BACKGROUND: COVID-19 disease has strained our healthcare system. Convalescent plasma is an adjunct treatment used in emerging infectious diseases in past epidemics. OBJECTIVE: This study aims to determine the outcome and clinical course of COVID-19 patients who received convalescent plasma (CP) transfusion at Cardinal Santos Medical Center. METHODS: This is a retrospective cohort analytical study of 75 patients who received convalescent plasma. RESULTS: Median time from admission to CP transfusion was 3 days. Majority of patients received additional therapies including dexamethasone (100%), antibiotics (100%), remdesivir (95%), hemoperfusion (88%), tocilizumab (65%), or combinations of these. Among the survivors, the median length of stay (LOS) was 15 days while non-survivors had a median LOS of 6 days. One patient (1.33%) had a mild transfusion reaction. Four patients (5.33%) developed deep vein thrombosis despite anticoagulation. There was improvement in the inflammatory markers (LDH p value 0.04, CRP p value 0.00, Ferritin p value 0.0001). There was improvement in the pulmonary parameters - increase in mean PaO2, mean SaO2, and mean PFR; and decrease in mean FiO2 and mean RR post-treatment. Median LOS is 14 days for the CP group vs 11 days for the non- CP group. Mortality rate among the CP group was 25.33% while the non-CP group was 26.67%. LOS and mortality rate did not reach statistical significance. CONCLUSIONS: There was no significant difference in mortality and length of hospital stay in patients given CP vs controls. CP when combined with other treatment modalities might have a role in the improvement of inflammatory markers and pulmonary status.
COVID-19 ; Plasma

As the COVID-19 pandemic worsens, early case detection is vital to limiting community spread. We describe our experiences with four COVID-19 cases at the polyclinics in January and February 2020. This retrospective case series highlights the challenges primary care clinicians face in the early identification of suspect cases based on clinical criteria only. To improve case detection, clinicians can sharpen their clinical acumen by keeping abreast with the latest COVID-19 developments and by maintaining a high state of vigilance.
Adult ; Aged ; COVID-19/epidemiology* ; Female ; Humans ; Male ; Pandemics ; Primary Health Care ; Retrospective Studies ; SARS-CoV-2 ; Singapore/epidemiology*

BACKGROUND: By March 2020, The World Health Organization (WHO) has declared Coronavirus disease-19 (COVID-19) as a global pandemic. Further investigations found that COVID-19 may lead to acute kidney injury (AKI). Some studies have been done, but the incidence and outcome of AKI in COVID-19 are variable between studies. Moreover, given the high number of COVID-19 cases in our country, we aimed to perform a systematic review and meta-analysis regarding the detailed outcome of AKI in COVID-19 patients as reported in the available literature. METHODS: We performed a comprehensive literature search from several databases, such as Europe PMC, PubMed, ProQuest, Directory of Open Access Journal (DOAJ), and related references between December 1, 2019, and December 5, 2020. The primary outcome was mortality, and the secondary outcomes were the need for Intensive Care Unit (ICU) care, severe and critical COVID-19 infection, and Acute Respiratory Distress Syndrome (ARDS). RESULTS: There were a total of 25,990 patients from 21 studies. Acute kidney injury was associated with increased odds of mortality (OR 13.43 [8.35, 21.60], p < 0.00001; I2 : 82%, p < 0.00001), need for ICU care (OR 14.57 [8.51, 24.94], p < 0.00001; I2: 84%; p < 0.0001), critical COVID-19 (OR 10.41 [3.88, 27.90], p < 0.00001; I2: 67%; p = 0.02), and ARDS (OR 2.84 [1.30, 6.22], p = 0.009; I2: 91%; p = 0.001). CONCLUSION: Acute kidney injury is associated with mortality, need for ICU care, critical COVID-19 patients, and ARDS.
Coronavirus ; COVID-19 ; Coronavirus Infections ; Acute Kidney Injury

PURPOSE: Since the outbreak of the unprecedented COVID-19 health crisis, Filipino nurses are one of the vital health workers in fighting its devastation in the Philippines. The study aimed to describe the lived-experiences of Filipino next generation nurses as frontliners in the midst of COVID-19 pandemic. DESIGN: The paper espoused the qualitative research design of inquiry exclusively Husserlian descriptive phenomenology. Study participants were selected using non-probability, purposive sampling design. The sample (N=19) was consisted of Filipino nurses with less than 10 years of practice experience, referred to as next-generation nurses, who function as frontline healthcare workers in healthcare settings, both male and female. The study was conducted in the national capital region (NCR), which has the most COVID-19 cases in the country. Due to the community quarantine imposed by the national government, the corpus of data was collected through virtual semi-structured interviews and from the participants' testimonies posted in social-media. METHOD: An adaptation of Colaizzi's empirical phenomenological research approach was utilized to obtain an in-depth understanding and analysis of study participants' experiences. FINDINGS: The profound, life-changing experiences of a select group of Filipino next- generation nurses were unified in three interesting themes, namely,: acclimatization to the challenges of the novel clinical situation, affirmation of the spirit of resiliency, and actualization of the valued calling. CONCLUSION: The contagion has demanded a new way of working, and these nurses have risen to the challenge, and demonstrated how capable they are at responding to new situations and uncertainty. Despite facing dire challenges, they demonstrate the spirit of resiliency. This health crisis enables them to impart the value of the nursing vocation. As they navigate this unprecedented contagion, their experiences and status could likely alter at different phases of the pandemic. Hence, the provision of long-term and holistic support for them is necessary to preserve their welfare.
COVID-19 ; Pandemics ; Family Characteristics

BACKGROUND: The COVID-19 pandemic has given rise to medical and non-medical issues. One of the subtler but equally important issues are the ethical ones. Most prominent among these is the ethical dilemma of health care professionals faced with the decision of whether or not they should continue working and serving the country despite the risks. OBJECTIVES: This paper intends to analyze the said bioethical dilemma by first, examining the ethical conundrum and defining its parameters; second, by assessing a previous attempt to arbitrate this issue and in the process, evaluating two different theories in ethics: egoism and Christian ethics; and third, by proposing a more nuanced normative ethical framework to fully understand the moral picture. METHODOLOGY: The paper employs the interpretive and analytical approach in philosophy and ethics, citing available literature, data, and sources to reinforce its arguments. RESULTS: The bioethical dilemma of healthcare professionals cannot be completely analyzed using the lens of egoism and Christian ethics as previously asserted by another scholar. A fuller understanding can be reached by using an Aristotelian normative framework as an anchor for analysis. CONCLUSION: All healthcare professionals want the good. While a dilemma may ensue because of conflict of values (e.g. for work and for safety), Aristotelian ethics subscribes to the need for hitting the mean between two extremes by honing one's practical wisdom and deliberation. Healthcare professionals exercise this faculty in confronting their dilemma.
Humans ; COVID-19 ; Bioethics ; Delivery of Health Care

The emergence of coronavirus disease 2019 (COVID-19) not only poses a serious threat to the health of people worldwide but also affects the global economy. The outbreak of COVID-19 began in December 2019, at the same time as the influenza season. However, as the treatments and prognoses of COVID-19 and influenza are different, it is important to accurately differentiate these two different respiratory tract infections on the basis of their respective early-stage characteristics. We reviewed official documents and news released by the National Health Commission of the People's Republic of China, the Chinese Center for Disease Control and Prevention (China CDC), the United States CDC, and the World Health Organization (WHO), and we also searched the PubMed, Web of Science, Excerpta Medica database (Embase), China National Knowledge Infrastructure (CNKI), Wanfang, preprinted bioRxiv and medRxiv databases for documents and guidelines from earliest available date up until October 3rd, 2020. We obtained the latest information about COVID-19 and influenza and summarized and compared their biological characteristics, epidemiology, clinical manifestations, pathological mechanisms, treatments, and prognostic factors. We show that although COVID-19 and influenza are different in many ways, there are numerous similarities; thus, in addition to using nucleic acid-based polymerase chain reaction (PCR) and antibody-based approaches, clinicians and epidemiologists should distinguish between the two using their respective characteristics in early stages. We should utilize experiences from other epidemics to provide additional guidance for the treatment and prevention of COVID-19.
COVID-19/therapy* ; Diagnosis, Differential ; Female ; Humans ; Influenza, Human/therapy* ; Male ; Pandemics/prevention & control* ; Prognosis ; SARS-CoV-2

The COVID-19 pandemic has caused numerous deaths around the world. A growing body of evidence points to the important role of overwhelming inflammatory responses in the pathogenesis of COVID-19 and the effectiveness of anti-inflammation therapy against COVID-19 is emerging. In addition to affecting the lungs, COVID-19 can be a severe systemic inflammatory disease that is related to endothelial dysfunction. We are calling for closer attention to endothelial dysfunction in COVID-19 not only for fully revealing the pathogenic mechanism of COVID-19 but also for properly adjusting the strategy of clinical intervention.
COVID-19 ; Endothelium ; Humans ; Inflammation ; Pandemics ; SARS-CoV-2

This research analyzed Chinese emergency approval policies and practices of medical devices at the local level under the circumstance of COVID-19 disease. The legal basis and administrative system were clarified, the implementation and characteristics of emergency approval policies were investigated, the products information including total approved number, product type and license's validity period were counted. Advices as enhancing the standardization of emergency approval system, strengthening registration guidance and optimize information disclose and management were provided.
COVID-19 ; Device Approval ; Humans ; Policy ; SARS-CoV-2

BACKGROUND: The COVID-19 outbreak broadly affected not only the physical but also the psychological wellbeing of the people. However, few studies have been conducted concerning its psychological impact specifically on employees from the academe. OBJECTIVES: To determine the psychological responses and coping styles of employees of the School of Health Sciences at the University of the Philippines - Manila during the COVID-19 pandemic. Specifically, this study sought to determine the association between participants’ socio-demographic characteristics and their psychological responses, and between participants’ psychological responses and their coping styles used. METHODS: We employed a cross-sectional design and self-selection or volunteer sampling to recruit 46 academics and support staff employed during the COVID-19 pandemic. The data were collected in April 2020. Psychological responses were determined with the 10-item Kessler’s Psychological Distress Scale. Coping styles were assessed with the short-form Cognitive Emotion Regulation Questionnaire. Likelihood ratio chi-square tests and Spearman rho tests were conducted to test the hypotheses. Statistical significance was determined at p < .05. RESULTS: The majority of participants reported low levels of psychological distress in the early stage of the pandemic (n=44; 95.65%). We found a statistically significant relationship between psychological responses and coping styles characterized by rumination (rs = 0.454; P = 0.002) and catastrophizing (rs = 0.408; P = 0.005). CONCLUSIONS: Our study confirmed the significance of psychological responses during the COVID-19 pandemic and demonstrated a specific association with coping styles characterized by rumination and catastrophizing but are unsuitably less adaptive. Hence, the application of less adaptive techniques when psychologically distressed from the pandemic need to be corrected or modified.
Philippines ; COVID-19 ; Adaptation, Psychological ; Universities

The Philippines has been the leading country in Southeast Asia in terms of infections (both in terms of total and active cases) brought forth by the SARS-COV-2 virus, known as the COVID-19 pandemic. We highlight the historical underpinnings of pandemic responses that are related to the Philippines, both globally and locally. We also present some counterfactuals in an economic recession that the pandemic caused. Arguing for fast-track rehabilitation and improvement of digital infrastructure, this development is essential in promoting e-commerce, quality education through remote learning, and the quality of health data generation and analysis. As the world is reminded of the Balmis expedition while the world still grapples to obtain a cure for the pandemic, we look at these tenets of the “new normal” to address issues of social justice in the Philippine setting.
Expeditions ; Philippines ; COVID-19 ; Socioeconomic Factors ; Pandemics