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

Practice-based learning is the key objective of postgraduate education. COVID-19 has revealed that medical institutions may need to adopt adaptive strategies to guide their students. The aim of this study is to describe the perception of Philippine medical clerks towards their surgical preparedness with an Enriched Virtual Mode (EVM)-Hybrid Learning during the pandemic. A cross-sectional survey was conducted among 176 fourth-year students using a 21-item 4-point-Likert questionnaire. Descriptive analysis showed that students sustained a strong enthusiasm for surgery (composite mean = 2.83 ± 0.62), with the highest ratings given to skill-oriented subjects, such as practical minors (3.05 ± 0.82) and clinical surgery (3.03 ± 0.78). Preparedness was similarly high (3.17 ± 0.46): practice was regarded as essential (3.50 ± 0.68) and operating-room exposure useful (3.22 ± 0.68), though time for hands-on practice was adequate (2.84 ± 0.74). Preference scores revealed a desire for richer tactile experience (3.36 ± 0.37), with scrubbing, suturing and live surgery observation receiving most support (>3.50). Overall satisfaction reached a moderate-to-high level (2.99 ± 0.48) but lagged behind interest and preparedness, indicating that limited physical immersion tempered fuller contentment. These suggest that while a blended curriculum can preserve enthusiasm and sense of readiness, emphasis on protected skills laboratories and increased exposure to the operating room may be needed to translate conceptual competence into experiential fulfillment.

Human ; Male ; Female ; Young Adult: 19-24 Yrs Old ; Cross-sectional Studies ; Education ; Curriculum ; Perception ; Observation ; Schools, Medical ; Personal Satisfaction ; Learning ; Mental Competency ; Laboratories ; Pandemics

BACKGROUND

A substantial number of COVID-19 recoverees are working-aged individuals, which makes return-towork (RTW) an essential part of rehabilitation. Many COVID-19 recoverees must deal with physical and mental symptoms of post-COVID conditions such as fatigue, dyspnea, difficulty concentrating, memory lapses, and anxiety. These symptoms coupled with often insufficient support from employers and the government can make the RTW process complicated. Although research related to RTW after COVID-19 has begun to emerge over the years, few primary studies have come out from developing countries.

OBJECTIVES

This exploratory study aims to describe perceived work ability and health-related quality of life, lived experiences of the RTW process, and role of rehabilitation in a limited sample of Filipino COVID-19 recoverees. 

METHODS

Using purposive sampling and a convergent parallel mixed-method design, the study draws on an online survey and group interviews to understand expectations, experiences, and self-rated work ability of working-age adults with post-COVID condition. We report the findings of the questionnaire data using descriptive statistics. From the questionnaire respondents, eight participants were interviewed to explore the RTW experiences from multiple perspectives. The group interview was conducted online, and narrative analysis was used to explore the data. This analytic process involved an iterative and inductive process between data gathering and data analysis.

RESULTS

Findings from our narrative analysis are reported under four themes: 1) The period of liminality; 2) A ‘positive’ problem; 3) Health as a psychosocial and justice issue; and 4) The reimagination of paid work. The narratives gathered document an overview of how selected Filipinos overcame the COVID-19 infection and their recovery and RTW process.

CONCLUSION

Results call for a re-examination of the concept of health and paid work for individuals undergoing rehabilitation and recovery.

Human ; Pandemics ; Rehabilitation, Vocational ; Occupational Therapy

BACKGROUND

The impact of the COVID-19 pandemic on respiratory virus activity in children has been studied globally, but no published study in the Philippines has provided viral profiling and epidemiological data on children during and after the pandemic’s peak.

OBJECTIVES

To identify respiratory pathogens detected using a multiplex RT-PCR assay (BioFire® Respiratory 2.1 Panel) among pediatric patients with respiratory symptoms admitted to St. Luke’s Medical Center–Global City during (March 2020–February 2022) and after (March 2022–March 2023) the peak of the COVID-19 pandemic; to compare the prevalence of these pathogens between the two periods; and to assess the clinico-demographic characteristics, diagnostic test results, and clinical outcomes of patients with single-pathogen infections versus co-infections.

METHODS

A single-center, cross-sectional study was conducted through a retrospective chart review of pediatric patients with respiratory symptoms tested using a multiplex RT-PCR assay (BioFire® Respiratory 2.1 Panel) at St. Luke’s Medical Center–Global City from March 2020 to March 2023.

RESULTS

Of 739 children, 92.02% were positive for at least one respiratory pathogen, mostly viruses. Rhinovirus/enterovirus (50.59%), RSV (19.71%), and COVID-19 (12.50%) were the most common. COVID-19 and Influenza A were more prevalent during the peak, while rhinovirus/enterovirus and adenovirus were higher post-peak. Most patients were male, aged 1–5 years, and cough (89.99%) was the most common symptom. Normal leukocyte, CRP, and procalcitonin levels were observed in 70.09%, 47.31%, and 68.25%, respectively. No significant differences were noted in diagnostic test results based on pathogen detection. Antibiotics were given to 53.31% of patients, and 99.86% were discharged. The average length of stay was 3.69 days.

CONCLUSION

The prevalence of respiratory pathogens among children admitted to our institution during and after the peak of the COVID-19 pandemic predominantly consisted of viruses, showing statistically significant differences. Rhinovirus/enterovirus and RSV were the leading respiratory pathogens in both periods. The peak group showed a higher prevalence of COVID-19 and Influenza A whereas the post-peak group exhibited a higher prevalence of rhinovirus/enterovirus and adenovirus. Single viral infections were more prevalent compared to co-infections

Human ; Pandemics ; Prevalence ; Philippines

BACKGROUND

Rabies causes 59,000 deaths globally each year, with 391 and 368 cases reported in the Philippines in 2022 and 2023, respectively. In Davao City, 4 human rabies deaths were recorded in 2023. Though fatal, rabies is preventable through vaccination. The COVID-19 pandemic disrupted rabies eradication and immunization efforts. This study investigated its effect on the compliance with post-exposure rabies prophylaxis (PEP) and the reasons for non-compliance.

OBJECTIVE

To compare the compliance with PEP and reasons for non-compliance among pediatric patients with animal bites before and during the COVID-19 pandemic.

METHODS

This single-center retrospective cross-sectional study in a private tertiary hospital in Davao City reviewed 1,277 animal bite cases between March 16, 2017 and March 16, 2023. Data was gathered through chart reviews with follow-up through phone interviews. Compliance rates and reasons for non-compliance to PEP were determined.

RESULTS

There were 1,224 cases of animal bites included in the study, 599 cases before the pandemic, and 625 during the pandemic. Thirty six percent of cases were aged 3-6 years old, with equal sex distribution. The highest cases were from the downtown area of the city (69% pre-pandemic and 53% during the pandemic); dogs were the primary biting animals. Bites in the upper extremities were common before the pandemic, while bites in the head and neck region increased during the pandemic. Most exposures were bites from vaccinated pets (65% pre-pandemic and 84% during the pandemic) and classified as Category III (52% pre-pandemic and 55% during the pandemic). Despite the pandemic, compliance with PEP among the animal bite cases remained to be high, 93.8% pre-pandemic and 93.1% during the pandemic. Non-compliance with PEP was influenced by psychological factors (fear of hospitals and vaccination and acquiring infection during hospital visit and socioeconomic factors (cost, distance and loss of wages).

CONCLUSION

The most significant factors for non-compliance with PEP during the pandemic were fear of hospitals and acquiring illnesses while in the hospital, while compliance was linked to parent’s higher socio-economic status and awareness.

Human ; Rabies ; Post-exposure Prophylaxis ; Covid-19 ; Pandemics

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

INTRODUCTION

The sudden designation as a COVID-19 Referral Center at the beginning of the pandemic brought about immense change to the Cardiac Catheterization Laboratory (CCL) services of a National Referral Center for tertiary care. As a proactive strategy to determine actions that can be undertaken should an unforeseen event ever happen again, this study was done to explore the impact of COVID-19 to the institution’s CCL caseload, and to review the challenges, innovations and adjustments made by the CCL to become pandemic-capable and crisis-ready.

METHODS

A qualitative cross-sectional study was conducted, with the first phase describing the CCL census starting from the baseline pre-COVID year of 2019 to the pandemic years of 2020-2022, and the second phase involving Key Informant Interviews (KII) and Focus Group Discussion (FGD) with the hospital and CCL healthcare staff.

RESULTS

The study revealed a large reduction in the urgent, elective and overall number of cases of the CCL in the first year, but has seen a steady increase in subsequent years. Surges of COVID variants were also seen to affect the CCL caseload. The following were noted to be the key elements in the CCL’s transformation to become COVID-19 capable: (a) changes in operations and patient selection, (b) appropriate use of PPE, (c) strict adherence to an infection control protocol, and (d) staffing modifications to reduce infectivity and protect staff availability.

CONCLUSION

The preparation of the hospital’s CCL to become a pandemic capable laboratory has been difficult and faced many challenges. However, the innovations and adjustments done through efforts and ingenuity of the CCL healthcare team allowed continuous delivery of the highest level of care to patients in spite of the changing pandemic landscape. These changes were duly documented as a basis for response to possible future global and/or national healthcare crises.

Human ; Covid-19 ; Pandemics