Introduction: Infection with HIV is multi-faceted and involves the interplay of medical, social, and economic factors thus, management of the disease continues to be a challenge to most physicians. The Philippines is experiencing a surge in cases since 2013. Understanding the local epidemiology of pediatric HIV may reveal opportunities to reduce or eliminate transmission through timely diagnosis. Objective: This study was conducted to identify the features and outcome of children living with HIV in a hospital where a program for HIV treatment and monitoring was implemented. Methodology: Medical records of all children Guidance Intervention Prevention (SAGIP) Unit were reviewed. Data was analysed using descriptive statistics. Results: Thirty pediatric HIV patients were included in the study. The most common mode of acquisition is by sexual transmission (57%) and most patients were male (76%),bisexual (47%), and heterosexual (47%). Weight loss (50%),rash (50%), fever (37%) and cough (37%) were the most common clinical findings. The most common opportunistic infections were tuberculosis (47%) and oral candidiasis (34%). Only 27 of 30 patients were started on antiretroviral therapy within 6 months from diagnosis. One patient showed resistance to a non-nucleoside reverse transcriptase inhibitor (NNRTI). There were 11 children who died of various opportunistic infections and its complications, while 2 were transferred to a different treatment hub after 6 months, and 1 lost to follow-up. Conclusion Sexual means of HIV transmission among adolescents is evident in this study. Weight loss, cough, rash, fever, and lymphadenopathy are common presenting features. Tuberculosis and oral candidiasis are the most common opportunistic infections and should alert physicians on possible HIV infection. A mortality rate of 37% was noted mostly in the first 6 months of initiating ART treatment.
HIV

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

Objectives: This case series aims to present three cases of pediatric cancer – two acute leukemia and one solid tumor with active COVID-19 infection who underwent chemotherapy Methodology: Three cases of pediatric cancer who tested positive for SARS-CoV2 are presented. All proceeded with scheduled chemotherapy despite active COVID-19 infection. Two had no post-chemotherapy complications, while one had febrile neutropenia and hospital-acquired pneumonia. Results: In this case series, COVID-19 infection in pediatric patients with cancer does not appear to be more severe compared with the general population. The severity of signs and symptoms can be attributed to a lower Cycle Threshold (CT) value and a co-infection. COVID-19 infection did not change the course and post-chemotherapy complications in all cases. Conclusion Patient demographics, comorbidities and type of malignancy played an essential role in the pre- and post-chemotherapy outcome. Individual patient factors including CT values, comorbidities, co-infections, COVID19 disease severity classification, and blood count picture are also instrumental in the management and outcome of these cases. Pediatric cancer treatment should be a priority during active COVID-19 infection.
COVID-19 ; Drug Therapy ; Neoplasms ; Child

Background: The COVID-19 pandemic continues to afflict nations worldwide. The Philippines is no exception which has recorded more than 3 million cases as of December 2021 with children comprising 12% of total cases. Since the start of the pandemic, the Pediatric Infectious Disease Society of the Philippines (PIDSP) has been collecting data nationwide, through an online pediatric COVID-19 registry (SALVACION registry), to provide a better understanding of COVID-19 in children in the local setting. Methods: This was an ambispective cohort study of pediatric COVID-19 cases in the Philippines reported from March 2020 to December 2021. Data on clinical features, laboratory findings, disease severity, and treatment outcomes were voluntarily reported by physicians across the country. This study was approved by the Department of Health Single Joint Research Ethics Board. Results: As of December 30, 2021, there were 2,127 cases reported in the registry, with a median age of 5 years (interquartile range: 1-13 years) and mostly mild (41.9%) or moderate (24.5%) in severity. The top symptoms reported were fever (57.9%), cough (42.7%), coryza/colds (29.4%), anorexia (25.2%), and difficulty of breathing (23.1%). The most common comorbidities were hematologic-oncologic diseases (7.4%), neurologic diseases (7.0%) and surgical conditions (4.4%), while the most common coinfections were sepsis (6.3%), dengue fever (4.8%) and healthcare-associated pneumonia (2.1%). Significantly higher median CRP, procalcitonin, D-dimer, ferritin, transaminases and lactate dehydrogenase were seen among severe/critical cases compared to non-severe cases. There was a high frequency of antibiotic use (58%). Most cases recovered, although 172 deaths were reported with an 8.6% case fatality rate. The most common comorbidities in those who died were neurologic (15.7%), cardiac (12.8%) and hematologic (11.6%) diseases. Conclusion Children across all age groups are susceptible to COVID-19 and most cases are mild or moderate in severity. Among severe and critical cases, the most common comorbidities were neurologic, hematologic-oncologic and cardiac diseases. Most patients recovered with supportive management.
COVID-19 ; SARS-CoV-2 ; Child ; Registries ; Philippines