID: 34501718 PMCID: PMC8431401 DOI: 10.3390/ijerph18179125] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 07/30/2021] [Accepted: 08/20/2021] [Indexed: 01/28/2023]
Abstract
Background—One year has passed since the first COVID-19 case in Singapore. This scoping review commemorates Singaporean researchers that have expanded the knowledge on this novel virus. We aim to provide an overview of healthcare-related articles published in peer-reviewed journals, authored by the Singapore research community about COVID-19 during the first year of the pandemic. Methods—This was reported using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) protocol. It included healthcare-related articles about COVID-19 published between 23 January 2020 and 22 January 2021 with a Singapore-affiliated author. MEDLINE, Embase, Scopus, Web of Science, CINAHL, PsycINFO, Google Scholar, and local journals were searched. The articles were screened independently by two reviewers. Results—The review included 504 articles. Most of the articles narrated the changes to hospital practice (210), while articles on COVID-19 pathology (94) formed most of the non-narrative papers. Publications on public health (61) and the indirect impacts to clinical outcomes (45) were other major themes explored by the research community. The remaining articles detailed the psychological impact of the pandemic (35), adaptations of medical education (30), and narratives of events (14). Conclusion—Amidst a resurgence of community cases involving variant COVID-19 strains, the resources from the research community will provide valuable guidance to navigate these uncertain times.
Collapse
Affiliation(s)
- S Vivek Anand
- Ministry of Health Holdings, Singapore 099253, Singapore;
| | - Yao Kang Shuy
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308207, Singapore;
| | - Poay Sian Sabrina Lee
- Clinical Research Unit, National Healthcare Group Polyclinics, Singapore 138543, Singapore;
| | - Eng Sing Lee
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308207, Singapore;
- Clinical Research Unit, National Healthcare Group Polyclinics, Singapore 138543, Singapore;
- Correspondence:
| |
Collapse
|
5
|
Li TYW, Ngiam JN, Chew NWS, Tham SM, Lim ZY, Cen S, Lim SL, Cherian R, Wong RCC, Chai P, Yeo TC, Tambyah PA, Santosa A, Cross GB, Sia CH. Low incidence of cardiac complications from COVID-19 and its treatment among hospitalised patients in Singapore. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2021; 50:490-493. [PMID: 34195758 DOI: 10.47102/annals-acadmedsg.202122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Affiliation(s)
- Tony Yi Wei Li
- Department of Cardiology, National University Heart Centre Singapore, Singapore
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
6
|
Ngiam JN, Chew N, Tham SM, Beh DLL, Lim ZY, Li TYW, Cen S, Tambyah PA, Santosa A, Sia CH, Cross GB. Demographic shift in COVID-19 patients in Singapore from an aged, at-risk population to young migrant workers with reduced risk of severe disease. Int J Infect Dis 2020; 103:329-335. [PMID: 33220440 PMCID: PMC7674985 DOI: 10.1016/j.ijid.2020.11.157] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 11/10/2020] [Accepted: 11/11/2020] [Indexed: 12/21/2022] Open
Abstract
Objectives The vast majority of COVID-19 cases in Singapore have occurred amongst migrant workers. This paper examined trends in the hospitalised cases and tested the assumption that the low severity of disease was related to the relatively young affected population. Methods All patients with PCR-positive SARS-CoV-2 admitted from February to April 2020 were divided into: (i) imported cases, (ii) locally-transmitted cases outside migrant worker dormitories and (iii) migrant worker dormitory cases. They were examined for underlying comorbidities, clinical progress and outcomes. Results Imported cases (n = 29) peaked in mid-March 2020, followed by local cases (n = 100) in mid-April 2020; migrant worker cases (n = 425) continued to increase in late April 2020. Migrant worker cases were younger, had few medical comorbidities and less severe disease. As the migrant worker cases increased, the proportion of patients with pneumonia decreased, whilst patients presenting earlier in their illness and asymptomatic disease became more common. Conclusion Singapore experienced a substantial shift in the population at risk of severe COVID-19. Successful control in the community protected an aging population. Large migrant worker dormitory outbreaks occurred, but the disease incurred was less severe, resulting in Singapore having one of the lowest case fatality rates in the world.
Collapse
Affiliation(s)
| | - Nicholas Chew
- Department of Cardiology, National University Heart Centre Singapore, Singapore
| | - Sai Meng Tham
- Division of Infectious Diseases, National University Health System, Singapore
| | | | - Zhen Yu Lim
- Department of Medicine, National University Health System, Singapore
| | - Tony Y W Li
- Department of Medicine, National University Health System, Singapore
| | - Shuyun Cen
- Department of Cardiology, National University Heart Centre Singapore, Singapore
| | - Paul Anantharajah Tambyah
- Division of Infectious Diseases, National University Health System, Singapore; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Amelia Santosa
- Division of Rheumatology, National University Health System, Singapore
| | - Ching-Hui Sia
- Department of Cardiology, National University Heart Centre Singapore, Singapore; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Gail Brenda Cross
- Division of Infectious Diseases, National University Health System, Singapore; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| |
Collapse
|
7
|
Ngiam JN, Tham SM, Vasoo S, Poh KK. COVID-19: local lessons from a global pandemic. Singapore Med J 2020; 61:341-342. [PMID: 32588583 DOI: 10.11622/smedj.2020097] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
| | - Sai Meng Tham
- Department of Infectious Diseases, National University Health System, Singapore
| | - Shawn Vasoo
- National Centre for Infectious Diseases, Singapore.,Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Kian Keong Poh
- Department of Cardiology, National University Heart Centre Singapore, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| |
Collapse
|