1.Chest radiographs in Coronavirus Disease 2019 (COVID-19)
Mohana Letchumanan ; Adi Afiq Bin Md Anour ; Shubash Shander Ganapathy ; Syaman Harry ; Nik Shah Hizan Binti Nik Lah ; Norlimah Binti Arsad ; Nur Farhana Binti Ahmad Fisol,
The Medical Journal of Malaysia 2021;76(2):131-137
Objectives: To recognize the radiographic patterns of
coronavirus disease 2019 (COVID-19) in Malaysia.
Materials and Methods: Chest radiographs of patients
confirmed with COVID-19 in Hospital Tawau, Sabah,
Malaysia were retrospectively analyzed by two radiologists.
The radiographic pattern, distribution among subgroups
and evolution of the disease over time were determined.
Results: Among the 82 patients studied, 65 (79.3%) were
males. Mean age of our cohorts was 37 ± 15 years. Baseline
chest radiographs were abnormal in 37 patients (45.1%).
Over half (52.9%) of the symptomatic patients had abnormal
baseline radiograph. Among the children, patients with
comorbidities, and patients 60 years of age and above, the
abnormal radiographs were 14.3%, 71.4% and 69.3%
respectively. Ground glass opacities were the commonest
abnormal radiographic feature (35.4%), were peripherally
located (35.4%) with predilection for the lower zones
(29.3%). Most radiographic abnormalities were multifocal
(20.7%) and frequently located in the left lung (19.5%).
Radiographic recovery was observed in 15 of 18 patients
(83%). Computed tomography (CT) scan demonstrated
greater extent of the disease than observed in radiographs
of the same patient.
Conclusions: COVID-19 pneumonia presented with a
specific radiographic pattern in our cohort of patients,
comprising of ground glass opacities in peripheral and
basilar distribution, affecting a single lung field and was
observed in both symptomatic and asymptomatic patients.
Chest radiograph is a useful adjunct screening tool, and in
combination with clinical and epidemiological assessment
may facilitate in early diagnosis of COVID-19 pneumonia.
2.Conducting verbal autopsy by telephone interview during the pandemic to support mortality surveillance: a feasibility study in Malaysia
Nur Hamizah binti Nasaruddin ; Shubash Shander Ganapathy ; S. Maria Awaluddin ; Mohamad Fuad Mohamad Anuar ; Nazirah binti Alias ; Chan Yee Mang ; Khaw Wan-Fei
Western Pacific Surveillance and Response 2022;13(2):08-14
Objective:
Verbal autopsy (VA) through face-to-face interviews with caregivers is a way to determine cause of death without medical certification. In Malaysia, the use of VA has improved mortality statistics. However, during the coronavirus disease 2019 (COVID-19) pandemic, face-to-face interviews were delayed, reducing VA data collection and affecting data for mortality surveillance. This study aims to investigate the feasibility and acceptability of conducting VA interviews via telephone calls, and the quality of the data gathered.
Methods:
The study was conducted in Malaysia from September to October 2020 using a cross-sectional design. Participants were health-care workers from established VA teams across the country. They conducted VA interviews via telephone and provided feedback through a customized online form. Data collected from the form were used to assess the feasibility, acceptability and quality of the telephone interviews using IBM SPSS version 23.
Results:
Responses were received from 113 participants. There were 74 (65.5%) successful interviews, representing 91% of the 81 cases who were able to be contacted. More than two thirds of health-care workers provided positive feedback on the telephone interview method for themselves and the interviewees. Only 10.8% of causes of death were unusable.
Discussion
This study provides preliminary evidence that VA via telephone interview is feasible, acceptable and can be used as an alternative to face-to-face interviews without affecting data quality. During times when face-to-face interviews are not advisable, VA telephone interviews can be used for data collection for mortality surveillance.
3.Comorbidities and clinical features related to severe outcomes among COVID-19 cases in Selangor, Malaysia
Wan Shakira Rodzlan Hasani ; Shubash Shander Ganapathy ; Chong Zhuo Lin ; Halizah Mat Rifin ; Mohammad Nazaruddin Bahari ; Muhammad Haikal Ghazali ; Noor Aliza Lodz ; Muhammad Hafizuddin Taufik Ramli ; Nur Liana Ab Majid ; Jane Ling Miaw Yn ; Muhammad Fadhli Mohd Yusoff ; Noor Ani Ahmad ; Anita Suleiman ; Ahmad Faudzi Yusoff ; Venugopalan Balan ; Sha&rsquo ; ari Ngadiman
Western Pacific Surveillance and Response 2021;12(1):46-52
Background: Pre-existing comorbidities can predict severe disease requiring intensive care unit (ICU) admission among COVID-19 cases. We compared comorbidities, clinical features and other predictive factors between COVID-19 patients requiring ICU admission for intubation/mechanical ventilation and all other COVID-19 cases in Selangor, Malaysia.
Methods: Field data collected during the COVID-19 outbreak in Selangor, Malaysia, up to 13 April 2020 were used, comprising socio-demographic characteristics, comorbidities and presenting symptoms of COVID-19 cases. ICU admission was determined from medical records. Multiple logistic regression analysis was performed to identify factors associated with ICU admission requiring intubation/mechanical ventilation among COVID-19 cases.
Results: A total of 1287 COVID-19-positive cases were included for analysis. The most common comorbidities were hypertension (15.5%) and diabetes (11.0%). More than one third of cases presented with fever (43.8%) or cough (37.1%). Of the 25 cases that required intubation/mechanical ventilation, 68.0% had hypertension, 88.0% had fever, 40.0% had dyspnoea and 44.0% were lethargic. Multivariate regression showed that cases that required intubation/mechanical ventilation had significantly higher odds of being older (aged 360 years) [adjusted odds ratio (aOR) = 3.9] and having hypertension (aOR = 5.7), fever (aOR = 9.8), dyspnoea (aOR = 9.6) or lethargy (aOR = 7.9) than cases that did not require intubation/mechanical ventilation.
Conclusion: The COVID-19 cases in Selangor, Malaysia requiring intubation/mechanical ventilation were significantly older, with a higher proportion of hypertension and symptoms of fever, dyspnoea and lethargy. These risk factors have been reported previously for severe COVID-19 cases, and highlight the role that ageing and underlying comorbidities play in severe outcomes to respiratory disease.