Clinical features and predictors of severity in COVID-19 patients with critical illness in Singapore
Abstract We aim to describe a case series of critically and non-critically ill COVID-19 patients in Singapore. This was a multicentered prospective study with clinical and laboratory details. Details for fifty uncomplicated COVID-19 patients and ten who required mechanical ventilation were collected...
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Nature Portfolio
2021
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oai:doaj.org-article:197fe4e9f596426bbbdff6f343b38abf2021-12-02T14:37:46ZClinical features and predictors of severity in COVID-19 patients with critical illness in Singapore10.1038/s41598-021-81377-32045-2322https://doaj.org/article/197fe4e9f596426bbbdff6f343b38abf2021-04-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-81377-3https://doaj.org/toc/2045-2322Abstract We aim to describe a case series of critically and non-critically ill COVID-19 patients in Singapore. This was a multicentered prospective study with clinical and laboratory details. Details for fifty uncomplicated COVID-19 patients and ten who required mechanical ventilation were collected. We compared clinical features between the groups, assessed predictors of intubation, and described ventilatory management in ICU patients. Ventilated patients were significantly older, reported more dyspnea, had elevated C-reactive protein and lactate dehydrogenase. A multivariable logistic regression model identified respiratory rate (aOR 2.83, 95% CI 1.24–6.47) and neutrophil count (aOR 2.39, 95% CI 1.34–4.26) on admission as independent predictors of intubation with area under receiver operating characteristic curve of 0.928 (95% CI 0.828–0.979). Median APACHE II score was 19 (IQR 17–22) and PaO2/FiO2 ratio before intubation was 104 (IQR 89–129). Median peak FiO2 was 0.75 (IQR 0.6–1.0), positive end-expiratory pressure 12 (IQR 10–14) and plateau pressure 22 (IQR 18–26) in the first 24 h of ventilation. Median duration of ventilation was 6.5 days (IQR 5.5–13). There were no fatalities. Most COVID-19 patients in Singapore who required mechanical ventilation because of ARDS were extubated with no mortality.Ser Hon PuahBarnaby Edward YoungPo Ying ChiaVui Kian HoJiashen LohRoshni Sadashiv GokhaleSeow Yen TanDuu Wen SewaShirin KalimuddinChee Keat TanSurinder K. M. S. PadaMatthew Edward CoveLouis Yi Ann ChaiPurnima ParthasarathyBenjamin Choon Heng HoJensen Jiansheng NgLi Min LingJohn A. AbisheganadenVernon J. M. LeeCher Heng TanRaymond T. P. LinYee Sin LeoDavid C. LyeTsin Wen YeoSingapore 2019 novel coronavirus outbreak research teamNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-11 (2021) |
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DOAJ |
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Medicine R Science Q Ser Hon Puah Barnaby Edward Young Po Ying Chia Vui Kian Ho Jiashen Loh Roshni Sadashiv Gokhale Seow Yen Tan Duu Wen Sewa Shirin Kalimuddin Chee Keat Tan Surinder K. M. S. Pada Matthew Edward Cove Louis Yi Ann Chai Purnima Parthasarathy Benjamin Choon Heng Ho Jensen Jiansheng Ng Li Min Ling John A. Abisheganaden Vernon J. M. Lee Cher Heng Tan Raymond T. P. Lin Yee Sin Leo David C. Lye Tsin Wen Yeo Singapore 2019 novel coronavirus outbreak research team Clinical features and predictors of severity in COVID-19 patients with critical illness in Singapore |
| description |
Abstract We aim to describe a case series of critically and non-critically ill COVID-19 patients in Singapore. This was a multicentered prospective study with clinical and laboratory details. Details for fifty uncomplicated COVID-19 patients and ten who required mechanical ventilation were collected. We compared clinical features between the groups, assessed predictors of intubation, and described ventilatory management in ICU patients. Ventilated patients were significantly older, reported more dyspnea, had elevated C-reactive protein and lactate dehydrogenase. A multivariable logistic regression model identified respiratory rate (aOR 2.83, 95% CI 1.24–6.47) and neutrophil count (aOR 2.39, 95% CI 1.34–4.26) on admission as independent predictors of intubation with area under receiver operating characteristic curve of 0.928 (95% CI 0.828–0.979). Median APACHE II score was 19 (IQR 17–22) and PaO2/FiO2 ratio before intubation was 104 (IQR 89–129). Median peak FiO2 was 0.75 (IQR 0.6–1.0), positive end-expiratory pressure 12 (IQR 10–14) and plateau pressure 22 (IQR 18–26) in the first 24 h of ventilation. Median duration of ventilation was 6.5 days (IQR 5.5–13). There were no fatalities. Most COVID-19 patients in Singapore who required mechanical ventilation because of ARDS were extubated with no mortality. |
| format |
article |
| author |
Ser Hon Puah Barnaby Edward Young Po Ying Chia Vui Kian Ho Jiashen Loh Roshni Sadashiv Gokhale Seow Yen Tan Duu Wen Sewa Shirin Kalimuddin Chee Keat Tan Surinder K. M. S. Pada Matthew Edward Cove Louis Yi Ann Chai Purnima Parthasarathy Benjamin Choon Heng Ho Jensen Jiansheng Ng Li Min Ling John A. Abisheganaden Vernon J. M. Lee Cher Heng Tan Raymond T. P. Lin Yee Sin Leo David C. Lye Tsin Wen Yeo Singapore 2019 novel coronavirus outbreak research team |
| author_facet |
Ser Hon Puah Barnaby Edward Young Po Ying Chia Vui Kian Ho Jiashen Loh Roshni Sadashiv Gokhale Seow Yen Tan Duu Wen Sewa Shirin Kalimuddin Chee Keat Tan Surinder K. M. S. Pada Matthew Edward Cove Louis Yi Ann Chai Purnima Parthasarathy Benjamin Choon Heng Ho Jensen Jiansheng Ng Li Min Ling John A. Abisheganaden Vernon J. M. Lee Cher Heng Tan Raymond T. P. Lin Yee Sin Leo David C. Lye Tsin Wen Yeo Singapore 2019 novel coronavirus outbreak research team |
| author_sort |
Ser Hon Puah |
| title |
Clinical features and predictors of severity in COVID-19 patients with critical illness in Singapore |
| title_short |
Clinical features and predictors of severity in COVID-19 patients with critical illness in Singapore |
| title_full |
Clinical features and predictors of severity in COVID-19 patients with critical illness in Singapore |
| title_fullStr |
Clinical features and predictors of severity in COVID-19 patients with critical illness in Singapore |
| title_full_unstemmed |
Clinical features and predictors of severity in COVID-19 patients with critical illness in Singapore |
| title_sort |
clinical features and predictors of severity in covid-19 patients with critical illness in singapore |
| publisher |
Nature Portfolio |
| publishDate |
2021 |
| url |
https://doaj.org/article/197fe4e9f596426bbbdff6f343b38abf |
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