Key Findings Very low-quality evidence suggests lower mortality (based on five observational studies) but higher failure rate of respiratory support (based on two observational studies) in COVID-19 patients given high-flow nasal cannula (HFNC) oxygen compared with noninvasive ventilation (NIV) and conventional oxygenation therapy. Randomized controlled trials (RCT) are urgently needed in this area. • Respiratory failure accounts for about half of deaths in patients with COVID-19. • High-flow nasal cannula (HFNC) oxygen therapy reduces the need for escalating respiratory support and improves patient comfort compared with conventional oxygen therapy among those with acute respiratory failure. • Mortality was consistently lower in COVID-19 patients who received HFNC rather than NIV or conventional oxygen therapy (COT) across 5 very low-quality retrospective observational studies from China. • Several international guidelines recommend the use of HFNC oxygen therapy in COVID-19 patients who develop acute hypoxemic respiratory failure. However, local guidelines from the Philippine Society for Microbiology and Infectious Diseases (PSMID) and the Philippine College of Chest Physicians (PCCP) recommend against HFNC due to risks of transmission and paucity of direct evidence for efficacy. • Additional infection control precautions, i.e. wearing a surgical mask over the cannula, and locating in a negative pressure room, are recommended whenever using HFNC or NIV. • There are at least two ongoing trials due to be completed by the second quarter of 2021 comparing HFNC oxygenation with NIV or COT in COVID-19 patients.
Cannula ; Noninvasive Ventilation ; COVID-19 ; Coronavirus

The World Health Organization declared mpox outbreak as a public health emergency of international concern in July 2022 and August 2024. To date, the Philippines has reported 15 confirmed cases. This report described the demographics, clinical presentations, transmission risks, outcome and viral genetic clades of confirmed mpox cases.

Data from six RT-PCR-confirmed cases at the Research Institute for Tropical Medicine identified MPXV clade II in five cases and MPXV clade III in one case. The cases involved five cisgender men who have sex with men (MSM), three of which were known to be people living with HIV (PLHIV) on antiretroviral therapy (ART) and one cisgender female. The median age was 31. Two cases had a history of international travel prior to symptoms.

The cases presented with skin rash (100%), fever (100%), malaise (100%), genital rash (67%), localized lymphadenopathy (16.67%), and headache (16.67%). Skin lesions were umbilicated, presenting as vesicles (100%), papules (83%), or pustules (50%). Secondary bacterial skin infections were reported in two cases. Sequelae included post-inflammatory hyperpigmentation and scarring. No severe complications or deaths occurred.

Mpox outbreak emphasized the threat of emerging and re-emerging infectious diseases. This report provides insights on mpox’ clinical manifestations, transmission, and outcomes in MSM and PLHIV. Mild disease presentations in HIV patients emphasize the importance of ART adherence in preventing severe complications. Despite the small sample size, this study underscores the need for ongoing surveillance and targeted public health intervention focusing on awareness, safe sexual practices, early diagnosis and treatment.

Human ; Hiv ; Mpox ; Mpox, Monkeypox