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

OBJECTIVE: The study determined the ocular manifestations as well as the clinico-demographic, maternal profile, and management of infants with Congenital Rubella Syndrome (CRS) seen at the Philippine Children‘s Medical Center from 2015 to 2021. MATERIALS AND METHODS: A retrospective chart review was conducted among children less than 1 year of age, born between January 1, 2015, to December 31, 2021, who met the clinical case definition of CRS. RESULTS: Among the 398 reviewed charts, 312 were suspected cases of CRS, 79 were probable, and 7 were laboratory-confirmed. Ocular conditions were found in 54 suspect cases, 14 probable cases, and 2 confirmed cases. Congenital cataract was the most common ocular manifestation in infants with CRS, and associated clinical manifestations were mainly congenital heart disease followed by microcephaly and hearing loss. CONCLUSION This study highlighted the challenge of CRS diagnosis in the country, with most cases diagnosed based on clinical manifestations and a limited number of laboratory-confirmed cases due to the expense and availability of confirmatory tests. These findings emphasize the importance of recognizing ocular manifestations as an early indicator of CRS and the need for improved surveillance and awareness of the disease to facilitate early recognition and management.
Rubella Syndrome, Congenital

The most frequent cause of mortality in neonates is infections which include sepsis, meningitis, pneumonia, diarrhea and tetanus. Approximately 1.6 million deaths due to neonatal infections occur annually in developing countries. The causes of sepsis vary from one geographic area to another. Thus, it is important to create a database for the Philippines regarding the etiologies of neonatal sepsis. Objectives: The study was undertaken to determine the most common bacterial pathogens of neonatal sepsis in the Philippines and the antibiotic sensitivity patterns of these pathogens. Methods: A multicenter surveillance and chart review was conducted in five hospital sites for a period of six months- from July to December 2006. All neonates less than or equal to 28 days who had positive cultures from a sterile site and or had fulfilled the SIRS criteria as defined by the International Pediatric Sepsis Consensus Conference in the presence of suspected or proven infection were included in the study. Results: A total of 289 neonates fulfilled the criteria of sepsis. More than 61% of the patients had early onset neonatal sepsis. The most common site of infection was the lungs, (57%), followed by sepsis without an obvious site of infection (35%). In 50% of patients, an organism was identified; gram-negative bacteria were the dominant bacteria found (Pseudomonas, Burkholderia, Klebsiella) which comprised 94% of the bacteria isolated. Resistance patterns varied among the different urban study centers. The Pseudomonas and Burkholderia isolates from the Philippine General Hospital (PGH) were sensitive to ceftazidime. All Klebsiella isolates from St. Louis University (SLU) were resistant to third generation cephalosporins. In contrast, Klebsiella isolates from PGH and Davao were sensitive to third generation cephalosporins but resistant to piperacillin-tazobactam. The overall mortality rate was 11%. Ampicillin and an aminoglycoside were the most common regimens used but were only successful in less than 50% of cases. Conclusion: Gram-negative organisms comprised the majority of the neonatal infections, with Pseudomonas and Burkholderia being the most prevalent. Resistance patterns differed among the different centers. Continuing surveillance of infections is still needed in order choose the most appropriate empiric therapy for each center.
Human ; Male ; Female ; Infant Newborn ; SEPSIS ; INFECTION