Background: RT-PCR using respiratory tract specimens, most commonly nasopharyngeal swab (NPS), has been used to confirm the diagnosis of COVID-19. NPS is a relatively invasive procedure that causes patient discomfort and risks viral transmission. Other specimens are therefore being investigated for the detection of SARS-CoV-2 RNA. Objective: To determine the sensitivity of non-respiratory tract specimens in detecting SARS-CoV-2 RNA in patients with COVID-19. Methodology: This review summarized the results of eight studies obtained from a literature search done in May 2020 in PubMed MEDLINE, Cochrane Library and MedRxiv. Two independent investigators reviewed and appraised the studies that were included, and pooled estimates of sensitivity for each specimen were determined using Stata’s Metaprop function Results: The sensitivity in detecting SARS-CoV-2 RNA in non-respiratory tract specimens of diagnosed COVID-19 patients are as follows: Saliva 77% (95% CI 71-83%), stool/rectal swab/anal swab 22% (95% CI 22-37%), blood/serum/plasma 2% (95% CI 1-3%), and urine 22% (95% CI 18-25%). Conclusion SARS-CoV-2 RNA is detected in saliva, stool/rectal swab/anal swab, blood/serum/plasma and urine. Among these, saliva has the highest estimated sensitivity. However, more studies are needed to correct the heterogeneity brought about by factors such as timing of specimen collection, disease severity and treatment.
COVID-19

Background: COVID-19 is an ongoing health concern that hospitals have struggled to keep up with, given its increasing burden with the passage of time. Considerations for the management of COVID-19 should be made especially for pregnant patients and their neonates. Objectives: To determine COVID-19 prevalence and the clinical profile of mothers admitted for childbirth at Chinese General Hospital and Medical Center from May 2020 to July 2020. The profile and outcomes of neonates born to these mothers were likewise studied. Materials and Method: A descriptive cross-sectional study was done that included mothers admitted for childbirth who had SARS-CoV-2 RT PCR swab test and their neonates. A total of 408 medical records of mother and neonate dyads were reviewed. Relevant variables such as the patients’ demographic profile, clinical characteristics, co-morbidities and the maternal and neonatal outcomes were obtained. Frequency distributions were made to assess the prevalence of COVID-19 among the patients, as well as maternal and neonatal outcomes. Results: Twenty-two (5.39%) mothers tested positive for COVID-19, while all neonates (n = 22) that underwent RT-PCR swab at the 24th hour of life had negative results. Of the 22 COVID-19 positive mothers, 2 (9.09%) were symptomatic upon admission while 20 (90.09%) were asymptomatic. The following were the key trends among those mothers who tested positive for COVID-19: (1) 81.82% were from ages 20-39 years old, (2) 72.73% were multigravida mothers, (3) 54.55% had normal spontaneous delivery, (4) diabetes mellitus was the only noted comorbidity. Key findings on the neonatal outcomes observed in the study population of both COVID-19 positive and negative cases, include: (1) majority of neonates had an APGAR score of greater than 7 at 1st and 5th minute of life; (2) higher frequency of neonates with Ballard’s score of more than 37 weeks AOG; (3) more male neonates as compared to female neonates; (4) a normal birth weight for majority of cases; (5) 45.45% of neonates born to COVID positive mothers had a length of stay of <48 hours as compared to 72.8% of neonates born to COVID negative mothers; and (6) neonatal pneumonia as the most common comorbid condition in both cases. Conclusion This study noted a prevalence of 5.39% COVID-19 positive mothers. SARS-CoV-2 virus was not detected in all of the neonates born to COVID-19 affected mothers. Neonates delivered to COVID-19 positive mothers had similar trends in the neonatal outcomes when compared to neonates delivered to mother who were COVID-19 negative.
COVID-19

Objective: This study aimed to describe the clinical profile and treatment outcomes of patients treated with a short course (<10 fractions) of palliative radiotherapy during the first year of the COVID-19 pandemic. Another aim of the study is to compare patients treated with short-course and long-course palliative radiotherapy in terms of the site and volume irradiated. Methods: An ambispective study comprised 23 patients treated with short-course palliative radiotherapy from March 2020 to February 2021. The retrospective aspect of this study included a review of medical records and radiotherapy plans, while the prospective part involved communication with patients or legally authorized representatives via phone call. Demographic, clinical, and treatment-related information were gathered. Results: Of 92 patients receiving palliative radiotherapy, 23 were treated with a short course, while 69 were planned for at least ten fractions. Of the 23 patients receiving short-course radiotherapy, most had colorectal (35%) and head and neck (26%) primary malignancies. The most commonly treated sites were the pelvis (24%), vertebral bones (21%), and head and neck masses (21%), and the most common indications were pain (45%) and bleeding (32%). The majority were treated with 20 Gy in 5 fractions (42%) and 25 Gy in 5 fractions (38%). Complete resolution of symptoms was observed in 43% of cases, and more than half reported no side effects (58%). Median survival was 71 days. All patients treated in the lung, stomach, and brain underwent a long course of palliative radiotherapy. Patients with a long course also had higher mean irradiated volumes (1871 cm3 vs. 2150 cm3). Conclusion In this single institution review, a short course of palliative radiotherapy was proven to provide good symptom control with few side effects. During the COVID-19 pandemic, its use should be strongly considered, especially in patients with poor performance status, transportation difficulties, and limited life expectancy.
COVID-19

Background: The global economy has been severely affected by the COVID-19 pandemic which proved to be more than a public health crisis. Volume and gross income have also declined in the health service sector including the diagnostic imaging and radiotherapy divisions of the radiology departments in other countries. Objective: This study determined the change in volume and gross income of the Radiology Department of a tertiary hospital which was designated as a COVID-19 referral center in the Philippines. Methodology: Monthly records of the profit centers of the Radiology Department were reviewed noting the volume and gross income one year before and during the first year of the pandemic. Results: Records were successfully retrieved for the volume of procedures and revenue for each profit center from one year before the pandemic (from March 1, 2019 to February 28, 2020) and the first year of the pandemic (from March 1, 2020 to February 28, 2021). There was a total reduction of 120,046 procedures conducted and Php 84,837,614.16 in revenues generated between the two periods. This is equivalent to a 61.98% (range: 47.92% to 83.37%) decrease in the volume of procedures and a 45.02% (range: 31.08% to 77.86%) decrease in revenue. These changes were found to be statistically significant. Conclusion The COVID-19 pandemic caused a decline of all profit centers in the Radiology Department. The decline was associated with changes in quarantine restrictions. Data from this study may help the administration of the institution or other institutions to conduct their own studies and cope with future pandemics of similar magnitude or further surges of the current pandemic on decisions regarding budget and resource allocation.
COVID-19

The Philippine COVID-19 Living Clinical Practice Guidelines (CPG) is a set of guidelines that provides up-to-date evidence-based recommendations on COVID-19 treatment, diagnosis, infection prevention and control. This living guideline follows the Department of Health’s Manual for Clinical Practice Guideline Development1 and the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) Approach.2 The diagram below is a summary of the treatment regimens gathered from the Philippine COVID-19 Living Recommendations website. The recommendation for each drug regimen is based on the assessment and literature review done by the Living CPG Task Force (LCTF).3 The LCTF follows the classification of quality of evidence enumerated and described in Box 1.
COVID-19

The Republic Act No. 11494, also known as the "Bayanihan to Recover as One Act," mandates the allocation of funds and provides guidance for the procurement of COVID-19 vaccines.1 However, with the limited availability of COVID-19 vaccines, the Department of Health (DOH) established different policies and guidelines for the selection, access, and deployment of these vaccines throughout the country.2 3 4 5 To date, the Philippine Food and Drugs Authority (FDA) has granted emergency use authorizations for eight COVID-19 vaccines, namely: Pfizer-BioNTech COVID-19 Vaccine, COVID-19 Vaccine AstraZeneca, CoronaVac, Sputnik V, Janssen COVID-19 Vaccine, Covaxin, COVID-19 Vaccine Moderna, and COVID-19 Vaccine BIBP/Sinopharm.6 One of the guidelines established by the DOH is the implementation of a prioritization scheme, wherein citizens are categorized into different prioritization groups based on risk of exposure to the virus and risk of mortality from COVID-19.4 In Davao City, the COVID-19 vaccination roll out started last 5 March 2021 among health care workers at Southern Philippines Medical Center. 7 Aiming to vaccinate 1,200,000 individuals in Davao City,8 the City Government of Davao, DOH Davao Region, and other participating sectors established 59 vaccination sites throughout the city.9 We gathered online data posted in the official facebook pages of DOH Davao Region and the City Government of Davao. According to the DOH Davao Region reports, as of 27 July 2021, a total of 742,710 doses of COVID-19 vaccines were allotted for Davao City. From the total allotted doses, the City Government of Davao City has successfully administered a total of 330,954 first doses, and 149,122 second doses of COVID-19 vaccines.10 According to the City Government of Davao, as of 25 July 2021, Davao City has administered a total of 85,260 doses (1st dose - 47,332 doses, 2nd dose - 37,928 doses) of COVID-19 vaccine among individuals in the A1 prioritization group, 103,837 doses (1st dose - 76,472 doses, 2nd dose - 27,365 doses) among those in the A2 prioritization group, 179,479 (1st dose - 101,833 doses, 2nd dose - 77,646 doses) among those in the A3 prioritization group, 98,502 doses (1st dose - 97,446 doses, 2nd dose - 1,056 doses) among those in the A4 prioritization group, and 12,998 doses (1st dose - 7,871 doses, 2nd dose - 5,127 doses) among those in the A5 prioritization group.11 All in all, as of 27 July 2021, 149,122 individuals out of Davao City's target of 1,200,000 individuals (12.43%) have received complete COVID-19 vaccination. In addition, 181,832 individuals have already received the first dose of a two-dose COVID-19 vaccine.8
COVID-19

As the biggest COVID-19 facility in Mindanao, Davao City’s Southern Philippines Medical Center (SPMC) rolled out its first doses of COVID-19 vaccines to some of its frontline health care workers (HCW) last March 5, 2021. The COVID-19 vaccination program in the Philippines is an extensive and comprehensive immunization campaign to help curb the spread of SARS-CoV-2 and protect the people against severe COVID-19. To expedite the vaccine procurement and administration process, the Republic Act 11525 or the “COVID-19 Vaccination Program Act of 2021” was enacted into law on February 26, 2021.1 The Department of Health (DOH) and the National Task Force against COVID-19 (NTF), in partnership with local governments, have been tasked to implement, facilitate, and monitor the COVID-19 vaccination program.2
COVID-19

Covid-19

COVID-19

In the Philippines, the coronavirus disease 2019 (COVID-19) pandemic has accorded a tremendous challenge to health care in terms of protecting frontline staff from contracting the virus and providing optimal medical management to patients with or without COVID-19. Across the globe, even countries with well-developed healthcare systems are battling COVID-19 with great difficulty. In terms of local response, on March 15, 2020, Davao City was placed under community quarantine1 to limit the movement of people and curb the spread of SARS-CoV-2, the virus that causes COVID-19. Further restrictions on work, businesses, transportation, and other daily activities were imposed during an enhanced community quarantine (ECQ) from April 4, 2020 to May 15, 2020,2 3 4 5 followed by a 15-day general community quarantine (GCQ).6 7 Patients from Davao City who are suspected of having COVID-19 began to be referred to the Southern Philippines Medical Center (SPMC) starting in early March 2020. The SPMC Laboratory Unit also started processing reverse transcription polymerase chain reaction (RT-PCR) tests for the diagnosis of COVID-19 as a subnational laboratory late in March. Being the only subnational laboratory in the southern Philippines during the first few weeks of community quarantine, SPMC processed most of Mindanao's COVID-19 RT-PCR tests.
COVID-19