1.Managing adult asthma during the COVID-19 pandemic: A 2022 review and current recommendations.
Kheng Yong ONG ; Pei Yee TIEW ; Mariko Siyue KOH
Annals of the Academy of Medicine, Singapore 2022;51(10):637-647
INTRODUCTION:
This review aims to examine asthma management during the COVID-19 pandemic.
METHOD:
Relevant recommendations and articles were identified by respiratory professional societies and PubMed search using the terms "asthma" and "COVID-19", and examined for relevance and inclusion in this study.
RESULTS:
Recommendations for the management of asthma have remained similar but are now supported by new evidence between the years 2020 and 2022. Patients with well-controlled, mild-to-moderate asthma are unlikely to be at increased risk of acquiring COVID-19 or having worse outcomes from COVID-19. All asthma patients should receive COVID-19 vaccination. Spirometry can be performed with the usual strict infection control procedures unless there is a suspicion of COVID-19. Mask-wearing and other health measures remain important for asthma patients.
CONCLUSION
While previous recommendations were largely based on expert opinion, the tremendous amount of literature published since the pandemic first emerged 2 years ago has helped guide respiratory professional bodies to update their recommendations. This study provides a timely review of the various recommendations and can be used to guide healthcare professionals in managing asthma patients, as the world prepares for a future with COVID-19 becoming endemic. The long-term consequences of COVID-19 infection in asthma patients and the ripple effects of COVID-19 remain uncertain and deserve ongoing study.
Adult
;
Humans
;
COVID-19
;
Pandemics/prevention & control*
;
COVID-19 Vaccines
;
Asthma/epidemiology*
;
Infection Control
3.Approaching chronic cough.
Vijo POULOSE ; Pei Yee TIEW ; Choon How HOW
Singapore medical journal 2016;57(2):60-63
Chronic cough is one of the most common reasons for referral to a respiratory physician. Although fatal complications are rare, it may cause considerable distress in the patient's daily life. Western and local data shows that in patients with a normal chest radiograph, the most common causes are postnasal drip syndrome, postinfectious cough, gastro-oesophageal reflux disease and cough variant asthma. Less common causes are the use of angiotensin-converting enzyme inhibitors, smoker's cough and nonasthmatic eosinophilic bronchitis. A detailed history-taking and physical examination will provide a diagnosis in most patients, even at the primary care level. Some cases may need further investigations or specialist referral for diagnosis.
Asthma
;
complications
;
diagnosis
;
Chronic Disease
;
Cough
;
diagnosis
;
etiology
;
Diagnosis, Differential
;
Gastroesophageal Reflux
;
complications
;
diagnosis
;
Humans
4.Heterogeneity of non-cystic-fibrosis bronchiectasis in multiethnic Singapore: A prospective cohort study at a tertiary pulmonology centre.
Si Ling YOUNG ; Youxin PUAN ; Si Yuan CHEW ; Salahudeen Mohamed HAJA MOHIDEEN ; Pei Yee TIEW ; Gan Liang TAN ; Mariko Siyue KOH ; Ken Cheah Hooi LEE
Annals of the Academy of Medicine, Singapore 2021;50(7):556-565
INTRODUCTION:
Non-cystic fibrosis bronchiectasis (NCFB) is a highly heterogenous disease. We describe the clinical characteristics of NCFB patients and evaluate the performance of Bronchiectasis Severity Index (BSI) in predicting mortality.
METHODS:
Patients attending the bronchiectasis clinic between August 2015 and April 2020 with radiologically proven bronchiectasis on computed tomography were recruited. Clinical characteristics, spirometry, radiology, microbiology and clinical course over a median period of 2.4 years is presented.
RESULTS:
A total of 168 patients were enrolled in this prospective cohort study. They were predominantly women (67.8%), Chinese (87.5%) and never-smokers (76.9%). Median age of diagnosis was 64 years (interquartile range 56-71) and the most common aetiology was "idiopathic" bronchiectasis (44.6%). Thirty-nine percent had normal spirometries. Compared to female patients, there were more smokers among the male patients (53.8% versus 8.5%,
CONCLUSION
The NCFB cohort in Singapore has unique characteristics with sex differences. Over half the patients had a history of haemoptysis. The BSI score is a useful predictor of mortality in our population.
Aged
;
Bronchiectasis/epidemiology*
;
Cohort Studies
;
Female
;
Fibrosis
;
Humans
;
Male
;
Middle Aged
;
Prospective Studies
;
Pulmonary Medicine
;
Severity of Illness Index
;
Singapore/epidemiology*