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  1. Article ; Online: Cerebrovascular infarct associated with intracoronary adenosine: a possible rare fractional flow reserve complication.

    Keh, Yann Shan / Pang, Yu Zhi / Chin, Chee Tang

    Singapore medical journal

    2021  Volume 63, Issue 11, Page(s) 699–700

    MeSH term(s) Humans ; Adenosine/adverse effects ; Fractional Flow Reserve, Myocardial ; Coronary Circulation ; Coronary Stenosis/diagnostic imaging ; Vasodilator Agents/adverse effects ; Coronary Angiography ; Coronary Vessels
    Chemical Substances Adenosine (K72T3FS567) ; Vasodilator Agents
    Language English
    Publishing date 2021-06-18
    Publishing country India
    Document type Letter
    ZDB-ID 604319-7
    ISSN 2737-5935 ; 0037-5675
    ISSN (online) 2737-5935
    ISSN 0037-5675
    DOI 10.11622/smedj.2021085
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  2. Article: Cerebral venous thrombosis in a patient with mild COVID-19 infection.

    Pang, Yu Zhi / Shafi, Humaira / Lee, Zheng Cong / Ting, Simon Kang Seng / De Silva, Deidre Anne

    Annals of the Academy of Medicine, Singapore

    2021  Volume 50, Issue 2, Page(s) 188–190

    MeSH term(s) Adult ; COVID-19/complications ; COVID-19/diagnosis ; Humans ; Intracranial Thrombosis/diagnosis ; Intracranial Thrombosis/virology ; Male ; Severity of Illness Index ; Venous Thrombosis/diagnosis ; Venous Thrombosis/virology
    Language English
    Publishing date 2021-03-17
    Publishing country Singapore
    Document type Case Reports ; Letter
    ZDB-ID 604527-3
    ISSN 0304-4602
    ISSN 0304-4602
    DOI 10.47102/annals-acadmedsg.2020435
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Cerebral Venous Thrombosis in Patients with COVID-19 Infection: a Case Series and Systematic Review.

    Tu, Tian Ming / Goh, Claire / Tan, Ying Kiat / Leow, Aloysius St / Pang, Yu Zhi / Chien, Jaime / Shafi, Humaira / Chan, Bernard Pl / Hui, Andrew / Koh, Jasmine / Tan, Benjamin Yq / Umapathi, N Thirugnanam / Yeo, Leonard Ll

    Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association

    2020  Volume 29, Issue 12, Page(s) 105379

    Abstract: Background: There has been increasing reports associating the coronavirus disease 2019 (COVID-19) with thromboembolic phenomenon including ischemic strokes and venous thromboembolism. Cerebral venous thrombosis (CVT) is a rare neurovascular emergency ... ...

    Abstract Background: There has been increasing reports associating the coronavirus disease 2019 (COVID-19) with thromboembolic phenomenon including ischemic strokes and venous thromboembolism. Cerebral venous thrombosis (CVT) is a rare neurovascular emergency that has been observed in some COVID-19 patients, yet much remains to be learnt of its underlying pathophysiology.
    Objective: We present a case series of local patients with concomitant COVID-19 infection and CVT; and aim to perform a systematic review of known cases in the current literature.
    Methods: We describe two patients with concomitant COVID-19 infection and CVT from a nationwide registry in Singapore. We then conducted a literature search in PubMed and Embase using a suitable keyword search strategy from 1st December 2019 to 11th June 2020. All studies reporting CVT in COVID-19 patients were included.
    Results: Nine studies and 14 COVID-19 patients with CVT were studied. The median age was 43 years (IQR=36-58) and majority had no significant past medical conditions (60.0%). The time taken from onset of COVID-19 symptoms to CVT diagnosis was a median of 7 days (IQR=6-14). CVT was commonly seen in the transverse (75.0%) and sigmoid sinus (50.0%); 33.3% had involvement of the deep venous sinus system. A significant proportion of patients had raised D-dimer (75.0%) and CRP levels (50.0%). Two patients reported presence of antiphospholipid antibodies. Most patients received anticoagulation (91.7%) while overall mortality rate was 45.5%.
    Conclusions: The high mortality rate of CVT in COVID-19 infection warrants a high index of suspicion from physicians, and early treatment with anticoagulation should be initiated.
    MeSH term(s) Adult ; Antibodies, Antiphospholipid/blood ; Anticoagulants/therapeutic use ; Biomarkers/blood ; C-Reactive Protein/analysis ; COVID-19/complications ; COVID-19/diagnosis ; Female ; Fibrin Fibrinogen Degradation Products/analysis ; Humans ; Male ; Middle Aged ; Risk Factors ; Sinus Thrombosis, Intracranial/blood ; Sinus Thrombosis, Intracranial/diagnostic imaging ; Sinus Thrombosis, Intracranial/drug therapy ; Sinus Thrombosis, Intracranial/etiology ; Treatment Outcome ; Venous Thrombosis/blood ; Venous Thrombosis/diagnostic imaging ; Venous Thrombosis/drug therapy ; Venous Thrombosis/etiology
    Chemical Substances Antibodies, Antiphospholipid ; Anticoagulants ; Biomarkers ; Fibrin Fibrinogen Degradation Products ; fibrin fragment D ; C-Reactive Protein (9007-41-4)
    Language English
    Publishing date 2020-10-06
    Publishing country United States
    Document type Case Reports ; Journal Article ; Systematic Review
    ZDB-ID 1131675-5
    ISSN 1532-8511 ; 1052-3057
    ISSN (online) 1532-8511
    ISSN 1052-3057
    DOI 10.1016/j.jstrokecerebrovasdis.2020.105379
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  4. Article: Cerebral venous thrombosis in patients with COVID-19 infection: a case series and systematic review

    Tu, Tian Ming / Goh, Claire / Tan, Ying Kiat / Leow, Aloysius S. T. / Pang, Yu Zhi / Chien, Jaime / Shafi, Humaira / Chan, Bernard P. L. / Hui, Andrew / Koh, Jasmine / Tan, Benjamin Y. Q. / Umapathi, N. Thirugnanam / Yeo, Leonard L. L.

    Journal of Stroke and Cerebrovascular Diseases

    Abstract: Background : There has been increasing reports associating the coronavirus disease 2019 (COVID-19) with thromboembolic phenomenon including ischemic strokes and venous thromboembolism Cerebral venous thrombosis (CVT) is a rare neurovascular emergency ... ...

    Abstract Background : There has been increasing reports associating the coronavirus disease 2019 (COVID-19) with thromboembolic phenomenon including ischemic strokes and venous thromboembolism Cerebral venous thrombosis (CVT) is a rare neurovascular emergency that has been observed in some COVID-19 patients, yet much remains to be learnt of its underlying pathophysiology Objective : We present a case series of local patients with concomitant COVID-19 infection and CVT;and aim to perform a systematic review of known cases in the current literature Methods : We describe two patients with concomitant COVID-19 infection and CVT from a nationwide registry in Singapore We then conducted a literature search in PubMed and Embase using a suitable keyword search strategy from 1st December 2019 to 11th June 2020 All studies reporting CVT in COVID-19 patients were included Results : Nine studies and 14 COVID-19 patients with CVT were studied The median age was 43 years (IQR=36-58) and majority had no significant past medical conditions (60 0%) The time taken from onset of COVID-19 symptoms to CVT diagnosis was a median of 7 days (IQR=6-14) CVT was commonly seen in the transverse (75 0%) and sigmoid sinus (50 0%);33 3% had involvement of the deep venous sinus system A significant proportion of patients had raised D-dimer (75 0%) and CRP levels (50 0%) Two patients reported presence of antiphospholipid antibodies Most patients received anticoagulation (91 7%) while overall mortality rate was 45 5% Conclusions : The high mortality rate of CVT in COVID-19 infection warrants a high index of suspicion from physicians, and early treatment with anticoagulation should be initiated
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #816739
    Database COVID19

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  5. Article ; Online: Cerebral Venous Thrombosis in Patients with COVID-19 Infection

    Tu, Tian Ming / Goh, Claire / Tan, Ying Kiat / Leow, Aloysius ST / Pang, Yu Zhi / Chien, Jaime / Shafi, Humaira / Chan, Bernard PL / Hui, Andrew / Koh, Jasmine / Tan, Benjamin YQ / Umapathi, N. Thirugnanam / Yeo, Leonard LL

    Journal of Stroke and Cerebrovascular Diseases

    a Case Series and Systematic Review

    2020  Volume 29, Issue 12, Page(s) 105379

    Keywords Surgery ; Rehabilitation ; Clinical Neurology ; Cardiology and Cardiovascular Medicine ; covid19
    Language English
    Publisher Elsevier BV
    Publishing country us
    Document type Article ; Online
    ZDB-ID 1131675-5
    ISSN 1052-3057
    ISSN 1052-3057
    DOI 10.1016/j.jstrokecerebrovasdis.2020.105379
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  6. Article ; Online: Corrigendum to 'Neurology of COVID-19 in Singapore' [Journal of the Neurological Sciences Volume 418, 15 November 2020, 117118].

    Koh, Jasmine Shimin / De Silva, Deidre Anne / Quek, Amy May Lin / Chiew, Hui Jin / Tu, Tian Ming / Seet, Christopher Ying Hao / Hoe, Rebecca Hui Min / Saini, Monica / Hui, Andrew Che-Fai / Angon, Jasmyn / Ker, Justin Ruixin / Yong, Ming Hui / Goh, Yihui / Yu, Wai-Yung / Lim, Tchoyoson Choie Cheio / Tan, Benjamin Yong Qiang / Ng, Kay Wei Ping / Yeo, Leonard Leong Litt / Pang, Yu Zhi /
    Prakash, Kumar M / Ahmad, Aftab / Thomas, Terrence / Lye, David Chien Boon / Tan, Kevin / Umapathi, Thirugnanam

    Journal of the neurological sciences

    2021  Volume 424, Page(s) 117406

    Language English
    Publishing date 2021-03-20
    Publishing country Netherlands
    Document type Published Erratum
    ZDB-ID 80160-4
    ISSN 1878-5883 ; 0022-510X ; 0374-8642
    ISSN (online) 1878-5883
    ISSN 0022-510X ; 0374-8642
    DOI 10.1016/j.jns.2021.117406
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  7. Article ; Online: Neurology of COVID-19 in Singapore.

    Koh, Jasmine Shimin / De Silva, Deidre Anne / Quek, Amy May Lin / Chiew, Hui Jin / Tu, Tian Ming / Seet, Christopher Ying Hao / Hoe, Rebecca Hui Min / Saini, Monica / Hui, Andrew Che-Fai / Angon, Jasmyn / Ker, Justin Ruixin / Yong, Ming Hui / Goh, Yihui / Yu, Wai-Yung / Lim, Tchoyoson Choie Cheio / Tan, Benjamin Yong Qiang / Ng, Kay Wei Ping / Yeo, Leonard Leong Litt / Pang, Yu Zhi /
    Prakash, Kumar M / Ahmad, Aftab / Thomas, Terrence / Lye, David Chien Boon / Tan, Kevin / Umapathi, Thirugnanam

    Journal of the neurological sciences

    2020  Volume 418, Page(s) 117118

    Abstract: Purpose: To describe the spectrum of COVID-19 neurology in Singapore.: Method: We prospectively studied all microbiologically-confirmed COVID-19 patients in Singapore, who were referred for any neurological complaint within three months of COVID-19 ... ...

    Abstract Purpose: To describe the spectrum of COVID-19 neurology in Singapore.
    Method: We prospectively studied all microbiologically-confirmed COVID-19 patients in Singapore, who were referred for any neurological complaint within three months of COVID-19 onset. Neurological diagnoses and relationship to COVID-19 was made by consensus guided by contemporaneous literature, refined using recent case definitions.
    Results: 47,572 patients (median age 34 years, 98% males) were diagnosed with COVID-19 in Singapore between 19 March to 19 July 2020. We identified 90 patients (median age 38, 98.9% males) with neurological disorders; 39 with varying certainty of relationship to COVID-19 categorised as: i) Central nervous system syndromes-4 acute disseminated encephalomyelitis (ADEM) and encephalitis, ii) Cerebrovascular disorders-19 acute ischaemic stroke and transient ischaemic attack (AIS/TIA), 4 cerebral venous thrombosis (CVT), 2 intracerebral haemorrhage, iii) Peripheral nervous system-7 mono/polyneuropathies, and a novel group, iv) Autonomic nervous system-4 limited dysautonomic syndromes. Fifty-one other patients had pre/co-existent neurological conditions unrelated to COVID-19. Encephalitis/ADEM is delayed, occurring in critical COVID-19, while CVT and dysautonomia occurred relatively early, and largely in mild infections. AIS/TIA was variable in onset, occurring in patients with differing COVID-19 severity; remarkably 63.2% were asymptomatic. CVT was more frequent than expected and occurred in mild/asymptomatic patients. There were no neurological complications in all 81 paediatric COVID-19 cases.
    Conclusion: COVID-19 neurology has a wide spectrum of dysimmune-thrombotic disorders. We encountered relatively few neurological complications, probably because our outbreak involved largely young men with mild/asymptomatic COVID-19. It is also widely perceived that the pandemic did not unduly affect the Singapore healthcare system.
    MeSH term(s) Adult ; COVID-19/epidemiology ; Comorbidity ; Female ; Humans ; Male ; Nervous System Diseases/epidemiology ; Pandemics ; Prospective Studies ; SARS-CoV-2 ; Singapore/epidemiology ; Young Adult
    Keywords covid19
    Language English
    Publishing date 2020-09-03
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 80160-4
    ISSN 1878-5883 ; 0022-510X ; 0374-8642
    ISSN (online) 1878-5883
    ISSN 0022-510X ; 0374-8642
    DOI 10.1016/j.jns.2020.117118
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  8. Article: Neurology of COVID-19 in Singapore

    Koh, Jasmine Shimin / De Silva, Deidre Anne / Quek, Amy May Lin / Chiew, Hui Jin / Tu, Tian Ming / Seet, Christopher Ying Hao / Hoe, Rebecca Hui Min / Saini, Monica / Hui, Andrew Che-Fai / Angon, Jasmyn / Ker, Justin Ruixin / Yong, Ming Hui / Goh, Yihui / Yu, Wai-Yung / Lim, Tchoyoson Choie Cheio / Tan, Benjamin Yong Qiang / Ng, Kay Wei Ping / Yeo, Leonard Leong Litt / Pang, Yu Zhi /
    Prakash, Kumar M / Ahmad, Aftab / Thomas, Terrence / Lye, David Chien Boon / Tan, Kevin / Umapathi, Thirugnanam

    J Neurol Sci

    Abstract: PURPOSE: To describe the spectrum of COVID-19 neurology in Singapore. METHOD: We prospectively studied all microbiologically-confirmed COVID-19 patients in Singapore, who were referred for any neurological complaint within three months of COVID-19 onset. ...

    Abstract PURPOSE: To describe the spectrum of COVID-19 neurology in Singapore. METHOD: We prospectively studied all microbiologically-confirmed COVID-19 patients in Singapore, who were referred for any neurological complaint within three months of COVID-19 onset. Neurological diagnoses and relationship to COVID-19 was made by consensus guided by contemporaneous literature, refined using recent case definitions. RESULTS: 47,572 patients (median age 34 years, 98% males) were diagnosed with COVID-19 in Singapore between 19 March to 19 July 2020. We identified 90 patients (median age 38, 98.9% males) with neurological disorders; 39 with varying certainty of relationship to COVID-19 categorised as: i) Central nervous system syndromes-4 acute disseminated encephalomyelitis (ADEM) and encephalitis, ii) Cerebrovascular disorders-19 acute ischaemic stroke and transient ischaemic attack (AIS/TIA), 4 cerebral venous thrombosis (CVT), 2 intracerebral haemorrhage, iii) Peripheral nervous system-7 mono/polyneuropathies, and a novel group, iv) Autonomic nervous system-4 limited dysautonomic syndromes. Fifty-one other patients had pre/co-existent neurological conditions unrelated to COVID-19. Encephalitis/ADEM is delayed, occurring in critical COVID-19, while CVT and dysautonomia occurred relatively early, and largely in mild infections. AIS/TIA was variable in onset, occurring in patients with differing COVID-19 severity; remarkably 63.2% were asymptomatic. CVT was more frequent than expected and occurred in mild/asymptomatic patients. There were no neurological complications in all 81 paediatric COVID-19 cases. CONCLUSION: COVID-19 neurology has a wide spectrum of dysimmune-thrombotic disorders. We encountered relatively few neurological complications, probably because our outbreak involved largely young men with mild/asymptomatic COVID-19. It is also widely perceived that the pandemic did not unduly affect the Singapore healthcare system.
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #741365
    Database COVID19

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  9. Article ; Online: Neurology of COVID-19 in Singapore

    Koh, Jasmine Shimin / De Silva, Deidre Anne / Quek, Amy May Lin / Chiew, Hui Jin / Tu, Tian Ming / Seet, Christopher Ying Hao / Hoe, Rebecca Hui Min / Saini, Monica / Hui, Andrew Che-Fai / Angon, Jasmyn / Ker, Justin Ruixin / Yong, Ming Hui / Goh, Yihui / Yu, Wai-Yung / Lim, Tchoyoson Choie Cheio / Tan, Benjamin Yong Qiang / Ng, Kay Wei Ping / Yeo, Leonard Leong Litt / Pang, Yu Zhi /
    Prakash, Kumar M. / Ahmad, Aftab / Thomas, Terrence / Lye, David Chien Boon / Tan, Kevin / Umapathi, Thirugnanam

    Journal of the Neurological Sciences

    2020  Volume 418, Page(s) 117118

    Keywords Neurology ; Clinical Neurology ; covid19
    Language English
    Publisher Elsevier BV
    Publishing country us
    Document type Article ; Online
    ZDB-ID 80160-4
    ISSN 1878-5883 ; 0022-510X ; 0374-8642
    ISSN (online) 1878-5883
    ISSN 0022-510X ; 0374-8642
    DOI 10.1016/j.jns.2020.117118
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