The allergic reaction that killed a Covid-19 patient may have been caused by some Traditional Chinese Medicine (TCM) pills.
The 61-year-old man had reportedly taken some Lianhua Qingwen pills after he tested positive.
According to Channel NewsAsia (CNA), Koh Choon Lim died in Tan Tock Seng Hospital on 21 Jul 2022. This was two days after he took four Lianhua Qingwen capsules.
On Wednesday (26 Apr), the Coroner’s Court heard the start of the inquiry into Koh’s death. During the hearing, investigators posited a link to the TCM pills.
The Lianhua Qingwen pills first gained popularity at the height of the Covid-19 pandemic. They supposedly helped alleviate some symptoms of the infection.
However, in 2021, the Health Sciences Authority (HSA) refuted those claims. They said they may help relieve cough and flu, but it is not meant to treat Covid-19 infections.
The court heard that Koh had taken four Lianhua Qingwen pills on 27 Jul 2022 at around 11.30pm. This was shortly after he had tested positive for Covid-19, following days of feeling tired and lethargic.
Per CNA, this was not Koh’s first time taking those pills. He had apparently taken them before to “clear body heatiness”.
Koh’s son told the court that he got the pills from a TCM clinic without a consultation.
A few hours later, he woke up at around 2am on 28 Jul and took two Panadol tablets before going back to sleep.
However, he woke again at 4.30am, complaining that he felt warm and his throat was hurting. At that point, he could not speak clearly due to the pain in his throat.
His family brought him to a clinic to seek treatment. There, the doctor noted that Koh’s lips were swollen and was having an allergic reaction.
Koh received three injections in total at the clinic for the reaction. After some observation, his swelling had subsided slightly, and he was allowed to go home.
Despite that, things took a turn for the worse that afternoon. Koh seemed disoriented when his family tried speaking to him. So, they immediately took Koh to Tan Tock Seng Hospital’s Emergency Department.
On 29 Jul, Koh was transferred to the National Centre for Infectious Diseases (NCID). His condition later worsened, and he passed away the same day.
While Koh had other medical conditions, his cause of death was confirmed to be anaphylaxis, a life-threatening allergic reaction, and Covid-19 respiratory tract infection.
The investigating officer told the court that Koh’s Lianhua Qingwen pills might have triggered the reaction. However, they are unable to confirm this post-mortem.
During the hearing, the Adjunct Assistant Professor Monica Chan from the NCID noted that this was not a usual case of anaphylaxis, CNA reported.
The typical symptoms of anaphylaxis are redness of the skin, rashes, swelling, and difficulty breathing. However, Koh did not exhibit those signs. His vitals were also not unusual when he was at NCID.
He also did not have low oxygen saturation, nor did he experience difficulty breathing. Professor Chan noted that he received treatment for anaphylaxis from the general practitioner, at the emergency department, as well as when he was in his ward.
What concerned the staff at NCID was, instead, Koh’s altered mental state and behavioural changes, said Professor Chan.
Professor Chan also explained why Koh did not experience any reaction the last time he took Lianhua Qingwen.
She said that this was due to a process called sensitisation. That refers to when a person’s body becomes sensitive to a given allergen.
As Koh had taken Lianhua Qingwen before, he was already sensitive to it. This time, however, a reaction occurred, and his ongoing Covid-19 infection probably exacerbated it.
State Coroner Adam Nakhoda then gave instructions for further investigations into this case at the end of the hearing.
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