1.Clinical presentation and outcome of pediatric COVID-19 patients admitted in Philippine Children's Medical Center (PCMC): The first 100 cases.
Jenneelyn A. Gonzales-Ritona ; Caridad M. Santos ; Mary Ann C. Bunyi
The Philippine Children’s Medical Center Journal 2022;18(1):105-141
BACKGROUND: There are numerous studies on adult patients admitted for COVID-19 but there is paucity of local data in children.
OBJECTIVE: This study aims to determine the clinical presentation and outcome of children admitted for COVID-19.
METHODOLOGY: This is a retrospective review of medical records of patients 0 to 18 years old with COVID-19 admitted in Philippine Children's Medical Center (PCMC). Descriptive statistics summarized the clinical profile of the patients. Pearson's Chi-Square and Fischer's Exact Test were used for data analysis.
RESULTS: There were 100 confirmed COVID-19 pediatric patients admitted at PCMC from March 2020 to March 2021. Most were within the 0-4 years of age (52%). Fever (63%), respiratory symptoms (31%), and shock (28%) were the predominant clinical manifestations. Most (78%) had no exposure to symptomatic household contacts but all came from communities with known local transmission. Fourteen cases of hospital-acquired COVID-19 were also identified. Out of the 100 cases, 53 had critical COVID-19 on admission and 82 had co-morbidities, mostly neurologic, hematologic and infectious diseases. Seventy-four patients recovered and 26 patients died.
Fever (p-value=0.014) and shock (p-value=0.000), thrombocytopenia or thrombocytosis (p=0.030) and electrolyte imbalances (p=0.045) were significantly associated with critical COVID-19. There was no significant association between the presence of co-morbid conditions on admission and clinical outcome. O2 support by facemask (p=0.001) or by mechanical ventilator (p=0.001), and inotropic support (p=0.000) were significantly associated with mortality.
CONCLUSION: Children admitted for COVID-19 infection generally recover but those with critical COVID-19 is highly associated with mortality.
Human ; Male ; Female ; Adolescent (a Person 13-18 Years Of Age) ; Pre-adolescent (a Child 6-12 Years Of Age) ; Child
2.Risk of Cognitive Impairment in Patients With Parkinson’s Disease With Visual Hallucinations and Subjective Cognitive Complaints
Diego SANTOS-GARCÍA ; Teresa de Deus FONTICOBA ; Carlos Cores BARTOLOMÉ ; Maria J. Feal PAINCEIRAS ; Jose M. Paz GONZÁLEZ ; Cristina Martínez MIRÓ ; Silvia JESÚS ; Miquel AGUILAR ; Pau PASTOR ; Lluís PLANELLAS ; Marina COSGAYA ; Juan García CALDENTEY ; Nuria CABALLOL ; Ines LEGARDA ; Jorge Hernández VARA ; Iria CABO ; Lydia López MANZANARES ; Isabel González ARAMBURU ; Maria A. Ávila RIVERA ; Víctor Gómez MAYORDOMO ; Víctor NOGUEIRA ; Víctor PUENTE ; Julio Dotor GARCÍA-SOTO ; Carmen BORRUÉ ; Berta Solano VILA ; María Álvarez SAUCO ; Lydia VELA ; Sonia ESCALANTE ; Esther CUBO ; Francisco Carrillo PADILLA ; Juan C. Martínez CASTRILLO ; Pilar Sánchez ALONSO ; Maria G. Alonso LOSADA ; Nuria López ARIZTEGUI ; Itziar GASTÓN ; Jaime KULISEVSKY ; Marta Blázquez ESTRADA ; Manuel SEIJO ; Javier Rúiz MARTÍNEZ ; Caridad VALERO ; Mónica KURTIS ; Oriol de FÁBREGUES ; Jessica González ARDURA ; Ruben Alonso REDONDO ; Carlos ORDÁS ; Luis M. López DÍAZ L ; Darrian MCAFEE ; Pablo MARTINEZ-MARTIN ; Pablo MIR ;
Journal of Clinical Neurology 2023;19(4):344-357
Background:
and Purpose Visual hallucinations (VH) and subjective cognitive complaints (SCC) are associated with cognitive impairment (CI) in Parkinson’s disease. Our aims were to determine the association between VH and SCC and the risk of CI development in a cohort of patients with Parkinson’s disease and normal cognition (PD-NC).
Methods:
Patients with PD-NC (total score of >80 on the Parkinson’s Disease Cognitive Rating Scale [PD-CRS]) recruited from the Spanish COPPADIS cohort from January 2016 to November 2017 were followed up after 2 years. Subjects with a score of ≥1 on domain 5 and item 13 of the Non-Motor Symptoms Scale at baseline (V0) were considered as “with SCC” and “with VH,” respectively. CI at the 2-year follow-up (plus or minus 1 month) (V2) was defined as a PD-CRS total score of <81.
Results:
At V0 (n=376, 58.2% males, age 61.14±8.73 years [mean±SD]), the frequencies of VH and SCC were 13.6% and 62.2%, respectively. VH were more frequent in patients with SCC than in those without: 18.8% (44/234) vs 4.9% (7/142), p<0.0001. At V2, 15.2% (57/376) of the patients had developed CI. VH presenting at V0 was associated with a higher risk of CI at V2 (odds ratio [OR]=2.68, 95% confidence interval=1.05–6.83, p=0.039) after controlling for the effects of age, disease duration, education, medication, motor and nonmotor status, mood, and PD-CRS total score at V0. Although SCC were not associated with CI at V2, presenting both VH and SCC at V0 increased the probability of having CI at V2 (OR=3.71, 95% confidence interval=1.36–10.17, p=0.011).
Conclusions
VH were associated with the development of SCC and CI at the 2-year follow-up in patients with PD-NC.