INTRODUCTION: A vast number of COVID-19 cases have been reported worldwide since the initial outbreak in China, and the disease has since become a global pandemic. Knowledge on this predominantly respiratory illness is evolving with studies suggesting myocardial injury reflected by elevated cardiac enzymes portending to more severe disease. CT scoring indices provide visual, semi-quantitative assessment of lung involvement and have aided in determining extent of COVID-19 pneumonia but, none have been validated for prognostication. Establishing a relationship between these non-invasive diagnostic parameters could provide timely identification and proper allocation of limited medical resources to patients in need of more aggressive therapy. METHODS AND RESULTS: A total of 50 COVID-19 patients were retrospectively enrolled and their clinical parameters collected from an electronic medical database. There was a total of 31 patients with troponin I-HS with chest CT scan done and another 42 patients for NT-proBNP and chest CT. The levels of both cardiac biomarkers in patients with clinically severe COVID pneumonia were higher than those with mild and moderate disease. Rank-order analysis showed that both troponin I-HS (moderate, p=0.0003174) and NT-proBNP (moderate, p=0.006255) correlated positively with CT severity scores. Furthermore, there is a significant relationship between mortality and septic shock with both Troponin I-HS (p<0.001; p=0.002) and NT-proBNP (p=0.004; p=0.031). CONCLUSION The cardiac markers troponin I-HS and NT-proBNP increased significantly at more severe CT scores and more notably, these biomarkers predicted the development of septic shock and mortality in COVID-19 pneumonia.
COVID-19 ; NT-proBNP ; pro-brain natriuretic peptide (1-76) ; Troponin I

INTRODUCTION: Accurate determination of volume status for patients with end-stage renal disease is essential in determining ultrafiltration rate during hemodialysis (HD). To complement the current dry weight method, inferior vena cava (IVC) collapsibility, made accessible by pointof-care ultrasonography, is considered. This study determined the utility of IVC measurement in estimating the volume status of patients during HD in comparison to clinical parameters. METHODS: A single-center cross-sectional design including 53 HD patients was conducted, with IVC measurements done through the Butterfly iQ ultrasound (Butterfly Network, Burlington, Massachusetts). RESULTS: Most patients were hypervolemic before HD based on weight (94.3%) and IVC collapsibility index (IVC CI; 75.5%), but only 30% had clinical symptoms. Body weight, maximum IVC diameter, minimum IVC diameter, and indexed IVC size significantly decreased after HD, whereas IVC-CI, blood pressure, and heart rate were unchanged. For the subset of patients with symptoms, absolute values of IVC measures were higher, but did not significantly change after HD, unlike in those without symptoms. For volume classification, there are discrepancies in the classifications based on the different measures, with most improvement seen when weight was used, but which was not reflected in IVC-CI. Change in weight and IVC measures were not significantly correlated. DISCUSSION This pilot study showed that the current dry weight method provides ultrafiltration rate estimation without causing intradialytic events. However, IVC can be a supplemental parameter to set higher targets and increase volume removal enough to cause intravascular change, especially in symptomatic patients. The incongruencies in classifying volume status suggest that there is no single measure to determine hemodynamic status and that using multiple parameters may provide a more reliable estimate.

BACKGROUND: Road traffic injuries (RTI) are a leading cause of morbidity and mortality globally. Despite underreporting, the scarce Philippine data suggest that RTI pose a significant health problem in the country. It is imperative, therefore, to accurately quantify the burden of RTI in the Philippines.

OBJECTIVE: This study aimed to provide the first comprehensive baseline estimation of the socioeconomic burden of RTI in the Philippines for year 2014.

METHODS: The study was a mixed method study design that utilized both primary and secondary data. These data were used to construct parameters needed for the modeling estimates. Measure of socioeconomic burden estimated were (1) economic costs, (2) disability-adjusted life years (DALYs), and (3) healthy life years (HeaLY).

RESULT: Estimated deaths due to RTI in 2014 were 12,336 translating to 454,650 years life lost due to premature death. Injury episodes from RTI were estimated to be 2,798,088 in 2014 with 186,174 leading to admissions, translating to 56,224 years life lost to disability. The total DALY loss due to RTI in 2014 was estimated at 510, 874, while healthy life years lost were estimated to be 76,215,477.4. The estimated deaths and injuries for that year equaled to direct medical cost of PhP 1.213 B, productivity loss due to premature death of PhP 24.620 B, and productivity loss due to illness of PhP 685 M resulting to a total economic cost of PhP 26.519 B to the society.

CONCLUSION: The findings indicate that RTI is an important public health concern in the Philippines with substantial economic and health burden. Investing in preventive measures will likely yield significant economic and health gains for the Philippines.