OBJECTIVE: Vaccine hesitancy has been a public health issue for some time now, but gained more attention during COVID-19 pandemic. This systematic review aimed to estimate the prevalence of COVID-19 vaccination hesitancy and identify factors affecting it among adolescents. MATERIALS AND METHODS: The preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P 2020) was used. A search was performed in PubMed/ MEDLINE, EMBASE, Google Scholar, Herdin, and Cochrane databases on September 2023 using the key words: (COVID-19 OR SARS-COV OR corona virus) AND (Vaccination OR immunization) AND (adolescence OR teenagers OR youth) AND (hesitancy OR acceptance). Observational studies which determined the prevalence or risk factors for COVID-19 vaccine hesitancy among adolescents aged 10-19 years old were included. RESULTS: There were 5 good quality cross-sectional studies included. The prevalence of adolescents who did not want to be vaccinated ranged between 8.4% and 61.0%; while the prevalence of being unsure if they want to be vaccinated was between 31.6% and 88.0%. Factors associated with vaccine hesitancy included being economically disadvantaged, not having influenza vaccination, worrying about its effectiveness and safety, and low perceived necessity. CONCLUSION There is good quality evidence that COVID-19 vaccine hesitancy exists among adolescents. It is recommended that health workers should conduct information and education campaigns to iterate the effectiveness, safety, and misconceptions about of COVID-19 vaccination. Vaccination programs should also reach out to economically disadvantaged adolescents, and tapping parents and social media may be an effective strategy to improve vaccination acceptance among adolescents.
COVID-19 ; SARS-COV ; Severe acute respiratory syndrome-related coronavirus ; Vaccination ; Immunization ; Adolescent ; Adolescence ; Teenagers ; Youth

Objective: To determine incidence, predictors, and impact of liver injury among hospitalized COVID-19 patients Methods: This is a retrospective cohort study of hospitalized COVID-19 patients at the University of the PhilippinesPhilippine General Hospital. Liver injury (LI) was defined as ALT elevation above institutional cut-off (>50 u/L) and was classified as mild (>1x to 3x ULN), moderate (>3x to 5x ULN), or severe (>5x ULN). Significant liver injury (SLI) was defined as moderate to severe LI. Univariate analysis of SLI predictors was performed. The impact of LI on clinical outcomes was determined and adjusted for known predictors -age, sex, and comorbidities. Results: Of the 1,131 patients, 565 (50.04%) developed LI. SLI was associated with male sex, alcohol use, chronic liver disease, increasing COVID-19 severity, high bilirubin, AST, LDH, CRP, and low lymphocyte count and albumin. An increasing degree of LI correlated with ICU admission. Only severe LI was associated with the risk of invasive ventilation (OR: 3.54, p=0.01) and mortality (OR: 2.76, p=0.01). Severe LI, male sex, cardiovascular disease, and malignancy were associated with longer hospital stay among survivors. Conclusion The liver injury occurred commonly among COVID-19 patients and was associated with important clinicodemographic characteristics. Severe liver injury increases the risk of adverse outcomes among hospitalized patients.
Liver injury ; Coronavirus disease-19 ; Severe Acute Respiratory Syndrome Coronavirus-2 ; Clinical outcomes

Fever is an increase in body temperature beyond the normal range, acting as a protective inflammatory mechanism. This article summarizes diseases with fever encountered in dental clinics, including what is known about pyrexia in coronavirus infection, and further proposes a "six steps in one" identification and analysis strategy to guide the clinical work of stomatology.
Humans ; Dental Clinics ; Fever/diagnosis* ; Coronavirus Infections

Introduction: Coronavirus disease (COVID-19) is currently a global health crisis and is caused by a new strain of coronavirus. However, emerging literature of case reports noted possible extrapulmonary manifestations of the disease. Because COVID 19 is a relatively new disease, at present, little existing literature tackles the diagnosis and therapeutic management of COVID‐19‐related conditions outside the pulmonary system. Case: A 24-year-old male presented with sudden stiffening of all extremities but non-contrast computed tomography (CT) scan was unremarkable. Chest X-ray revealed interstitial pneumonia and SARS-CoV-2 RT-PCR (OPS/NPS) was positive. Electrocardiogram (ECG) findings showed supraventricular tachycardia and had elevated Troponin I levels. Pertinent physical findings noted were slurring of speech, dysmetria, and vertical nystagmus. The patient was initially treated as a case of Bacterial Abscess versus Viral encephalitis. Pericardial ultrasound revealed small pericardial effusion and was started on Colchicine. Repeat cranial CT scan noted unremarkable results but due to persistence of symptoms, the patient was started with Dexamethasone. On Day 16 of illness, the patient was noted to have full resolution of symptoms. Rapid antibody testing was done which revealed positive for both IgG and IgM hence the patient was discharged with the final diagnosis of Viral Myopericarditis resolved, Viral encephalitis resolved, COVID-19 pneumonia recovered. Conclusion Extrapulmonary manifestations have been reported increasingly as an atypical presentation of COVID 19 infection. Early recognition of viral myopericarditis and viral encephalitis as a manifestation of COVID 19 can lead to the initiation of proper treatment and management. More reports on these cases can aid future studies on diagnostics and therapeutic approaches during the COVID-19 pandemic.
COVID-19 ; Encephalitis, Viral ; SARS-CoV-2 ; Coronavirus Infections

The aim of this study was to develop a blocking enzyme-linked immunosorbent assay (bELISA) based on a biotinylated nanobody target the S1 protein of porcine epidemic diarrhea virus (PEDV) for detecting the anti-PEDV antibodies and evaluating the immune effect of the vaccine. The gene encoding the single-domain antibody sdAb3 target the PEDV S1 protein was amplified and the Avitag sequence was fused at its 3'-end. The PCR product was cloned into the expression vector pET-21b for expression and purification of the sdAb3-Avitag protein. The purified sdAb3-Avitag fusion protein was biotinylated and its activity was determined. Using the recombinant S1 protein as a coating antigen, a bELISA was established and optimized. Serum samples were tested in parallel by the bELISA and a commercial kit. The recombinant vector pET21b-sdAb3-Avitag was constructed to express the tagged sdAb3. After induction for expression, the biotin-labeled sdAb3 (sdAb3-Biotin) with high purity and good activity was obtained. For the optimized bELISA, the coating concentration of the S1 protein was 200 ng/well, the serum dilution was 1:2 and incubated for 2 h, the dilution ratio of the biotinylated sdAb3 was 1:8 000 and incubated for 30 min, the dilution of the enzyme-labeled antibody was 1:5 000 and incubated for 30 min. The bELISA had no cross reaction with the sera of major porcine viruses including transmissible gastroenteritis virus, porcine reproductive and respiratory syndrome virus and showed good specificity and reproducibility. For a total of 54 porcine serum samples tested, the overall compliance rate of the bELISA with a commercial kit was 92.56%. This study developed a rapid and reliable bELISA method, which can be used for serosurveillance and vaccine evaluation for PEDV.
Animals ; Antibodies, Viral ; Coronavirus Infections/veterinary* ; Enzyme-Linked Immunosorbent Assay ; Porcine epidemic diarrhea virus/genetics* ; Reproducibility of Results ; Sensitivity and Specificity ; Single-Domain Antibodies ; Swine ; Swine Diseases

Porcine epidemic diarrhea (PED) is a major disease of pigs that inflicts heavy losses on the global pig industry. The etiologic agent is the porcine epidemic diarrhea virus (PEDV), which is assigned to the genus Alphacoronavirus in the family Coronaviridae. This review consists of five parts, the first of which provides a brief introduction to PEDV and its epidemiology. Part two outlines the passive immunity in new born piglets and the important role of colostrum, while the third part summarizes the characteristics of the immune systems of pregnant sows, discusses the concept of the "gut-mammary gland-secretory IgA(sIgA) axis" and the possible underpinning mechanisms, and proposes issues to be addressed when designing a PEDV live vaccine. The final two parts summarizes the advances in the R&D of PEDV vaccines and prospects future perspectives on prevention and control of PEDV, respectively.
Animals ; Antibodies, Viral ; Coronavirus Infections/veterinary* ; Female ; Immunization ; Porcine epidemic diarrhea virus ; Pregnancy ; Swine ; Swine Diseases/prevention & control* ; Viral Vaccines

To investigate whether the engineered Lactobacillus plantarum expressing the porcine epidemic diarrhea virus (PEDV) S1 gene can protect animals against PEDV, guinea pigs were fed with recombinant L. plantarum containing plasmid PVE5523-S1, with a dose of 2×10⁸ CFU/piece, three times a day, at 14 days intervals. Guinea pigs fed with wild type L. plantarum and the engineered L. plantarum containing empty plasmid pVE5523 were used as negative controls. For positive control, another group of guinea pigs were injected with live vaccine for porcine epidemic diarrhea and porcine infectious gastroenteritis (HB08+ZJ08) by intramuscular injection, with a dose of 0.2 mL/piece, three times a day, at 14 days intervals. Blood samples were collected from the hearts of the four groups of guinea pigs at 0 d, 7 d, 14 d, 24 d, 31 d, 41 d and 48 d, respectively, and serum samples were isolated for antibody detection and neutralization test analysis by enzyme-linked immunosorbent assay (ELISA). The spleens of guinea pigs were also aseptically collected to perform spleen cells proliferation assay. The results showed that the engineered bacteria could stimulate the production of secretory antibody sIgA and specific neutralizing antibody, and stimulate the increase of IL-4 and IFN-γ, as well as the proliferation of spleen cells. These results indicated that the engineered L. plantarum containing PEDV S1 induced specific immunity toward PEDV in guinea pigs, which laid a foundation for subsequent oral vaccine development.
Animals ; Antibodies, Viral ; Coronavirus Infections/veterinary* ; Guinea Pigs ; Lactobacillus plantarum/genetics* ; Porcine epidemic diarrhea virus/genetics* ; Swine ; Swine Diseases ; Viral Vaccines/genetics*

Amino Acid Sequence ; Coronavirus/drug effects* ; Coronavirus Infections/drug therapy* ; Drug Design ; Humans ; Protein Structure, Secondary ; Spike Glycoprotein, Coronavirus/metabolism* ; Viral Fusion Protein Inhibitors/pharmacology* ; Viral Fusion Proteins/metabolism*

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

Objectives. The ongoing Coronavirus disease 2019 (COVID-19) pandemic has disrupted healthcare systems worldwide. This study aimed to document the effect of COVID-19 on osteosarcoma treatment pathways in the Philippine General Hospital (PGH) and determine if there were any delays. Method. A retrospective review of osteosarcoma patients treated at the PGH from January 1, 2019 – January 1, 2020 (pre-COVID-19) was compared to those treated during the COVID-19 pandemic from March 1, 2020 – September 1, 2020. Rates of diagnosed osteosarcoma, admission for chemotherapy, admission for surgery, treatment abandonment, metastatic disease on presentation, 1-year mortality, and amputation were calculated and compared between the two groups. Results. From March to September 2020, 11 newly diagnosed osteosarcoma patients sought consult at the PGH. Only one patient sought consult during the initial 3-4 months of the study, suggesting that patients delayed seeking healthcare during the period of enhanced community quarantine. Patients seen during the pandemic had a higher rate of metastatic disease on presentation, reflecting the delay in diagnosis. Due to COVID-19 restrictions early in the pandemic, osteosarcoma patients were coordinated and referred to outside hospitals for intravenous chemotherapy and surgery. Normalization of services (hospital admissions, limb salvage surgeries) were seen at the later stages of the study, corresponding to the loosening of the quarantine. Conclusions. Osteosarcoma patients experienced delays in seeking consult, diagnosis, and treatment at the PGH due to the COVID-19 pandemic. Early indicators suggest worse outcomes for these patients due to the delays. Strategies employed during the pandemic, such as networking of care and telemedicine, may help in future outbreaks.
Coronavirus ; COVID-19 ; Coronavirus Infections ; Pandemics ; Osteosarcoma