BACKGROUND AND OBJECTIVES

The global pandemic caused by Coronavirus Disease 2019 (COVID-19) has affected millions, with growing evidence of the potential role of ocular tissues in viral transmission. At the time of writing, local data regarding the phenomenon was limited. This study investigated external ocular manifestations in patients with COVID-19 at a referral center in the Philippines, examined correlations between demographics, systemic manifestations, and laboratory results with ocular manifestations, and determined their timing relative to systemic symptoms.

METHODS

This single-center, descriptive cross-sectional study was carried out from December 8 to 18, 2020 at the adult COVID-19 wards of the Philippine General Hospital involving 72 participants. Data collection involved relevant clinical history taking and performing gross eye examination. The prevalence of ocular manifestations was described with 95% confidence intervals. Correlations between ocular manifestations and quantitative variables were analyzed with point-biserial correlation, and associations with qualitative variables were tested using chi-square or Fisher’s exact tests.

RESULTS

Among participants, 31.9% presented with ocular manifestations with foreign body sensation as the most prevalent ocular symptom (11.1%) and conjunctival hyperemia as the most prevalent ocular finding (19.4%). The median age of patients with ocular manifestations was 41 years old with a higher prevalence in the male population (73.9%, CI=95%, p=0.001). No significant correlation was observed between presence of external ocular manifestations and the different systemic and ocular co-morbidities as well as with COVID-19 clinical classification. Among those who experienced symptoms, majority (29.2%) of the patients experienced systemic symptoms prior to the onset of ocular symptoms. Ocular complaints may present as the sole manifestation (13.9%). Several laboratory parameters were measured and only temperature and AST levels showed a low positive correlation with the presence of ocular manifestations. 

CONCLUSION

Ocular manifestations occur in roughly one third of patients with COVID-19 based on this study population. With some individuals presenting with ocular signs or symptoms as the initial and sole manifestation, healthcare practitioners must exercise caution and remain vigilant in managing patients who present as such. At the time of writing, this is the first local study investigating the different external ocular manifestations in patients with COVID-19. There is a need to pursue more robust studies and conduct more local investigations which will guide both ophthalmologists and other practitioners in strengthening existing guidelines regarding precautionary practices, clinical diagnosis, and management of COVID-19 patients.

Human ; Sars-cov-2 ; Covid-19 ; Philippines ; Adult ; Association ; Classification ; Collection ; Confidence Intervals ; Coronavirus ; Cross-sectional Studies ; Data Collection ; Demography ; Diagnosis ; Disease ; Exercise ; Eye ; Foreign Bodies ; History ; Hospitals ; Hospitals, General ; Hyperemia ; Laboratories ; Male ; Morbidity ; Ophthalmologists ; Pandemics ; Patients ; Population ; Prevalence ; Referral And Consultation ; Role ; Sensation ; Temperature ; Time ; Tissues ; Volition ; World Health Organization ; Writing

BACKGROUND AND OBJECTIVE

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as the causative agent of COVID-19 has significantly challenged the public health landscape in late 2019. After almost 3 years of the first ever SARS-CoV-2 case, the World Health Organization (WHO) declared the end of this global health emergency in May 2023. Although, despite the subsequent drop of COVID-19 cases, the SARS-CoV-2 infection still exhibited multiple waves of infection, primarily attributed to the appearance of new variants. Five of these variants have been classified as Variants of Concern (VOC): Alpha, Beta, Gamma, Delta, and the most recent, Omicron. Therefore, the development of methods for the timely and accurate detection of viral variants remains fundamental, ensuring an ongoing and effective response to the disease. This study aims to evaluate the feasibility of the application of an in-house approach in genomic surveillance for the detection of SARS-CoV-2 variants using in silico designed primers.

METHODS

The primers used for the study were particularly designed based on conserved regions of certain genes in the virus, targeting distinct mutations found in known variants of SARS-CoV-2. Viral RNA extracts from nasopharyngeal samples (n=14) were subjected to quantitative and qualitative tests (Nanodrop and AGE). Selected samples were then analyzed by RT-PCR and amplicons were submitted for sequencing. Sequence alignment analysis was carried out to identify the prevailing COVID-19 variant present in the sample population.

RESULTS

The study findings demonstrated that the in-house method was able to successfully amplify conserved sequences (spike, envelope, membrane, ORF1ab) and enabled identification of the circulating SARS-CoV-2 variant among the samples. Majority of the samples were identified as Omicron variant. Three out of four designed primers effectively bound into the conserved sequence of target genes present in the sample, revealing the specific SARSCoV-2 variant. The detected mutations characterized for Omicron found in the identified lineages included K417N, S477N, and P681H which were also identified as mutations of interest. Furthermore, identification of the B.1.448 lineage which was not classified in any known variant also provided the potential of the developed in-house method in detecting unknown variants of COVID-19.

CONCLUSION

Among the five VOCs, Omicron is the most prevalent and dominant variant. The in-house direct PCR product sequencing surveillance (DPPSS) method provided an alternative platform for SAR-CoV-2 variant analysis which is accessible and affordable than the conventional diagnostic surveillance methods and the whole genome sequencing. Further evaluation and improvements on the oligonucleotide primers may offer significant contribution to the development of a specific and direct PCRbased detection of new emerging COVID-19 variants.

Sars-cov-2 ; Polymerase Chain Reaction ; Dna Primers ; Oligonucleotide Primers ; Computer Simulation ; Conserved Sequence ; Coronavirus ; Covid-19 ; Disease ; Emergencies ; Evaluation Studies As Topic ; Genes ; Genome ; Global Health ; Health ; Identification (psychology) ; Infection ; Infections ; Membranes ; Methods ; Mutation ; Oligonucleotides ; Organizations ; Population ; Public Health ; Rna ; Rna, Viral ; Sars Virus ; Sequence Alignment ; Severe Acute Respiratory Syndrome ; Syndrome ; Viruses ; Whole Genome Sequencing ; World Health Organization

OBJECTIVES

The increasing prevalence of Kawasaki disease in Southeast Asia (SEA) and its potential relation with Coronavirus Disease 2019 (COVID-19) infection resulted in heightened interest in KD in the region, thus, this paper aimed to determine the trend and the socioeconomic facilitators of scientific productivity of KD research within the region. Specifically, this article determined the number of publication and citations related to KD per country, institution, and journal. We also explored the networks of countries within the region to the rest of the world and the keywords mostly associated with KD research in the region. Lastly, correlation of these bibliometric indices with socioeconomic factors in the region was analyzed.

METHODS

A literature search of KD papers in SEA was performed using Scopus database. We obtained bibliographic data from the available literature and visualized network of existing collaborations and keywords using VOSviewer software.

RESULTS

A total of 196 papers were included in the study. Bibliometric analysis showed a rising trend in publication within the region, most of which were from institutions in Singapore and Thailand. The most common topics on KD studies included clinical features, complications, treatment, and comorbidities. 

Country characteristics such as gross domestic product (GDP) per capita, research and development (R&D) expenditure (% GDP), and number of physician and R&D researchers were positively correlated with bibliometric indices of KD research in SEA. Moreover, number of international linkages was significantly associated with KD research productivity in the region. 

CONCLUSION

In summary, we showed an increasing trend of KD research in SEA. Funding allocation and capacity building are necessary to strengthen research productivity within the region.

Asia ; Asia, Southeastern ; Bibliometrics ; Capacity Building ; Coronavirus ; Covid-19 ; Database ; Disease ; Efficiency ; Gross Domestic Product ; Guanosine Diphosphate ; Infection ; Infections ; Literature ; Mucocutaneous Lymph Node Syndrome ; Paper ; Physicians ; Prevalence ; Publications ; Research ; Research Personnel ; Rest ; Singapore ; Socioeconomic Factors ; Software ; Thailand ; Therapeutics

Neutralizing antibodies have been designed to specifically target and bind to the receptor binding domain (RBD) of spike (S) protein to block severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus from attaching to angiotensin converting enzyme 2 (ACE2). This study reports a distinctive nanobody, designated as VHH21, that directly catalyzes the S-trimer into an irreversible transition state through postfusion conformational changes. Derived from camels immunized with multiple antigens, a set of nanobodies with high affinity for the S1 protein displays abilities to neutralize pseudovirion infections with a broad resistance to variants of concern of SARS-CoV-2, including SARS-CoV and BatRaTG13. Importantly, a super-resolution screening and analysis platform based on visual fluorescence probes was designed and applied to monitor single proteins and protein subunits. A spontaneously occurring dimeric form of VHH21 was obtained to rapidly destroy the S-trimer. Structural analysis via cryogenic electron microscopy revealed that VHH21 targets specific conserved epitopes on the S protein, distinct from the ACE2 binding site on the RBD, which destabilizes the fusion process. This research highlights the potential of VHH21 as an abzyme-like nanobody (nanoabzyme) possessing broad-spectrum binding capabilities and highly effective anti-viral properties and offers a promising strategy for combating coronavirus outbreaks.
Single-Domain Antibodies/immunology* ; Spike Glycoprotein, Coronavirus/metabolism* ; SARS-CoV-2/immunology* ; Animals ; Humans ; Antibodies, Neutralizing/immunology* ; Camelus ; COVID-19/immunology* ; Antibodies, Viral/immunology* ; Angiotensin-Converting Enzyme 2

BACKGROUND

Coronavirus disease 2019 (COVID-19) infection is still a problem in our country for the past 2 years. The pandemic severely affected the immunocompromised and high-risk group of patients, such as the pregnant and lactating women. Research shows that this group has higher risk of being critically ill as well as dying. However, there are only a few studies on how COVID-19 vaccine is perceived among this vulnerable group. Hence, this study aims to assess the knowledge, attitude, and practices on COVID-19 vaccine among high-risk pregnant and lactating women. Moreover, the results will be used in crafting health policies that affect this specific group of patients.

METHODOLOGY

A prospective cross-sectional study was conducted on high-risk pregnant and lactating women who sought antenatal consults at the High-Risk Clinic in a tertiary training hospital for a 1-month period. Participants were asked to answer a validated questionnaire assessing their knowledge, attitudes, and practices on COVID-19 vaccine. They were also asked about their sociodemographic characteristics, co-morbidities, history of COVID-19 infection, and vaccination status, as well as the source of their information regarding the vaccine. Descriptive statistics was used to summarize in this study. In addition, frequency and proportion were used for nominal variables, median and range for ordinal variables, and mean and standard deviation for interval or ratio variables. MINITAB 20 was used for data analysis.

RESULTS

A total of 323 high-risk pregnant and lactating women were enrolled in the study with an average age of 29 years old. Socio-demographic characteristics of the participants showed that they were high-school graduate, single, mostly financially disadvantaged, and resides in Cavite, Laguna, Batangas, Rizal and Quezon area. The majority have diabetes mellitus as their co-morbidity, were not infected with COVID-19 and had already been vaccinated. The significant source of information of vaccine information was mainly from social media. The study presented that more than 90% were aware that COVID-19 vaccine was recommended by professional organizations, however, only 55%–59% only agree that it is safe during pregnancy and breastfeeding. The result also conveyed a positive attitude toward vaccination as the pregnancy progresses, as well as during lactation. As to practices, 80% of the participants were told by their health care providers to get vaccinated and 72% of them reported vaccine side effects. Furthermore, 58% of the participants would recommend vaccination during pregnancy while only 54% will recommend it while breastfeeding.

CONCLUSION

Assessment of knowledge, attitudes, and practices of COVID-19 vaccine among high-risk pregnant and lactating women gave an understanding on how a vulnerable population perceives vaccination. In general, this research study presented high percentage COVID-19 vaccine awareness and acceptance; however, it can also be seen that there is a mixed perception regarding vaccine safety during pregnancy and lactation. Strategies to improve health literacy which are evidenced based that can be carried out by a health care provider could be established to achieve maximum vaccination coverage among high-risk group of patients.

Human ; Female ; Coronavirus ; Covid-19 ; Vaccines ; Pandemics

BACKGROUND

The occurrence of the COVID-19 pandemic resulted in increased risk of developing antimicrobial resistance due to the high utilization of antimicrobial agents. Since antimicrobial utilization is a crucial driver in the development of antimicrobial resistance, the need for antimicrobial use surveillance is crucial in identifying prescription patterns that would help provide proper interventions.

OBJECTIVE

To determine the antibiotic use and prevalence of prescription quality indicators among COVID-19 patients admitted at a tertiary government hospital.

METHODS

A retrospective cross-sectional survey was conducted to provide data on antibiotic use and the prevalence of prescription quality indicators among COVID-19 patients in a tertiary-level hospital from June 2021 to June 2022.

RESULTS

A total of 342 patient medical records were surveyed. The majority (119, 34.8%) of the patients were in the age group 41-60 years old and there were more male patients (52.34%) than female patients (47.66%). About 88.99% of the patients were considered to have community-acquired COVID-19 infections. Co-morbidities among patients were seen in more than half of the surveyed population (64%). These include hypertension, diabetes mellitus, chronic kidney disease, coronary artery disease, chronic lung disease, and hematologic disorders.

Empiric antibiotic therapy was high at 88.88%, while definitive treatment with confirmed bacterial infection was only at 11.11%. The most frequently prescribed antibiotic therapies are azithromycin (250, 45.9%), ceftriaxone (188, 32.2%), and cefuroxime (58, 9.9%). Patterns of antibiotic use are attributed to the similarities of respiratory bacterial infections with COVID-19 cases.

Prescription quality indicators assessed in the study include documentation of indication for prescriptions, guideline compliance, collection of culture before antibiotic therapy, and stop/review documentation. Out of 583 antibiotic prescriptions, 464 (79.58%) were properly documented with an indication. Non-compliance to guidelines reached 39.11%, while the stop and review date documentation rate was 20.41%. The collection of culture before the start of antibiotic therapy was at 50.2%.

CONCLUSION

The results from the study highlighted the need for antimicrobial surveillance and stewardship efforts among COVID-19 and other viral infections.

Human ; Covid-19 ; Anti-bacterial Agents ; Antibiotic ; Coronavirus

BACKGROUND AND OBJECTIVE

COVID-19 has been associated with cardiac injury, often detectable through electrocardiographic (ECG) changes. This study seeks to characterize the cardiovascular and electrocardiographic profiles of adult patients diagnosed with COVID-19.

METHODS

This study included adult patients with confirmed COVID-19 from June 2021 to June 2022. Clinical profiles and 12-lead ECG tracings were obtained from electronic medical records and reviewed independently by three cardiologists. Descriptive analysis was performed to summarize the cardiovascular and electrocardiographic findings in this population.

RESULTS

The study included 998 COVID-19 patients (mean age: 50 years; 53.7% male). The most common comorbidities were hypertension, diabetes, and dyslipidemia. A majority (31.36%) presented with severe COVID-19 infection. The most frequent significant ECG abnormalities observed at admission were sinus tachycardia (22.8%), and atrial fibrillation (11.02%). Additional ischemic findings included ST segment depression (2.91%), T-wave inversion (1.70%), and ST segment elevation (2.71%).

CONCLUSION

The baseline ECG findings among COVID-19 patients were predominantly normal; however, significant abnormalities were also identified. The most frequent abnormalities included sinus tachycardia, atrial fibrillation, and ischemic changes, all of which may have clinical implications.

Human ; Coronavirus Disease 19 ; Covid-19 ; Electrocardiography ; Atrial Fibrillation

BACKGROUND AND OBJECTIVE

COVID-19 has been associated with cardiac injury, often detectable through electrocardiographic (ECG) changes. This study seeks to characterize the cardiovascular and electrocardiographic profiles of adult patients diagnosed with COVID-19.

METHODS

This study included adult patients with confirmed COVID-19 from June 2021 to June 2022. Clinical profiles and 12-lead ECG tracings were obtained from electronic medical records and reviewed independently by three cardiologists. Descriptive analysis was performed to summarize the cardiovascular and electrocardiographic findings in this population.

RESULTS

The study included 998 COVID-19 patients (mean age: 50 years; 53.7% male). The most common comorbidities were hypertension, diabetes, and dyslipidemia. A majority (31.36%) presented with severe COVID-19 infection. The most frequent significant ECG abnormalities observed at admission were sinus tachycardia (22.8%), and atrial fibrillation (11.02%). Additional ischemic findings included ST segment depression (2.91%), T-wave inversion (1.70%), and ST segment elevation (2.71%).

CONCLUSION

The baseline ECG findings among COVID-19 patients were predominantly normal; however, significant abnormalities were also identified. The most frequent abnormalities included sinus tachycardia, atrial fibrillation, and ischemic changes, all of which may have clinical implications.

Human ; Coronavirus Disease 19 ; Covid-19 ; Electrocardiography ; Atrial Fibrillation

BACKGROUND

The occurrence of the COVID-19 pandemic resulted in increased risk of developing antimicrobial resistance due to the high utilization of antimicrobial agents. Since antimicrobial utilization is a crucial driver in the development of antimicrobial resistance, the need for antimicrobial use surveillance is crucial in identifying prescription patterns that would help provide proper interventions.

OBJECTIVE

To determine the antibiotic use and prevalence of prescription quality indicators among COVID-19 patients admitted at a tertiary government hospital.

METHODS

A retrospective cross-sectional survey was conducted to provide data on antibiotic use and the prevalence of prescription quality indicators among COVID-19 patients in a tertiary-level hospital from June 2021 to June 2022.

RESULTS

A total of 342 patient medical records were surveyed. The majority (119, 34.8%) of the patients were in the age group 41-60 years old and there were more male patients (52.34%) than female patients (47.66%). About 88.99% of the patients were considered to have community-acquired COVID-19 infections. Co-morbidities among patients were seen in more than half of the surveyed population (64%). These include hypertension, diabetes mellitus, chronic kidney disease, coronary artery disease, chronic lung disease, and hematologic disorders.

Empiric antibiotic therapy was high at 88.88%, while definitive treatment with confirmed bacterial infection was only at 11.11%. The most frequently prescribed antibiotic therapies are azithromycin (250, 45.9%), ceftriaxone (188, 32.2%), and cefuroxime (58, 9.9%). Patterns of antibiotic use are attributed to the similarities of respiratory bacterial infections with COVID-19 cases.

Prescription quality indicators assessed in the study include documentation of indication for prescriptions, guideline compliance, collection of culture before antibiotic therapy, and stop/review documentation. Out of 583 antibiotic prescriptions, 464 (79.58%) were properly documented with an indication. Non-compliance to guidelines reached 39.11%, while the stop and review date documentation rate was 20.41%. The collection of culture before the start of antibiotic therapy was at 50.2%.

CONCLUSION

The results from the study highlighted the need for antimicrobial surveillance and stewardship efforts among COVID-19 and other viral infections.

Human ; Covid-19 ; Anti-bacterial Agents ; Antibiotic ; Coronavirus

INTRODUCTION: Health literacy plays an essential role in one's ability to acquire and understand critical medical information in the coronavirus disease 2019 (COVID-19) infodemic and in other pandemics. We aimed to summarise the assessment, levels and determinants of pandemic-related health literacy and its associated clinical outcomes. METHODS: A systematic review was performed in Medline ® , Embase ® , PsycINFO ® , CINAHL ® and four major preprint servers. Observational and interventional studies that evaluated health literacy related to the novel COVID-19, severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) were included. Items used in health literacy instruments were grouped under the themes of knowledge, attitudes and practices. Determinants of health literacy were grouped into five domains: sociodemographic, medical, psychological/psychiatric, health systems-related and others. RESULTS: Of the 2,065 articles screened, 70 articles were included. Of these, 21, 17 and 32 studies evaluated health literacy related to COVID-19, SARS and MERS, respectively. The rates of low pandemic health literacy ranged from 4.3% to 57.9% among medical-related populations and from 4.0% to 82.5% among nonmedical populations. Knowledge about the symptoms and transmission of infection, worry about infection, and practices related to mask usage and hand hygiene were most frequently evaluated. Sociodemographic determinants of health literacy were most frequently studied, among which higher education level, older age and female gender were found to be associated with better health literacy. No studies evaluated the outcomes associated with health literacy. CONCLUSION The level of pandemic-related health literacy is suboptimal. Healthcare administrators need to be aware of health literacy determinants when formulating policies in pandemics.
Humans ; Health Literacy ; COVID-19/epidemiology* ; Severe Acute Respiratory Syndrome/epidemiology* ; Health Knowledge, Attitudes, Practice ; Pandemics ; SARS-CoV-2 ; Coronavirus Infections/epidemiology* ; Middle East Respiratory Syndrome Coronavirus ; Female ; Male