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.

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

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.

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%.

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

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.

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.

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%).

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.

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.

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.

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.

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.

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 describe the prevalence, onset, associated symptoms, and clinical characteristics of COVID-19 in-patients with olfactory and gustatory dysfunction at the Philippine General Hospital from March 2021 to January 2022 and determine the number of patients with olfactory dysfunction/dysgeusia who recovered or expired. : Methods Design: Prospective Cohort Study Setting: COVID-19 Referral Hospital (Tertiary National University Hospital) Participants: COVID-19 RT-PCR positive in-patients, ages 19 and older Results: A total of 207 patients were included. Sixty-four (64) patients reported olfactory dysfunction and 79 reported dysgeusia. Olfactory and gustatory dysfunction were observed early in the course of infection, before day 6 of illness. The average length of hospital stay was 20.36 days; those with olfactory dysfunction stayed for 17.53 days, dysgeusia for 19.92 days, and 21.09 days for those who noted neither. For those subsequently intubated, 0 had olfactory dysfunction, three reported dysgeusia, three had both and six had neither. Thirteen (13) patients in the study expired. Among them, none reported olfactory dysfunction and two had dysgeusia. Conclusions Our results corroborate existing literature that olfactory and gustatory dysfunction as key indicators of COVID-19 with 42.5% of participants reporting these symptoms early, often before day 6 of illness. Ninety-two percent (92%) of those affected recovered and had shorter hospital stays, emphasizing the importance of recognizing these dysfunctions for improved disease detection and outcomes.
Anosmia ; Dysgeusia ; COVID-19 ; Coronavirus

OBJECTIVE: Late 2019 witnessed the outbreak and widespread transmission of coronavirus disease 2019 (COVID-19), a new, highly contagious disease caused by novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Consequently, considerable attention has been paid to the development of new diagnostic tools for the early detection of SARS-CoV-2. METHODS: In this study, a new poly-N-isopropylacrylamide microgel-based electrochemical sensor was explored to detect the SARS-CoV-2 spike protein (S protein) in human saliva. The microgel was composed of a copolymer of N-isopropylacrylamide and acrylic acid, and gold nanoparticles were encapsulated within the microgel through facile and economical fabrication. The electrochemical performance of the sensor was evaluated through differential pulse voltammetry. RESULTS: Under optimal experimental conditions, the linear range of the sensor was 10 ^-13-10 ^-9 mg/mL, whereas the detection limit was 9.55 fg/mL. Furthermore, the S protein was instilled in artificial saliva as the infected human saliva model, and the sensing platform showed satisfactory detection capability. CONCLUSION The sensing platform exhibited excellent specificity and sensitivity in detecting spike protein, indicating its potential application for the time-saving and inexpensive detection of SARS-CoV-2.
Humans ; Microgels ; Spike Glycoprotein, Coronavirus ; COVID-19/diagnosis* ; Gold ; Metal Nanoparticles ; SARS-CoV-2

As main recipient cells for porcine reproductive and respiratory syndrome virus (PRRSV), porcine alveolar macrophage (PAM) are involved in the progress of several highly pathogenic virus infections. However, due to the fact that the PAM cells can only be obtained from primary tissues, research on PAM-based virus-host interactions remains challenging. The improvement of induced pluripotent stem cells (iPSCs) technology provides a new strategy to develop IPSCs-derived PAM cells. Since the CD163 is a macrophage-specific marker and a validated receptor essential for PRRSV infection, generation of stable porcine induced pluripotent stem cells lines containing CD163 reporter system play important roles in the investigation of IPSCs-PAM transition and PAM-based virus-host interaction. Based on the CRISPR/Cas9- mediated gene editing system, we designed a sgRNA targeting CD163 locus and constructed the corresponding donor vectors. To test whether this reporter system has the expected function, the reporter system was introduced into primary PAM cells to detect the expression of RFP. To validate the low effect on stem cell pluripotency, we generated porcine iPSC lines containing CD163 reporter and assessed the pluripotency through multiple assays such as alkaline phosphatase staining, immunofluorescent staining, and EdU staining. The red-fluorescent protein (RFP) expression was detected in CD163-edited PAM cells, suggesting that our reporter system indeed has the ability to reflect the expression of gene CD163. Compared with wild-type (WT) iPSCs, the CD163 reporter-iPSCs display similar pluripotency-associated transcription factors expression. Besides, cells with the reporter system showed consistent cell morphology and proliferation ability as compared to WT iPSCs, indicating that the edited-cells have no effect on stem cell pluripotency. In conclusion, we generated porcine iPSCs that contain a CD163 reporter system. Our results demonstrated that this reporter system was functional and safe. This study provides a platform to investigate the iPS-PAM development and virus-host interaction in PAM cells.
Swine ; Animals ; Induced Pluripotent Stem Cells/metabolism* ; Receptors, Cell Surface/genetics* ; Antigens, CD/metabolism* ; Porcine respiratory and reproductive syndrome virus/genetics*

The twenty-first century has already recorded more than ten major epidemics or pandemics of viral disease, including the devastating COVID-19. Novel effective antivirals with broad-spectrum coverage are urgently needed. Herein, we reported a novel broad-spectrum antiviral compound PAC5. Oral administration of PAC5 eliminated HBV cccDNA and reduced the large antigen load in distinct mouse models of HBV infection. Strikingly, oral administration of PAC5 in a hamster model of SARS-CoV-2 omicron (BA.1) infection significantly decreases viral loads and attenuates lung inflammation. Mechanistically, PAC5 binds to a pocket near Asp49 in the RNA recognition motif of hnRNPA2B1. PAC5-bound hnRNPA2B1 is extensively activated and translocated to the cytoplasm where it initiates the TBK1-IRF3 pathway, leading to the production of type I IFNs with antiviral activity. Our results indicate that PAC5 is a novel small-molecule agonist of hnRNPA2B1, which may have a role in dealing with emerging infectious diseases now and in the future.
Animals ; Mice ; Antiviral Agents/pharmacology* ; COVID-19 ; Hepatitis B virus ; Interferon Type I/metabolism* ; SARS-CoV-2/drug effects* ; Heterogeneous-Nuclear Ribonucleoprotein Group A-B/antagonists & inhibitors*

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

In order to understand the prevalence and evolution of porcine reproductive and respiratory syndrome virus (PRRSV) in China and to develop subunit vaccine against the epidemic lineage, the genetic evolution analysis of PRRSV strains isolated in China from 2001 to 2021 was performed. The representative strains of the dominant epidemic lineage were selected to optimize the membrane protein GP5 and M nucleotide sequences, which were used, with the interferon and the Fc region of immunoglobulin, to construct the eukaryotic expression plasmids pCDNA3.4-IFNα-GP5-Fc and pCDNA3.4-IFNα-M-Fc. Subsequently, the recombinant proteins IFNα-GP5-Fc and IFNα-M-Fc were expressed by HEK293T eukaryotic expression system. The two recombinant proteins were mixed with ISA206VG adjuvant to immunize weaned piglets. The humoral immunity level was evaluated by ELISA and neutralization test, and the cellular immunity level was detected by ELISPOT test. The results showed that the NADC30-like lineage was the main epidemic lineage in China in recent years, and the combination of IFNα-GP5-Fc and IFNα-M-Fc could induce high levels of antibody and cellular immunity in piglets. This study may facilitate the preparation of a safer and more effective new PRRSV subunit vaccine.
Humans ; Animals ; Swine ; Porcine respiratory and reproductive syndrome virus/genetics* ; Porcine Reproductive and Respiratory Syndrome/prevention & control* ; HEK293 Cells ; Viral Envelope Proteins/genetics* ; Antibodies, Viral ; Viral Vaccines/genetics* ; Recombinant Proteins ; Vaccines, Subunit