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

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

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