Browse publications by year: 2023

  1. Wong HJ, Harith S, Lua PL, Ibrahim KA
    Sci Rep, 2023 Mar 30;13(1):5189.
    PMID: 36997594 DOI: 10.1038/s41598-023-31006-y
    Individuals with stroke are at high malnutrition risk in both the acute and chronic phases. This study aimed to assess the validity of different malnutrition screening tools for stroke patients in rehabilitation phase. Participants in this study were 304 stroke patients from three hospitals in the East-Coast region of Peninsular Malaysia from May-August 2019. The concurrent validity of the Malnutrition Risk Screening Tool-Hospital (MRST-H), Mini Nutritional Assessment-Short Form (MNA-SF), Malnutrition Screening Tool (MST), Malnutrition Universal Screening (MUST) and Nutritional Risk Screening (NRS-2002) was assessed with the diagnostic criteria for malnutrition proposed by the Global Leadership Initiative on Malnutrition (GLIM-DCM). Sensitivity, specificity, positive predictive value, negative predictive value, and the area under the curve were computed. MUST and MRST-H demonstrated good validity regardless of different age groups (> 80% sensitivity and specificity); meanwhile, MST and MNA-SF had fair validity, yet NRS-2002 had poor to fair validity with GLIM-DCM. Only MRST-H and NRS-2002 were significantly correlated with all anthropometric indices, dietary energy intake, and health-related quality of life in both age groups. In conclusion, MRST-H and MUST showed good concurrent validity with GLIM-DCM and can be considered as appropriate malnutrition screening tool in discriminating malnutrition among stroke individuals attending rehabilitation centre in Malaysia regardless of their age groups.
    MeSH terms: Humans; Leadership*; Malaysia/epidemiology; Mass Screening; Nutritional Status; Quality of Life; Nutrition Assessment
  2. Awang Hasyim N, Ismail S, Ling XF, Tilakaratne WM
    Head Neck Pathol, 2023 Sep;17(3):731-738.
    PMID: 36997684 DOI: 10.1007/s12105-023-01545-x
    BACKGROUND: Odontogenic carcinosarcoma (OCS) is an exceptionally rare malignant mixed odontogenic neoplasm, which mostly arises from recurrent benign odontogenic tumour that undergoes malignant transformation.

    METHODS: A literature review was conducted using the keyword of "Odontogenic carcinosarcoma" and all relevant articles were screened. The data collected include demographic profile (age, gender), clinical information (symptoms, location, size), radiologic features, histopathological examination, management, recurrence, metastases, and survival status.

    RESULTS: A total of 17 OCS cases including a new case from our hospital. The incidence of OCS was highest in the third decades of life with predilection for male and posterior region of mandible. Clinically, patients may present with swelling and neurological symptoms. Radiographic examination often showed radiolucency with ill-defined border. This tumour demonstrates an aggressive behaviour with reported cases of distant metastases to the lung, lymph nodes, rib, and pelvis. Here, we report an interesting case of OCS in a 38-year-old man with a previous diagnosis of ameloblastoma. The patient was diagnosed with ameloblastoma but refused surgical intervention and returned after 10 years with rapidly enlarging mass on the right side of mandible. Microscopically, the lesion appears as biphasic odontogenic tumour with malignant cytological features seen in both epithelium and mesenchymal components. The spindle to round mesenchymal tumour cells were only positive for vimentin. Ki67 proliferation index was high in both epithelium and mesenchymal components.

    CONCLUSION: This case showed the tendency of untreated ameloblastoma to undergo malignant changes in the long term.

    MeSH terms: Adult; Humans; Male; Mandible/pathology; Mouth Neoplasms*
  3. Sultan MAH, Zin MHM, Hayati F, Zainuddin ZM, Kosai NR, Rajan R, et al.
    Obes Surg, 2023 Mar 30.
    PMID: 36997694 DOI: 10.1007/s11695-023-06547-w
    PURPOSE: Obesity is associated with multiple health-related complications and affects various aspects of life, including erectile dysfunction (ED). The aim of this study is to postulate that erectile dysfunction in male obese patients can be reversed following bariatric surgery.

    MATERIALS AND METHODS: We conducted a non-randomized quasi-experimental study (prospective) between 2 groups, those who underwent surgery with the control group. In this study, the resolution of erectile dysfunction following bariatric surgery comparing with the control group was evaluated in terms of International Index of Erectile Function (IIEF) score. IIEF score is taken by delivering validated questionnaire to participants that enrolled in this study, both the control and intervention group.

    RESULTS: A total of 25 patients were included in this study, 13 from the intervention group and 12 from the control group. From our study, we evaluated the resolution of IIEF score in both groups. We found that the resolution of erectile function is statistically significant in the intervention group compared to control group. Spearman rank correlation (rs) test was performed to identify the correlation between age and IIEF score.

    CONCLUSION: Statistically significant improvements in erectile function were found following bariatric surgery. This is evidenced by the improvements in the IIEF score post-surgery compared to control group.

  4. Jacky D, Bibi C, Meng LMC, Jason F, Gwendoline T, Jeremy L, et al.
    BMC Microbiol, 2023 Mar 30;23(1):88.
    PMID: 36997838 DOI: 10.1186/s12866-023-02822-z
    BACKGROUND: Plant-based diets offer more beneficial microbes and can modulate gut microbiomes to improve human health. We evaluated the effects of the plant-based OsomeFood Clean Label meal range ('AWE' diet), on the human gut microbiome.

    METHODS: Over 21 days, ten healthy participants consumed OsomeFood meals for five consecutive weekday lunches and dinners and resumed their regular diets for other days/meals. On follow-up days, participants completed questionnaires to record satiety, energy and health, and provided stool samples. To document microbiome variations and identify associations, species and functional pathway annotations were analyzed by shotgun sequencing. Shannon diversity and regular diet calorie intake subsets were also assessed.

    RESULTS: Overweight participants gained more species and functional pathway diversity than normal BMI participants. Nineteen disease-associated species were suppressed in moderate-responders without gaining diversity, and in strong-responders with diversity gains along with health-associated species. All participants reported improved short-chain fatty acids production, insulin and γ-aminobutyric acid signaling. Moreover, fullness correlated positively with Bacteroides eggerthii; energetic status with B. uniformis, B. longum, Phascolarctobacterium succinatutens, and Eubacterium eligens; healthy status with Faecalibacterium prausnitzii, Prevotella CAG 5226, Roseburia hominis, and Roseburia sp. CAG 182; and overall response with E. eligens and Corprococcus eutactus. Fiber consumption was negatively associated with pathogenic species.

    CONCLUSION: Although the AWE diet was consumed for only five days a week, all participants, especially overweight ones, experienced improved fullness, health status, energy and overall responses. The AWE diet benefits all individuals, especially those of higher BMI or low-fiber consumption.

    MeSH terms: Gastrointestinal Microbiome*; Diet; Feces/microbiology; Humans; Overweight; Meals
  5. Hasan AH, Mohamed Yusof FS, Kamarudin NA, Murugesan S, Shakya S, Jamalis J
    Curr Org Synth, 2023 Mar 28.
    PMID: 36998126 DOI: 10.2174/1570179420666230328121554
    INTRODUCTION: Seven new psoralen derivatives were synthesised by carbodiimide coupling to active carboxylic acid to amide formation in mild reaction conditions.

    METHODS: The psoralen derivatives were produced through the condensation of seven different types of amine groups consisting of electron withdrawing groups and electron donating groups.

    RESULTS: All the synthesised compounds were obtained with moderate to high yields. Structural characterization using ATR-FTIR, 1H NMR, 13C NMR, and HRMS has confirmed their structure. Moreover, in silico evaluation of the psoralen derivatives against the AChE enzyme was performed, and acetylcholinesterase inhibitory activity of psoralen derivatives was also conducted.

    CONCLUSION: Results from molecular docking show the potential of compound 12e as AChE inhibitors due to its highest binding energy value. It was further supported by the anti-acetylcholinesterase activity of compound 12e, which has 91.69% inhibition, comparable to galantamine (94.12%). Furthermore, 100 ns run molecular dynamics (MD) simulation was used to refine docking results.

  6. Yu L, Abd Ghani MK, Aghemo A, Barh D, Bassetti M, Catena F, et al.
    Curr Med Chem, 2023;30(39):4390-4408.
    PMID: 36998130 DOI: 10.2174/0929867330666230330092725
    The COVID-19 pandemic, caused by the coronavirus, SARS-CoV-2, has claimed millions of lives worldwide in the past two years. Fatalities among the elderly with underlying cardiovascular disease, lung disease, and diabetes have particularly been high. A bibliometrics analysis on author's keywords was carried out, and searched for possible links between various coronavirus studies over the past 50 years, and integrated them. We found keywords like immune system, immunity, nutrition, malnutrition, micronutrients, exercise, inflammation, and hyperinflammation were highly related to each other. Based on these findings, we hypothesized that the human immune system is a multilevel super complex system, which employs multiple strategies to contain microorganism infections and restore homeostasis. It was also found that the behavior of the immune system is not able to be described by a single immunological theory. However, one main strategy is "self-destroy and rebuild", which consists of a series of inflammatory responses: 1) active self-destruction of damaged/dysfunctional somatic cells; 2) removal of debris and cells; 3) rebuilding tissues. Thus, invading microorganisms' clearance could be only a passive bystander response to this destroy-rebuild process. Microbial infections could be self-limiting and promoted as an indispensable essential nutrition for the vast number of genes existing in the microorganisms. The transient nutrition surge resulting from the degradation of the self-destroyed cell debris coupled with the existing nutrition state in the patient may play an important role in the pathogenesis of COVID-19. Finally, a few possible coping strategies to mitigate COVID-19, including vaccination, are discussed.
    MeSH terms: Aged; Humans; Inflammation; Pandemics
  7. Wahab MSA, Hamdi H, Ali AA, Karuppannan M, Zulkifli MH, Maniam S, et al.
    J Herb Med, 2023 Jun;39:100650.
    PMID: 36998482 DOI: 10.1016/j.hermed.2023.100650
    INTRODUCTION: The spread of the novel coronavirus disease (COVID-19) may lead people to seek preventative measures. The use of herbal and dietary supplements (HDS) may have become prevalent during the COVID-19 pandemic. This study aims to identify the prevalence, predictors, and patterns of HDS use for COVID-19 prevention in a sample of the general public in a suburban town in Malaysia.

    METHODS: An online cross-sectional survey was conducted between May and June 2021 involving adults ≥ 18 years old. Data on the self-reported use of HDS for COVID-19 prevention were collected. Logistic regression analysis was conducted to determine the predictors of HDS use.

    RESULTS: Overall, 41.9 % (168/401) reported using HDS to prevent COVID-19. Multivariate analysis showed that HDS users were more likely to be individuals ≥ 40 years old (adjusted odds ratio [aOR] = 1.774, 95 % confidence interval [CI] = 1.016 - 3.098), and to have had a history of HDS use prior to the pandemic (aOR = 19.378, 95 % CI = 5.901 - 63.639). Most HDS users referred to social media or websites (66.7 %, 112/168) for HDS information. Approximately half of them had consulted either pharmacists or doctors about their HDS use.

    CONCLUSION: HDS use to prevent COVID-19 was common among the respondents. Several issues - such as the concurrent use of HDS with conventional medications, the use of unreliable sources of information, and the lack of consultation with healthcare providers (HCPs) - indicate that HCPs should be more proactive in their consultative and information-providing roles regarding HDS use.

  8. Murayama A, Shigeta H, Kamamoto S, Yamashita E, Saito H, Sawano T, et al.
    OTO Open, 2023;7(1):e31.
    PMID: 36998569 DOI: 10.1002/oto2.31
    OBJECTIVE: To evaluate the magnitude, prevalence, and trend of the financial relationship between Japanese head and neck surgeons and pharmaceutical companies between 2016 and 2019.

    STUDY DESIGN: Cross-sectional analysis.

    SETTING: Japan.

    METHODS: This study evaluated personal payments concerning lecturing, consulting, and writing paid by 92 major pharmaceutical companies to all Japanese head and neck surgeons board-certified by the Japan Society for Head and Neck Surgery between 2016 and 2019. The payments were descriptively analyzed and payment trend were assessed using population-averaged generalized estimating equations. Further, the payments to board executive board members with specialist certification were also evaluated separately.

    RESULTS: Of all 443 board-certified head and neck surgeons in Japan, 365 (82.4%) received an average of $6443 (standard deviation: $12,875), while median payments were $2002 (interquartile ranges [IQR] $792-$4802). Executive board specialists with a voting right received much higher personal payments (median $26,013, IQR $12,747-$35,750) than the non-executive specialists (median $1926, IQR $765‒$4134, p 

  9. Mohamad MSB, Reyes RJ, De Rubis G, Paudel KR, Hansbro PM, Dua K, et al.
    EXCLI J, 2023;22:188-190.
    PMID: 36998703 DOI: 10.17179/excli2023-5845
  10. Jimi N, Bessho-Uehara M, Nakamura K, Sakata M, Hayashi T, Kanie S, et al.
    R Soc Open Sci, 2023 Mar;10(3):230039.
    PMID: 36998762 DOI: 10.1098/rsos.230039
    Bioluminescence, a phenomenon observed widely in organisms ranging from bacteria to metazoans, has a significant impact on the behaviour and ecology of organisms. Among bioluminescent organisms, Polycirrus, which has unique emission wavelengths, has received attention, and advanced studies such as RNA-Seq have been conducted, but they are limited to a few cases. In addition, accurate species identification is difficult due to lack of taxonomic organization. In this study, we conducted comprehensive taxonomic survey of Japanese Polycirrus based on multiple specimens from different locations and described as three new species: Polycirrus onibi sp. nov., P. ikeguchii sp. nov. and P. aoandon sp. nov. The three species can be distinguished from the known species based on the following characters: (i) arrangement of mid-ventral groove, (ii) arrangement of notochaetigerous segments, (iii) type of neurochaetae uncini, and (iv) arrangement of nephridial papillae. By linking the bioluminescence phenomenon with taxonomic knowledge, we established a foundation for future bioluminescent research development. We also provide a brief phylogenetic tree based on cytochrome c oxidase subunit I (COI) sequences to discuss the evolution of bioluminescence and the direction of future research.
  11. Taufek T, Manurung YHP, Adenan MS, Akma S, Choo HL, Louhichi B, et al.
    3D Print Addit Manuf, 2023 Feb 01;10(1):156-169.
    PMID: 36998800 DOI: 10.1089/3dp.2021.0197
    This research concerns on the application of combined thermomechanical-inherent strain method (TMM-ISM) in predicting the distortion of additively manufactured component. The simulation and experimental verification were conducted in the form of vertical cylinder using selective laser melting, which was subsequently cut in the middle section. The setup and procedure of simulation approaches followed the actual process parameters such as laser power, layer thickness, scan strategy, and temperature dependent material, including flow curve retrieved from specialized computational numerical software. The investigation began with virtual calibration test using TMM, followed by manufacturing process simulation using ISM. Based on the maximum deformation result of simulated calibration and accuracy consideration from previous equivalent study, the inherent strain values used in ISM analysis were obtained using self-developed optimization algorithm with direct pattern search Nelder-Mead method in finding the minimum error of distortion using MATLAB. The error minima were measured between transient TMM-based simulation and simplified formulation in calculating the inherent strain values with respect to longitudinal and transverse laser directions. Furthermore, the combined TMM-ISM distortion results were compared to fully TMM with equivalent mesh number and verified based on experimental investigation conducted by renowned researcher. It can be concluded that the result of slit distortion from TMM-ISM and TMM showed good agreement with the error percentage of 9.5% and 3.5%, respectively. However, the computational time for combined TMM-ISM was reduced tremendously with only 63 min if compared to TMM with 129 min in running full simulation on solid cylindrical component. Hence, combined TMM-ISM-based simulation can be considered as an alternative method to replace time-consuming and cost-intensive calibration preparation and analysis.
  12. Nasir NAM, Saad AZM, Bachok NS, Rashid AHA, Ujang Z, Noorsal K, et al.
    Indian J Plast Surg, 2023 Feb;56(1):44-52.
    PMID: 36998939 DOI: 10.1055/s-0042-1759503
    Background  This clinical trial aimed to evaluate the clinical efficacy of chitosan derivative hydrogel paste (CDHP) as a wound bed preparation for wounds with cavities. Methods  This study enrolled 287 patients, with 143 patients randomized into the CDHP group (treatment) and 144 patients randomized into the commercial hydroactive gel (CHG) group (control). The granulation tissue, necrotic tissue, patient comfort, clinical signs, symptoms, and patient convenience during the application and removal of the dressing were assessed. Results  The study was completed by 111 and 105 patients from the treatment and control groups, respectively. Both groups showed an increasing mean percentage of wound granulation over time when the initial wound size and comorbidity were adjusted (F(10,198) = 4.61; p  
  13. Lam HY, Sulaiman WAW, Ismail WFW, Halim AS
    Arch Plast Surg, 2023 Mar;50(2):188-193.
    PMID: 36999154 DOI: 10.1055/a-1962-6009
    Vascular injury following traumatic knee injury quoted in the literature ranges from 3.3 to 65%, depending on the magnitude and pattern of the injury. Timely recognition is crucial to ensure the revascularization is done within 6 to 8 hours from the time of injury to avoid significant morbidity, amputation, and medicolegal ramifications. We present a case of an ischemic limb following delayed diagnosis of popliteal artery injury after knee dislocation. Even though we have successfully repaired the popliteal artery, the evolving ischemia over the distal limb poses a reconstruction challenge. Multiple surgical debridement procedures were performed to control the local tissue infection. Free tissue transfer with chimeric latissimus dorsi flap was done to resurface the defect. However, the forefoot became gangrenous despite a free muscle flap transfer. His limb appeared destined for amputation in the vicinity of tissue and recipient vessels, but we chose to use a cross-leg free flap as an option for limb salvage.
  14. Khoo KS, Nadesalingam KDT, Ong DB, Teoh LY, Teh MS, Jamaris S, et al.
    Case Rep Surg, 2023;2023:3114843.
    PMID: 36999167 DOI: 10.1155/2023/3114843
    Metastatic lesions to the breast from extramammary malignant neoplasms are rare and reported account for 0.5-6.6% of all breast malignancies. Distant metastasis of thymoma is even rarer, especially to extrathoracic regions. We reported a woman with invasive malignant thymoma postneoadjuvant and resection of the thymoma, who developed breast metastasis 7 years later. Breast imaging showed high-density lesion with no intralesional microcalcifications and no significant axillary lymphadenopathy. Core biopsy and histopathology proved the lesion to be metastatic thymic carcinoma. Despite rarity, breast lumps with underlying extramammary malignancy should raise the suspicious of breast metastasis.
  15. Muniandy G, Kamaruzaman L, Jan TH, Mohd R, Neesam MT, Fong Voon K, et al.
    Acta Med Indones, 2023 Jan;55(1):78-82.
    PMID: 36999269
    Cefepime is a frequently used fourth-generation cephalosporin antibiotic for a wide variety of infections. Toxic levels of this drug can cause neurological complications. The most common neurological adverse event of cefepime is headache and lightheadedness. Here, we presented a case of cefepime induced encephalopathy in a 57-year-old female patient with acute on chronic kidney disease. With an accurate diagnosis that requires a high index of clinical suspicion, prompt management was instituted. She had full resolution of symptoms following discontinuation of the medication and also emergent dialysis.
    MeSH terms: Anti-Bacterial Agents/adverse effects; Cephalosporins/adverse effects; Female; Humans; Middle Aged
  16. Lee SH, Ng CX, Wong SR, Chong PP
    Curr Drug Targets, 2023;24(6):484-508.
    PMID: 36999414 DOI: 10.2174/1389450124666230329123409
    MicroRNAs have a plethora of roles in various biological processes in the cells and most human cancers have been shown to be associated with dysregulation of the expression of miRNA genes. MiRNA biogenesis involves two alternative pathways, the canonical pathway which requires the successful cooperation of various proteins forming the miRNA-inducing silencing complex (miRISC), and the non-canonical pathway, such as the mirtrons, simtrons, or agotrons pathway, which bypasses and deviates from specific steps in the canonical pathway. Mature miRNAs are secreted from cells and circulated in the body bound to argonaute 2 (AGO2) and miRISC or transported in vesicles. These miRNAs may regulate their downstream target genes via positive or negative regulation through different molecular mechanisms. This review focuses on the role and mechanisms of miRNAs in different stages of breast cancer progression, including breast cancer stem cell formation, breast cancer initiation, invasion, and metastasis as well as angiogenesis. The design, chemical modifications, and therapeutic applications of synthetic anti-sense miRNA oligonucleotides and RNA mimics are also discussed in detail. The strategies for systemic delivery and local targeted delivery of the antisense miRNAs encompass the use of polymeric and liposomal nanoparticles, inorganic nanoparticles, extracellular vesicles, as well as viral vectors and viruslike particles (VLPs). Although several miRNAs have been identified as good candidates for the design of antisense and other synthetic modified oligonucleotides in targeting breast cancer, further efforts are still needed to study the most optimal delivery method in order to drive the research beyond preclinical studies.
    MeSH terms: Female; Humans; Oligonucleotides; Proteins
  17. Liew Y, Capule FR, Rahman RA, Nor NM, Teo R, Makmor-Bakry M
    Pharmacogenomics, 2023 Apr;24(5):247-259.
    PMID: 36999508 DOI: 10.2217/pgs-2023-0006
    Aims: To investigate the roles of MDR1 (1236C>T, 2677G>T/A, and 3435C>T) and OPRM1 (118A>G) gene polymorphisms on the anesthetic and adverse effects of propofol-remifentanil total intravenous anesthesia in pediatric surgery. Materials & methods: The genotypes were identified through Sanger sequencing. The clinical data including hemodynamics on anesthesia, postanesthesia pain and sedation score and the occurrence of adverse effects were recorded and compared against the genetic data. Results: A total of 72 pediatric patients undergoing surgery were recruited. A weak to no association was found between the genetic polymorphisms of MDR1 and OPRM1 and the anesthetic and adverse effects of propofol-remifentanil. Conclusion: Genetic polymorphisms in OPRM1, but not in MDR1, gene polymorphism, demonstrated plausible association with the effects of propofol-remifentanil.
    MeSH terms: Child; Humans; Piperidines/adverse effects; Polymorphism, Genetic; Receptors, Opioid, mu/genetics; Anesthetics, Intravenous/adverse effects
  18. Cheah WH
    Asia Pac J Clin Oncol, 2023 Apr;19(2):e80-e88.
    PMID: 35437926 DOI: 10.1111/ajco.13782
    Rectal cancer is common and accounts for more than one-third of colorectal tumors. It is associated with significant morbidity and mortality. Previously computed tomography scan is the key imaging modality in preoperative assessment to detect local invasion and distant metastasis. However, the advent of magnetic resonance imaging (MRI) has aided in local staging and prognosticates the outcome of rectal tumor. Here, the author briefly explains why rectal MRI has a comprehensive role and provides a simple and easy way in reporting an MRI rectal carcinoma, even for a non-radiologist.
    MeSH terms: Carcinoma*; Humans; Magnetic Resonance Imaging/methods; Neoplasm Staging; Rectum/pathology
  19. Saniasiaya J, Kulasegarah J
    Braz J Otorhinolaryngol, 2023;89(2):329-338.
    PMID: 35659765 DOI: 10.1016/j.bjorl.2022.05.002
    OBJECTIVE: Airway reflux, a member of extra-esophageal reflux, has been linked to countless respiratory pathologies amongst children. The advent of novel instrumentation has enabled the discovery of non-acid reflux which was postulated as the main culprit of airway reflux. The objective of this review is to outline the association between non-acid reflux and airway reflux in children.

    METHODS: A comprehensive review of recent literature on non-acid reflux and airway reflux in children was conducted. Studies ranged from January 2010 till November 2021 were searched over a period of a month: December 2021.

    RESULTS: A total of eleven studies were identified. All studies included in this review revealed a strong link between non-acid reflux and airway reflux in children. 6 of the included studies are prospective studies, 3 retrospective studies, 1 cross-section study, and type of study was not mentioned in 1 study. The most common reported respiratory manifestation of non-acid reflux in children was chronic cough (7 studies). Predominant non-acid reflux was noted in 4 studies. The total number of children in each study ranges from 21 to 150 patients. MII-pH study was carried out in all studies included as a diagnostic tool for reflux investigation.

    CONCLUSION: Non-acid reflux is the culprit behind airway reflux as well as other myriads of extra-esophageal manifestations in children. Multicentre international studies with a standardized protocol could improve scientific knowledge in managing non-acid reflux in airway reflux amongst children.

    MeSH terms: Child; Humans; Prospective Studies; Retrospective Studies; Electric Impedance; Esophageal pH Monitoring
  20. Kho SS, Lim KC, Muhammad NA, Nasaruddin MZ, Ismail I, Daut UM, et al.
    Med J Malaysia, 2023 Mar;78(2):131-138.
    PMID: 36988520
    INTRODUCTION: COVID-19 patients frequently demonstrate radiological organising pneumonia (OP) pattern. The longterm outcome and treatment options for this group of patients remain uncertain. We aim to describe the clinical and radiological outcomes of patients with COVID-19-related OP and identify possible clinical factors associated with inferior radiological outcome.

    MATERIALS AND METHODS: Post-COVID-19 clinic attendees, consisting of post-COVID-19 patients discharged from major hospitals in the state of Selangor during the third pandemic wave of COVID-19 in Malaysia, were enrolled in this retrospective study for 6 months. Physician-scored Modified Medical Research Council (mMRC), patient self-reported quality of life (EQ-VAS) score and follow-up CT scan were evaluated.

    RESULTS: Our cohort comprised 131 patients, with a median age of 52 (IQR 39-60) years and median BMI of 29.40 (IQR 25.59-34.72). Majority (72.5%) had co-morbidities, and 97.7% had severe disease requiring supplementary oxygen support during the acute COVID-19 episode. 56.5% required intensive care; among which one-third were invasively ventilated. Median equivalent dose of methylprednisolone prescribed was 2.60 (IQR 1.29-5.18) mg/kg during admission, while the median prednisolone dose upon discharge was 0.64 (IQR 0.51-0.78) mg/kg. It was tapered over a median of 8.0 (IQR 5.8-9.0) weeks. Upon follow-up at 11 (IQR 8-15) weeks, one-third of patients remained symptomatic, with cough, fatigue and dyspnoea being the most reported symptoms. mMRC and EQ-VAS scores improved significantly (p<0.001) during follow-up. Repeat CT scans were done in 59.5% of patients, with 94.8% of them demonstrating improvement. In fact, 51.7% had complete radiological resolution. Intensive care admission and mechanical ventilation are among the factors which were associated with poorer radiological outcomes, p<0.05.

    CONCLUSION: Approximately one-third of patients with SARSCoV- 2-related OP remained symptomatic at 3 months of follow-up. Majority demonstrated favourable radiological outcomes at 5-month reassessment, except those who required intensive care unit admission and mechanical ventilation.

    MeSH terms: Adult; Humans; Middle Aged; Quality of Life; Retrospective Studies
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