It has been considered that viral infections predispose patients to bacterial infections due to immunosuppression.3 However, it is still unclear what exact roles co-infections play in patients with COVID-19 infection1. Centers for Disease Control and Prevention defines co -infection as an infection concurrent with the initial infection. This report discusses a case of meningoencephalitis presenting with seizures. Notable in this case was the detection of SARS-CoV-2 RNA and Salmonella in the CSF.
Coronavirus

Objectives. The ongoing Coronavirus disease 2019 (COVID-19) pandemic has disrupted healthcare systems worldwide. This study aimed to document the effect of COVID-19 on osteosarcoma treatment pathways in the Philippine General Hospital (PGH) and determine if there were any delays. Method. A retrospective review of osteosarcoma patients treated at the PGH from January 1, 2019 – January 1, 2020 (pre-COVID-19) was compared to those treated during the COVID-19 pandemic from March 1, 2020 – September 1, 2020. Rates of diagnosed osteosarcoma, admission for chemotherapy, admission for surgery, treatment abandonment, metastatic disease on presentation, 1-year mortality, and amputation were calculated and compared between the two groups. Results. From March to September 2020, 11 newly diagnosed osteosarcoma patients sought consult at the PGH. Only one patient sought consult during the initial 3-4 months of the study, suggesting that patients delayed seeking healthcare during the period of enhanced community quarantine. Patients seen during the pandemic had a higher rate of metastatic disease on presentation, reflecting the delay in diagnosis. Due to COVID-19 restrictions early in the pandemic, osteosarcoma patients were coordinated and referred to outside hospitals for intravenous chemotherapy and surgery. Normalization of services (hospital admissions, limb salvage surgeries) were seen at the later stages of the study, corresponding to the loosening of the quarantine. Conclusions. Osteosarcoma patients experienced delays in seeking consult, diagnosis, and treatment at the PGH due to the COVID-19 pandemic. Early indicators suggest worse outcomes for these patients due to the delays. Strategies employed during the pandemic, such as networking of care and telemedicine, may help in future outbreaks.
Coronavirus ; COVID-19 ; Coronavirus Infections ; Pandemics ; Osteosarcoma

No abstract available.
Coronavirus* ; Korea ; Middle East*

Coronavirus Infections ; epidemiology ; Humans

Introduction: Musculoskeletal complaints have been observed in the recovery phase of patients with moderate-to-severe coronavirus disease 2019 (COVID-19). We noted several referrals for physical rehabilitation at the University of the Philippines-Philippine General Hospital (UP-PGH), a designated COVID-19 referral center. These observations resembled the musculoskeletal manifestations associated with poorer outcomes reported in other coronavirus studies. Objectives: The study determined the musculoskeletal signs and symptoms of adults in the recovery phase of moderate to severe COVID-19 using the COVID Musculoskeletal Assessment Tool (CMAT). Methods: This was a three-phased, prospective, descriptive study of adults admitted for COVID-19 at the UP-PGH. Phase 1 was the development of the CMAT based on a review of related literature and patient charts, and patient interviews. The tool was pretested and validated in Phase 2 before it was used in the evaluation of study participants in Phase 3 of the research. Data was encoded using Microsoft® Excel 2007 and analyzed using STATA, Version 12.0 (Texas, USA). Descriptive statistics were used to summarize the variables collected for the study. Results: A cohort of 40 patients admitted at the UP-PGH for moderate-to-severe COVID-19 infection was evaluated using the CMAT. Most of the patients had an average age of 55 years and were males. Majority resided in an urban area, reached high school education, and were ambulatory before their illness. The most common comorbidities were hypertension and diabetes. All patients required oxygen support. Based on the CMAT, majority of the participants complained of muscle pain, generalized weakness, and easy fatigability. Other common findings were neck-shoulder and lower limb pain, dyspnea on exertion, limited mobility in the trunk, hips, and knees, joint pains, and decreased muscle strength. Half of the participants needed a wheelchair or walker to ambulate. These findings may be due to the COVID-19 disease and to prolonged confinement in bed. Only one patient underwent physical therapy through bedside instructions. Conclusion Musculoskeletal signs and symptoms were common in the patients recovering from COVID-19 disease. The COVID-19 Musculoskeletal Assessment Tool facilitated the evaluation of patients and the recording of results. Early referral for medical rehabilitation and timely intervention are strongly recommended.
COVID-19 ; Coronavirus ; Myalgia

No abstract available.
Coronavirus ; Korea ; Quarantine

No abstract available.
Coronavirus ; Humans ; Korea ; Pneumonia

No abstract available.
Coronavirus ; Pneumonia ; Prognosis

Background: Numerous studies have demonstrated various information about COVID-19 infection. With this, the authors intend to abridge, present, and synthesize current available information, focusing on the cutaneous manifestations of COVID-19 infection, to help guide dermatologists in understanding the dermatologic aspect of this disease. Objective: This study aims to review the different cutaneous manifestations of COVID-19 by morphology and to evaluate the lesions seen in the different age groups. Furthermore, this study aims to discuss cutaneous findings together with histologic evidence and hypothesized pathophysiology, and to review the management used in treating COVID-19-related cutaneous manifestations. Methods: OVID® and PubMed databases were used to search in detail for COVID-19-induced skin lesions across all ages and their management. Discussion: COVID-19 affects the skin, hair and nails of patients. These may be attributed to the different virologic phases as well as the immune response of the body. Histopathologic findings of these lesions vary depending on the clinical presentation. Use of corticosteroid therapy and antihistamines as treatment for some cutaneous manifestations of COVID-19 showed good response. Conclusion COVID-19 infection-associated cutaneous manifestations present with different morphologies. It is important for dermatologists to gain better understanding of this disease in order to promptly identify and suspect the possibility of this illness, as well as provide appropriate actions.
COVID-19 ; Coronavirus ; Skin

One of the consequences of the COVID-19 pandemic is an avalanche of information that is unprecedented in magnitude. In the past 2 months, healthcare providers, policy-makers and the general public have been overwhelmed by this phenomenon. Aside from usual news from TV, radio, newspapers and medical journals, people from all walks of life have had to process kilometric threads on viber, facebook and twitter, as well as hundreds of issuances from all government agencies - from the Office of the President down to the barangays. The information from these various sources are often inconsistent or conflicting, and are always rapidly evolving. New information emerges as outdated information is just beginning to circulate. To aggravate the situation, the chaos is taken advantage of by perpetrators of false information. Clearly, this “informageddon” has led to “information overload” – the inability to process facts because of volume or pace. The manifestation is the widespread panic we are witnessing from all sectors of society. The consequence is impaired decision making – by individuals, families, communities and policy makers. Ultimately, this may lead to a prolonged, uncontrolled pandemic characterized by avoidable deaths, disability, and huge social and economic costs. Even healthcare providers are affected. Because of fear, many feel pressured to do tests and give treatments for COVID-19, that are poorly tested for effectiveness and safety. To help manage the information for policy-makers, healthcare workers and the general public, a group of 70 clinical epidemiologists and health professionals gathered together from the Institute of Clinical Epidemiology, National Institutes of Health-UP Manila and the Asia-Pacific Center for Evidence Based Healthcare Inc. The group conducted voluntary rapid evidence reviews and referred to themselves as “The Rappers”. The reviews were graciously shared by Philippine Society of Microbiology and Infectious Diseases through their website (PSMID.org). The online version allowed regular and rapid updates as evidence accrued.
Covid-19 ; coronavirus