Introduction. The University of the Philippines-Philippine General Hospital (UP-PGH) began its operations as a COVID-19 referral center on March 30, 2020. Local studies reporting characteristics of patients in the intensive care units (ICUs) are lacking. Objectives. 1) To describe the baseline characteristics and outcomes of the initial cohort of COVID-19 patients in the medical ICU. 2) To report the initial situation and strategies in the ICU during the first two months of being a COVID-19 referral center. Methods. We conducted a review of records of all patients with confirmed COVID-19 admitted to the medical ICU of UP-PGH between April 1 to May 31, 2020. Patient demographics, comorbidities, APACHE-II score, signs and symptoms, laboratory and radiologic results, respiratory and vasopressor support, and outcomes were collected. Results. Out of 35 patients with confirmed COVID-19, majority were above 60 years old (63%). Hypertension was the most frequent comorbidity (77%). Fever was the most common symptom (51%). The mean duration of symptoms prior admission was 9 ± 7 days. Anemia and leukocytosis with neutrophilia was common. Lactate dehydrogenase (LDH) and high-sensitivity C-reactive protein (HSCRP) were elevated in most patients. Majority of patients (66%) had moderate level of hypoxemia on admission. Bilateral pneumonia on chest radiograph was found in 34 patients. Hydroxychloroquine and chloroquine were the most commonly used drugs. A total of 24 patients (69%) required invasive mechanical ventilation while 15 (43%) needed pressor support. Twenty-two expired (63%) while thirteen (37%) patients were discharged from the medical ICU. Conclusion. The clinical characteristics in our set of patients are consistent with other studies on critically ill patients. Mortality in the medical ICU was high.
Philippines ; COVID-19 ; Coronavirus Infections ; Intensive Care Units

BACKGROUND: Contrast-induced nephropathy (CIN) is associated with increased morbidity and mortality of patients. One of the mechanisms that have been investigated in the development of CIN is the presence of hyperuricemia. Thus, it has been postulated that using urate-lowering agents may be beneficial in preventing CIN. This report aims to determine the efficacy of giving allopurinol along with standard IV hydration in reducing the incidence of contrast-induced nephropathy after coronary catheterization. METHODS: We conducted as electronic search using PUBMED, MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Kidney and Transplant register of Studies, Google Scholar, and Research Gate. Studies fulfilling the inclusion and exclusion criteria were quality assessed based on the criteria provided in the Cochrane Handbook for Systematic Reviews of Interventions. Only published full manuscripts written in English from 1966 to April 2018 were included. The incidences of CIN were analyzed using a random-effects model in Review Manager (Rev Man) Version 5.3 with a 95% confidence interval. RESULTS: Five studies of 2,033 were included with a total of 753 patients. Results showed that there is a 63% decrease in CIN [RR = 0.37 (0.25 to 0.54, 95% CI, Z = 5.10, p < 0.00001) in the allopurinol group compared to those who received hydration alone. When adjusted for heterogeneity by using the random effects model, there remains a 35% decrease in the incidence of CIN [RR = 0.65 (0.43 to 0.99, 95% CI, Z = 2.02, p = 0.04) in the allopurinol group. CONCLUSION: Allopurinol administration may be protective in the development of CIN in patients undergoing coronary interventions. However larger, multi-centered randomized-controlled trials are needed to validate this claim.