BACKGROUND

Persistent symptoms following SARS-CoV-2 infection have increasingly been reported globally, although currently there are no available local epidemiological data on this. This study aimed to determine the prevalence, common manifestations, and clinical predictors of post COVID-19 condition among the pediatric population.

A cross-sectional analytical study adapting the ISARIC (International Severe Acute Respiratory and Emerging Infection Consortium) Global COVID 19 – pediatric survey questionnaire was done. There were 356 patients with confirmed SARS-CoV-2 infection (RNA detected by RT-PCR/GeneXpert). Out of the 189 with complete data and who responded, 3 were excluded due to deaths during the acute infection. A total of 186 children aged 0-18 years old were enrolled and children of the same age group having SARS-CoV-2 negative result were included as control in 1:1 ratio. Univariate and multivariate regression analyses were performed to identify variables associated with post COVID-19 symptoms.

The prevalence of post COVID-19 condition was 15%. The most common presenting symptoms during the acute infection were fever and cough, while the common post COVID-19 symptoms included persistent cough (65%), rhinorrhea (55%) and loss of taste (3%). In the univariate analysis, the age group 5-11 years (OR 13.83, p value < 0.05) and hospitalization (OR 2.37, p value < 0.05) were statistically correlated with persisting symptoms. However, multivariate logistic regression analysis showed that hospitalization (aOR 4.1, p value < 0.05) was the only factor significantly associated with the persistence of symptoms.

Children less than 11 years old and male sex have a higher prevalence of persistent symptoms following acute COVID-19 infection. The age group 5-11 years old was identified as a clinical predictor of post COVID-19 condition along with those who were hospitalized.

BACKGROUND

COVID-19 pandemic led to a dramatic loss of human life worldwide and presented an unprecedented challenge to public health. One of the solutions in addressing the problem was mass vaccination in order to attain herd immunity. However, most people were hesitant to be vaccinated particularly due to their fear of the adverse events; hence the goal of this study was to determine the possible adverse events (AEs) experienced during administration of CoronaVac^TM COVID-19 Vaccine.

The objective of the study was to monitorthe occurrence of adverse events within one hour, two to 24 hours, and 25 to 72 hours after administration of the first and second dose of CoronaVac^TM COVID-19 Vaccine in a tertiary government hospital in Pangasinan.

This cross-sectional study was done from February to April 2021 at Region 1 Medical Center. Employees who received the two doses of Sinovac-CoronaVac^TM vaccine and gave their informed consent were included in the study. Participants were monitored closely for adverse events within 30 minutes following administration of the vaccine and were instructed to report any local and systemic AEs to the Hospital Epidemiology Center Office. Individuals were also followed up through telephone to investigate the occurrence of any complaints after 24 to 72 hours.

A total of 353 participants who received the complete doses of CoronaVac^TM were included in the study. The incidence of AEs was higher after the first dose compared with the second dose. After the first dose of CoronaVac^TM 12.5% reported AEs after the 1st hour, 14.2% two to 24 hours after the vaccine, and 1.4% on the 25^th hour up to the 72^nd hour. Pain on injection site was the most common adverse event during the first hour (8.2%). On the 2nd hour up to 24 hours, headache, and myalgia (14.2%) were more evident. Headache was reported in 1.1% of the participants after 25-72 hours of vaccination. After the second dose, only one participant reported multiple AEs such as fatigue, headache, rash and retroorbital pain (1, 0.7%).

In this study, 28.1% of the participants experienced adverse events afterthe first dose of CoronaVac^TM vaccine. AEs were higher after the first dose (28.1%) compared with the second dose (0.3%). Injection site pain was the most common adverse event during the first hour, then headache and myalgia during the 2^nd hour up to 24 hours, and headache on the 25^th – 72^nd hour after vaccination. Only one participant reported several AEs after the 2^nd dose of the vaccine.

Background: During the COVID-19 outbreak, studies indicated that neonates born to COVID-19-positive mothers are susceptible to adverse outcomes. However, limited research explored the link between maternal COVID-19 severity and perinatal outcomes. Objectives: To determine the characteristics and outcomes of newborns born to COVID-19 positive mothers and its association with maternal COVID-19 severity. Methodology: This was a cross-sectional study conducted in a tertiary hospital which involved a retrospective chart review of mother-newborn dyads who delivered between June 1, 2020, and December 31, 2022. Results: One hundred forty COVID-19 infected mothers and their respective newborns (143) were included in the study. Majority of mothers were 18 - 30 yrs. old, multigravida, multiparous, delivered by normal spontaneous delivery (NSD) and were asymptomatic. Only 3.6 % have severe COVID-19. Neonatal outcome was generally good in both non-infected and COVID-19 infected newborns. Most were term, with normal birthweights, appropriate for gestational age (AGA), with good APGAR scores. Hyperbilirubinemia is a common morbidity (15%). There is a higher prevalence of preterm births, low birthweight, low APGAR score in the 5th minute of life, respiratory distress syndrome (RDS), neonatal sepsis, neonatal intensive care unit (NICU) admission and mortality among neonates born to mothers with severe COVID-19, but there is no statistically significant association between maternal COVID - 19 severity and neonatal outcome except for APGAR score on the 5th minute of life. Conclusion Most COVID-19-infected pregnant women were asymptomatic and neonatal outcomes were generally favorable. Maternal COVID-19 severity did not substantially contribute to adverse neonatal outcomes.
COVID-19 ; Infant, Newborn

Background: Numerous studies have demonstrated various information about COVID-19 infection. With this, the authors intend to abridge, present, and synthesize current available information, focusing on the cutaneous manifestations of COVID-19 infection, to help guide dermatologists in understanding the dermatologic aspect of this disease. Objective: This study aims to review the different cutaneous manifestations of COVID-19 by morphology and to evaluate the lesions seen in the different age groups. Furthermore, this study aims to discuss cutaneous findings together with histologic evidence and hypothesized pathophysiology, and to review the management used in treating COVID-19-related cutaneous manifestations. Methods: OVID® and PubMed databases were used to search in detail for COVID-19-induced skin lesions across all ages and their management. Discussion: COVID-19 affects the skin, hair and nails of patients. These may be attributed to the different virologic phases as well as the immune response of the body. Histopathologic findings of these lesions vary depending on the clinical presentation. Use of corticosteroid therapy and antihistamines as treatment for some cutaneous manifestations of COVID-19 showed good response. Conclusion COVID-19 infection-associated cutaneous manifestations present with different morphologies. It is important for dermatologists to gain better understanding of this disease in order to promptly identify and suspect the possibility of this illness, as well as provide appropriate actions.
COVID-19 ; Coronavirus ; Skin

Aims: Coronavirus disease-2019 (COVID-19) is an ongoing global pandemic. In Syria, the first case was reported in March 2020. This study was aimed to investigate the incidences of COVID-19 in the Banias and Alkadmos areas in Tartus, Syria, in 2021. Methodology and results: Our data were obtained from the records of Banias and Alkadmos hospitals. The results were inferred by analysing data for 1026 COVID-19 patients. About 58.4% of total cases were among males and 41.6% were among females. Most patients were living in rural areas; 73% compared to 27% in urban ones. The severity of the disease varied between patients. About 67.4% of cases needed to be hospitalized for treatment, most of which were from the elderly. The same was noticed with the mortality rate, with 14.5% of total cases and 66.4% of them were older than 65. Conclusion, significance and impact of study Our study indicated that age and gender are risk factors for contracting COVID-19.
COVID-19 ; Syria

Background: COVID-19 is an ongoing health concern that hospitals have struggled to keep up with, given its increasing burden with the passage of time. Considerations for the management of COVID-19 should be made especially for pregnant patients and their neonates. Objectives: To determine COVID-19 prevalence and the clinical profile of mothers admitted for childbirth at Chinese General Hospital and Medical Center from May 2020 to July 2020. The profile and outcomes of neonates born to these mothers were likewise studied. Materials and Method: A descriptive cross-sectional study was done that included mothers admitted for childbirth who had SARS-CoV-2 RT PCR swab test and their neonates. A total of 408 medical records of mother and neonate dyads were reviewed. Relevant variables such as the patients’ demographic profile, clinical characteristics, co-morbidities and the maternal and neonatal outcomes were obtained. Frequency distributions were made to assess the prevalence of COVID-19 among the patients, as well as maternal and neonatal outcomes. Results: Twenty-two (5.39%) mothers tested positive for COVID-19, while all neonates (n = 22) that underwent RT-PCR swab at the 24th hour of life had negative results. Of the 22 COVID-19 positive mothers, 2 (9.09%) were symptomatic upon admission while 20 (90.09%) were asymptomatic. The following were the key trends among those mothers who tested positive for COVID-19: (1) 81.82% were from ages 20-39 years old, (2) 72.73% were multigravida mothers, (3) 54.55% had normal spontaneous delivery, (4) diabetes mellitus was the only noted comorbidity. Key findings on the neonatal outcomes observed in the study population of both COVID-19 positive and negative cases, include: (1) majority of neonates had an APGAR score of greater than 7 at 1st and 5th minute of life; (2) higher frequency of neonates with Ballard’s score of more than 37 weeks AOG; (3) more male neonates as compared to female neonates; (4) a normal birth weight for majority of cases; (5) 45.45% of neonates born to COVID positive mothers had a length of stay of <48 hours as compared to 72.8% of neonates born to COVID negative mothers; and (6) neonatal pneumonia as the most common comorbid condition in both cases. Conclusion This study noted a prevalence of 5.39% COVID-19 positive mothers. SARS-CoV-2 virus was not detected in all of the neonates born to COVID-19 affected mothers. Neonates delivered to COVID-19 positive mothers had similar trends in the neonatal outcomes when compared to neonates delivered to mother who were COVID-19 negative.
COVID-19

Background: The COVID-19 pandemic became a severe public health threat to the Philippines, overwhelming the health system and its healthcare workers. As infections spread globally, it became imperative to understand the infection prevention practices (e.g., face mask-wearing, handwashing, social distancing) to better understand the pandemic and its effects on the healthcare workforce. Objective: The study aims to describe the sociodemographic and medical profile and the COVID-19 infection prevention practices, and the correlation between both among employees of a medical center in the National Capital Region (NCR), Philippines, Methods: The analytic cross-sectional study utilized an online survey administered to employees of a medical center in NCR, Philippines. A total of 112 responses were analyzed. Descriptive statistics were used to analyze respondents’ sociodemographic and medical characteristics and summarize their COVID-19 infection prevention practices. Spearman’s rank correlation and Pearson’s chi-square tests were performed to determine the association of the respondents’ sociodemographic and medical profiles with their corresponding infection prevention practices. Results: Majority of respondents were between ages 30-50 (52.68%), female (71.43%), with college (83.93%) as their highest educational attainment, single (70.54%), and without comorbidities (66.07%). 76.5% (72/94) of respondents living in multi-person households lived with familial ties, and 59.6% (56/94) of respondents living in a multi-person household lived with at least one member considered a high-risk individual (i.e., a senior citizen with comorbidities). The respondents practiced face mask-wearing (4.92) and respiratory etiquette (4.90) the most, whereas reduction of unnecessary outings (3.81), not drinking alcohol (3.81), and sleeping at least 7 hours per day (3.42) were least practiced. Results showed that only age and having chronic kidney disease correlated with infection prevention practices with a p-value of <0.05, showing that people with chronic kidney disease and those aged 30-50 were more likely to engage in infection prevention practices. Conclusion The study findings provide insight into sociodemographic and medical factors that may contribute to adherence to infection prevention practices among the hospital-based workforce. Recommendations for further research were discussed.
COVID-19 ; Hospitals

Summary Cutaneous manifestations of Coronavirus disease (COVID-19) are variable. We present a case of non-drug related symmetrical flexural and intertriginous exanthema in a patient with COVID-19 infection. A 58-year-old Chinese male who was diagnosed to have COVID-19 infection, developed maculopapular erythematous rashes at bilateral axillary and inguinal folds on the fourth day of illness. He was treated symptomatically with anti-histamine and topical corticosteroid. The skin condition improved and he was discharged well on tenth day of illness. Although symmetrical flexural intertriginous exanthema isclassically caused by drug reaction, this case demonstrated the possibility of the rash being directly associated with COVID-19 infection. More cohorts should be evaluated to fully describe the full spectrum of dermatological manifestation in COVID-19.
Exanthema ; COVID-19 ; Skin Manifestations

BACKGROUND

Patient experience is the interaction with the healthcare system and is one of the three pillars of quality in healthcare. Its assessment provides an opportunity to assure quality of care, meet patients’ expectations, direct strategic decision making, and document benchmarks for healthcare organizations.

The onset of the pandemic pushed the employees’ clinic to institute new processes and focus on COVID-19 screening and monitoring of affected employees. The clinic used patient feedback to improve its services.

A survey tool was developed and released by the clinic in June 2020 to elicit feedback and improve its services. Most items were yes/no questions and patients were asked to rate based on a Likert scale of 0-5 for the other items. They were also given space for their additional comments/feedback.

The study described the experience of patients utilizing the COVID-19 services of the employees’ clinic of a tertiary hospital.

This was a cross-sectional study that involved a retrospective review of all data retrieved from the feedback forms from those who availed the COVID-19 services of the employees’ clinic, namely consultation, swabbing, and/ or telemonitoring, from June 2020 to December 2021.

A total of 4,136 feedback forms were retrieved from the employees’ clinic. There were 1,598 forms from consultation, 1,268 forms from swabbing and 1,270 forms from telemonitoring. A total of 456 comments were positive and 275 were negative. Most forms listed receiving an introduction from their physician/nurse (92.74%) and received instructions for swabbing (90.43%) during consultation. For swabbing, most received information regarding their schedule (95.43%). Almost all forms listed receiving SMS or calls (98.74%) and information regarding returnto- work or admission (96.14%) from the telemonitoring service. Only about half were able to discuss fears and anxieties (48.76%) during consultation and about twothirds (68.93%) received information regarding their RT-PCR results. Feedback stated that the clinic staff were respectful and courteous, and the service hours were convenient. However, concerns with data privacy were apparent.

Overall patient experience was generally positive despite the rapidly changing processes of the clinic.

Background: Children with COVID-19 may present with gastrointestinal (GI) symptoms and liver dysfunction. Objective: To determine the type and prevalence of gastrointestinal (GI) and hepatic manifestations of COVID-19 in children and its association with severity of illness. Methods: A systematic literature search was done from inception until January 4, 2021 using PubMed, Cochrane Library, Google Scholar and prepublication repositories with no language restrictions. Studies that reported the demographic and clinical features of children with COVID-19 and provided data on their GI and hepatic signs and symptoms were included. Prevalence of GI and hepatic manifestations were pooled using Stata14. Results: We included 58 studies with total of 4497 participants. Overall, one-third of children with COVID-19 presented with at least one GI symptom (33.8%; 95% confidence interval (CI) 23.0, 45.4; I2 97.5%; 42 studies, 3327 participants) with abdominal pain, nausea or vomiting, and diarrhea each occurring in approximately 20%. Children with severe COVID-19 were more likely to present with GI symptoms (odds ratio 2.59; 95% CI 1.35, 4.99; I2 24%; 4 studies, 773 participants). The pooled prevalence of elevated transaminases was 11% for both AST (11.3%, 95% CI 4.9, 19.3; I2 74.7%; 11 studies, 447 participants) and ALT (11.2%, 95% CI 7.1, 16.0; I2 40.8%; 15 studies, 513 participants). Hepatic findings such as jaundice (2-17%), hepatomegaly (2%) or behavioral changes (2%) from hepatic encephalopathy were variably reported by a few studies. The degree of heterogeneity was not improved on exclusion of studies with poor quality, but markedly improved on subgroup analysis according to geographical region and presence of MIS-C. Studies from China showed that children with COVID-19 had significantly lower pooled prevalence for any of the GI symptoms with low degree of heterogeneity, particularly for diarrhea, nausea/vomiting, and abdominal pain, all of which had I2 of 0%. Those with multisystem inflammatory syndrome in children (MIS-C) had significantly more common GI symptoms and increased transaminases than those without. Conclusion One-third of children with COVID-19 exhibit at least one GI symptom and more likely present in those with severe disease. Elevated transaminases were present in 10%. Prevalence of GI and hepatic manifestations were higher among children with MIS-C.
COVID-19 ; Liver Diseases