SINGAPORE - After a few days of high fever, Mr Tony Goh was rushed to the intensive care unit (ICU) six days after testing positive for Covid-19 on Oct 13, 2021.
His oxygen levels had plummeted from 90 per cent to a mere 54 per cent, seriously endangering the life of the 73-year-old.
This marked the start of 89 harrowing days in the National University Hospital’s (NUH) ICU for the owner of an audio production studio; he was sedated, intubated and hooked up to a ventilator as viral pneumonia wrecked his lungs.
Patients like him who have been hospitalised in the ICU, aged 21 and above, are currently being recruited in Singapore for a global trial to quickly discover the best combination of therapies for community acquired pneumonia.
Community acquired pneumonia – one of the leading causes of death in Singapore – is an inflammation of the lungs caused by a bacterial or viral respiratory infection, which takes place outside the hospital.
While Mr Goh can cycle, eat and drink normally again, his wife Elaine Guoh told The Straits Times that having to deal with different consultants on a weekly basis during her husband’s stay in the ICU had been a struggle even though they were supportive.
They often had their own varying interpretation of the situation at hand, she said.
The 57-year-old marketing consultant added: “One time, a consultant hinted that we might want to consider taking Tony off the ventilator. In the following week, another one suggested a tracheotomy. And after we made a decision to go ahead (with the procedure), another one said it would make little difference.”
The Randomised Embedded Multifactorial Adaptive Platform for Community Acquired Pneumonia (Remap-Cap) – as the global trial is called – simultaneously assesses the effectiveness of multiple treatments for critically ill people across 25 countries, including Singapore, to help intensive care units manage the expected surge in patients with breathing problems in future pandemics.
It was launched in Europe in 2020.
Since the global trial commenced in Singapore at NUH in August 2022 with funding from the National University of Singapore (NUS), three patients have joined the study.
With funding from the National Medical Research Council, the study will expand to Singapore General Hospital, Tan Tock Seng Hospital and Ng Teng Fong General Hospital this year.
Speaking to ST, senior investigator of the Remap-Cap International Trial Steering Committee Paul Tambyah said: “There are no good treatments for viral pneumonia right now, especially for ICU patients.
“The big lesson of Covid-19 is that once you start getting an epidemic... or a spate of patients with worsening of chronic lung disease with a known virus, that puts a strain on ICU resources.”