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

Convalescent plasma therapy (CPT) has been utilized as an emergency and last-resort treatment for viral infections, particularly in the absence of vaccine. During the COVID-19 pandemic, CPT was implemented worldwide based on its potential to provide passive immunity through SARS-CoV-2 antibodies. While numerous studies explored the effectiveness of CPT to cure COVID-19 patients, there has no research specifically focused on superiority of CPT impact on the length of hospitalization.

OBJECTIVE

This study aimed to evaluate the effect of CPT on the length of hospital stay among patients with moderate COVID-19.

METHODS

This is a single blind randomized controlled trial (RCT) study involved 30 moderate-grade COVID-19 patients age 18-75 years with positive PCR result treated at Unggul Karsa Medika Hospital Bandung from February 2 to May 31, 2022. Moderate-grade COVID-19 defined by clinical pneumonia symptoms based on World Health Organization (WHO) criteria. Eligible patients were randomly assigned (1:1 ratio) and outcome assessors were blinded, while care providers and patients were not due to the intervention nature. The intervention arm (n=15) received 200 ml of high-titer CPT within 24 hours of admission with standard care and the control arm (n=15) received standard care only. The primary outcome measured was the length of stay (LOS) in both the Emergency Room (ER) and COVID-19 High Care Unit (HCU). Data were analyzed using independent T-tests.

RESULTS

Thirty (30) eligible patients (mean age 40 years; 53% female) were analyzed for the primary outcome and all completed follow-ups. The CPT group had significantly shorter LOS than controls (mean difference for ER:-32.7 hours [95% CI:-45.0,-20.4]; HCU:-33.3 hours [95% CI:- 45.8,-20.8]; p

CONCLUSION

The administration of CPT may reduce the LOS in moderate COVID-19 patients. However, the small sample size can limit the generalizability of this result and larger sample studies are needed to strengthen this finding. Early CPT implementation may improve patient management and optimize healthcare resource utilization during the pandemic.

Pandemics ; Polymerase Chain Reaction ; Randomized Controlled Trial ; Emergency Service, Hospital ; Hospitalization ; Emergencies ; Covid-19 ; Length Of Stay ; Antibodies

BACKGROUND

The COVID-19 pandemic disrupted education worldwide, prompting a rapid shift to emergency remote teaching that challenged students’ learning and mental health. Nursing students, in particular, faced heightened pressures due to the suspension or online adaptation of essential clinical experiences, alongside the need to master theoretical and practical competencies. Emerging evidence indicates that such stressors adversely affect students’ emotional and psychological well-being, potentially influencing academic outcomes. Understanding the relationship between mental health and academic performance among nursing students is crucial for developing targeted interventions that support their well-being and professional readiness.

OBJECTIVE

This study analyzed the mental health status and academic performance of graduating nursing students during the challenging period of remote learning amid the pandemic in a government school in Leyte.

METHODS

The study utilized a descriptive correlational design to explore the relationships between mental health status and academic performance among nursing students. A modified self-administered questionnaire was utilized to gather data. Ethical approval from Eastern Visayas Health Research and Development ConsortiumEthics Review with ERC number 2023-024 was secured, and data collection occurred through various methods. Data analysis used SPSS version 24, emphasizing the importance of understanding these relationships in educational settings.

RESULTS

The study assessed the demographic profile, online learning attributes, mental health status, and academic performance of 20 nursing students during the pandemic. All students passed their courses, despite reporting moderate emotional loneliness and irritability, but minimal fear of COVID-19. Significant correlations were found between demographic factors and mental health indicators. The null hypothesis, suggesting no relationship between demographic factors and mental health, is void, as significant associations were identified. Recommendations include enhancing mental health support in nursing education to address these challenges.

CONCLUSION

This study highlights the experiences of 20 nursing students from a government college in Leyte during the COVID-19 pandemic. Predominantly young women from rural, low-income backgrounds, these students faced challenges like poor internet access but successfully completed their academic requirements, showcasing resilience. While they reported low fear of COVID-19, moderate emotional loneliness and irritability indicated underlying mental health issues. The findings stress the need for educational institutions to provide mental health support and address the digital divide to enhance student well-being and success.

Human ; Male ; Female ; Young Adult: 19-24 Yrs Old ; Adult: 25-44 Yrs Old ; Statistics As Topic ; Psychological Well-being ; Indicators And Reagents ; Students, Nursing ; Suspensions ; Academic Performance ; Learning ; Pandemics ; Nursing ; Education, Nursing ; Covid-19 ; Mental Health

BACKGROUND AND OBJECTIVE

The COVID-19 pandemic has adversely affected various healthcare services worldwide, including tuberculosis (TB) control programs. This paper examines the impact of the COVID-19 pandemic on TB case notification rate (CNR) and treatment success rate (TSR), and the challenges and interventions in TB-DOTS (directly observed treatment short-course) services in the Province of South Cotabato, SOCCSKSARGEN Region, Philippines. 

METHODS

An explanatory sequential mixed methods design was used to describe the experiences of South Cotabato in implementing TB-DOTS services during COVID-19 pandemic. Monthly data on CNR and TSR under TB-DOTS from March 2019 to February 2022 were retrieved from the Department of Health’s Integrated Tuberculosis Information System (ITIS) through records review. One-way analysis of variance (ANOVA) and Tukey’s test were used to analyze quantitative data. Focus group discussions (FGD) were conducted among four groups of program implementers (NTP coordinators, nurses, medical technologists, and barangay health workers) encompassing the challenges encountered in the implementation of TB-DOTS services as well as interventions done before and during the COVID-19 pandemic.

RESULTS

During the pre-COVID-19 period (March 2019-February 2020), a CNR of 334 per 100,000 population was reported in the province. There is a 35.19% decrease in TB CNR during COVID-19 Year 1 (March 2020-February 2021) at 216 per 100,000 population, followed by a 37.63% increase in Year 2 at 298 per 100,000 population. The mean TSR covering the pre-COVID period was 96% (SD = 0.01) while the mean TSR in COVID-19 Year 1 was 93% (SD = 0.02), significantly lower than that of the pre-pandemic period, followed by monthly TSR ranging from 91% to 98% (SD = 0.02), an increase in Year 2. From the FGDs, six pre-existing barriers were identified such as patients’ f inancial constraints, hard-to-reach areas, poor health seeking behavior, persistence of TB stigma, medicine and supply shortages, and inadequate health workforce were experienced before and during the COVID-19 pandemic. On the other hand, six emerging challenges brought by the COVID-19 pandemic were reallocation of services, movement restriction, additional protocols, reporting delays, and fears among patients and health workers. The decrease in CNR and TSR during COVID-19 Year 1 aligned with the emergence of new challenges in TB-DOTS services brought by the pandemic. These aggravated pre-existing barriers which further caused delays in the diagnosis and treatment of TB patients. Nine interventions done to address these challenges were also described, the most critical being health education, strengthening community-based services, use of telecommunications, resource pooling for essential medicines, adjusting medication dispensing, and coordination with local government units and policy enhancements.

CONCLUSION

TB-DOTS services in South Cotabato experienced various difficulties during the COVID-19 pandemic which led to initial declines in CNR and TSR. Addressing barriers and challenges were vital in ensuring the continuity of TB services and mitigating the impact of COVID-19 crisis on CNR and TSR. This study demonstrates the adaptability and resilience of South Cotabato's TB-DOTS services in response to COVID-19 challenges and highlights the need for strategies ensuring continuity of TB services and healthcare system resilience in light of Universal Health Care. Recommendations are outlined to improve current policies and practices as well as lay future directions for research on health service delivery and program implementation in relation to pandemics and other types of disasters.

Human ; Tuberculosis ; Covid-19 ; Pandemics ; Philippines

BACKGROUND

The COVID-19 pandemic brought insurmountable changes, leading to work demands and resource limitations that placed additional physical and occupational stress.

OBJECTIVES

This study aimed to determine the change in the occurrence and intensity of musculoskeletal discomfort among selected university faculty members. It also determined the association of sociodemographic and anthropometric factors, workplace conditions, and involvement in physical activity with musculoskeletal pain.

METHODS

This is an analytical cross-sectional study conducted from June 2022 to May 2023 that surveyed university faculty members from Metro Manila and Metro Cebu. Outcome measures include sociodemographic data, anthropometric measures of weight, height, body mass index, workplace conditions, exercise participation, and musculoskeletal discomfort using the Cornell Musculoskeletal Discomfort Questionnaire.

RESULTS

Data from 120 participants, mostly female, with an average BMI of 27.78 ± 12.09 kg/m2 and 11.82 ± 10.39 years of teaching experience revealed increased computer usage and reduced teaching hours during the Pandemic lockdown. There was also prevalent musculoskeletal discomfort (MSD), particularly in the neck, shoulder, and upper back. Factors associated with increased MSD were female gender, longer computer use, and pre pandemic MSD history.

CONCLUSION

This study underscores the significance of addressing ergonomic factors and work conditions to mitigate MSD risks among educators during challenging situations.

Human ; Musculoskeletal Pain ; Covid-19 ; Pandemics ; Occupational Stress

Out-of-hospital Cardiac Arrest ; Heart Arrest ; Policy ; Covid-19 ; Pandemics

BACKGROUND

Community pharmacists play a strategic and indispensable role as healthcare professionals with direct patient access during the COVID-19 pandemic. Nevertheless, there had been no studies that document the challenges, adaptive measures, and opportunities of community pharmacy practice in the country during such period.

OBJECTIVES

This study aimed to describe the challenges encountered and adaptive measures implemented by community pharmacies, and to explore opportunities of community pharmacy practice brought about by the COVID-19 pandemic in the Philippines.

METHODS

The study employed a qualitative, cross-sectional study design. Convenience sampling was conducted representative of chain and independent drug stores, online and other stores with service variations, and pharmacy organizations. Recruitment was pursued until data saturation with a total of 16 participants. Interviews were transcribed and analyzed through thematic analysis using NVivo 12. The study received ethical clearance for implementation from the UP Manila Research Ethics Board.

RESULTS

Results showed there were various challenges that affected both the supply- and demand- side of pharmacy operations in the community pharmacy practice during the pandemic. Due to the adaptive role of the pharmacy profession during the pandemic, there has been an increased relevance of pharmacists in public health. Furthermore, the pandemic has exhibited the need to shift to the use of e-prescriptions. However, there are limitations to its current use, such as ensuring the validity of the prescription when presented in a pharmacy.

CONCLUSION

There are several challenges encountered by community pharmacists during the pandemic. These challenges led to several adaptive measures being implemented that also became an opportunity to emphasize the vital role community pharmacists play in the healthcare system.

Covid-19 ; Pandemics

Introduction: COVID-19 pandemic placed unprecedented strain on hospital resources and manpower. This study assesses the impact of Malaysia’s nationwide lockdown on the incidence, types, severity, and outcomes of emergency general surgery (EGS) cases at a tertiary care hospital. Methods: This retrospective cohort study analysed the data of patients who underwent EGS procedures for the period 2017 and 2021. Results: During the pandemic period, there was a 48.3% reduction in EGS cases (n=889) compared to the pre-pandemic period (n=1720). Significant reductions were observed in surgeries for appendicitis, soft tissue infection, colorectal, urology, peptic ulcer, and vascular disorders in the COVID period. Conversely, procedures for biliary disorders and hernia complications increased by 7.4% and 5.5%, respectively. Length of hospital stay increased by 57.8% for patients with small bowel disorders, while ICU/HDU admissions rose by 43.5% for colorectal cases (P < 0.05). There was no significant difference in mortality rates between the two periods. Conclusions The overall reduction in EGS procedures during the COVID-19 period was consistent with global trends. Despite the challenges posed by the pandemic, the outcomes related to duration of stay, ICU/HDU utilisation, and mortality remained comparable to the pre-pandemic period. These findings highlight the adaptability of healthcare professionals in maintaining continuity and quality of emergency surgical care during a crisis.
Acute Care Surgery ; COVID-19 ; Pandemics

BACKGROUND

Vaccine hesitancy among senior citizens remains common in many countries. This was significantly observed during the COVID-19 pandemic in Dauis, Bohol, Philippines. However, there is limited research on the factors influencing this hesitancy.

OBJECTIVE

This study aimed to identify the determinants associated with COVID-19 vaccine hesitancy among senior citizens in the municipality of Dauis, Bohol.

METHODS

This case-control study employed a modified survey questionnaire adapted from relevant literatures. A total of 497 registered senior citizens participated, of whom 331 were vaccinated against COVID-19 and 166 were unvaccinated. The study determined the socio-demographic factors, health status, and perceptions of COVID-19 vaccine safety. Bivariate and multivariable logistic regression analyses were used to identify factors associated with vaccine hesitancy.

RESULTS

The study found that respondents aged 84 and older were significantly more likely to exhibit vaccine hesitancy (p = 0.018, OR = 7.817). In contrast, factors associated with a reduced likelihood of hesitancy included having tertiary education (p = 0.012, OR = 0.239), a low income (p = 0.042, OR = 0.138), receiving an annual flu vaccine (p = 0.020, OR = 0.328), and perceiving the COVID-19 vaccine as safe (p = 0.000, OR = 0.032).

CONCLUSION

Age is a significant determinant of COVID-19 vaccine hesitancy. Educational attainment, monthly income, receipt of annual influenza vaccine and perception on vaccine safety were found to be influential determinants. These findings offer valuable insights for evidence-based interventions to enhance vaccine acceptance to this vulnerable population.

Human ; Vaccination Hesitancy ; Covid-19 ; Pandemics ; Vaccination

BACKGROUND AND OBJECTIVE

There are mixed reports on nurses’ satisfaction with electronic medical records (EMR) in literature, and facilitators and barriers to its adoption were reported frequently. A Philippine public tertiary hospital developed an EMR to facilitate remote access to patient charts outside its COVID-designated areas during the pandemic. This study aims to assess nurses’ satisfaction with EMR use in order to improve their user experience. The Delone and McLean Information System (D&M IS) Success Model was used as its framework. This offers a unique perspective to EMR adoption by accounting for the effects of the pandemic.

METHODS

A descriptive, cross-sectional, quantitatively driven, concurrent mixed-methods design was employed. Nurses from the hospital were recruited for the survey (n=353) and the focus group discussions (n=14). Ethical approval was obtained prior to its conduct. Analysis was done through descriptive statistics, multiple linear regression, and thematic analysis. Data were integrated to appreciate the differences in their experiences from the point of adoption up to their current experiences.

RESULTS

Nurses initially faced challenges with the EMR when it was introduced, but improvements and continuous use have led to their current high satisfaction. Despite mandatory use and high usage scores, some daily tasks are still done manually. Use, length of service, number of patients handled, designation, and area of assignment were found to be associated with satisfaction. Thematic analysis highlighted several adoption prerequisites in this setup, including assessment of user competence and experience, and the provision of training, structural necessities, and organizational support.

CONCLUSION

This study found high use and satisfaction scores, aligning with the D&M IS Success Model, despite initial adoption challenges. Recommendations include maintaining high EMR use and improving efficiency, communication, and collaboration. Emphasis was placed on the provisions of better training and continuous feedback gathering.

Human ; Electronic Health Records ; Health Information Systems ; Nurses ; Pandemics ; Philippines