ABSTRACT
Background@#The COVID-19 pandemic continues to afflict nations worldwide. The Philippines is no exception which has recorded more than 3 million cases as of December 2021 with children comprising 12% of total cases. Since the start of the pandemic, the Pediatric Infectious Disease Society of the Philippines (PIDSP) has been collecting data nationwide, through an online pediatric COVID-19 registry (SALVACION registry), to provide a better understanding of COVID-19 in children in the local setting. @*Methods@#This was an ambispective cohort study of pediatric COVID-19 cases in the Philippines reported from March 2020 to December 2021. Data on clinical features, laboratory findings, disease severity, and treatment outcomes were voluntarily reported by physicians across the country. This study was approved by the Department of Health Single Joint Research Ethics Board. @*Results@#As of December 30, 2021, there were 2,127 cases reported in the registry, with a median age of 5 years (interquartile range: 1-13 years) and mostly mild (41.9%) or moderate (24.5%) in severity. The top symptoms reported were fever (57.9%), cough (42.7%), coryza/colds (29.4%), anorexia (25.2%), and difficulty of breathing (23.1%). The most common comorbidities were hematologic-oncologic diseases (7.4%), neurologic diseases (7.0%) and surgical conditions (4.4%), while the most common coinfections were sepsis (6.3%), dengue fever (4.8%) and healthcare-associated pneumonia (2.1%). Significantly higher median CRP, procalcitonin, D-dimer, ferritin, transaminases and lactate dehydrogenase were seen among severe/critical cases compared to non-severe cases. There was a high frequency of antibiotic use (58%). Most cases recovered, although 172 deaths were reported with an 8.6% case fatality rate. The most common comorbidities in those who died were neurologic (15.7%), cardiac (12.8%) and hematologic (11.6%) diseases. @*Conclusion@#Children across all age groups are susceptible to COVID-19 and most cases are mild or moderate in severity. Among severe and critical cases, the most common comorbidities were neurologic, hematologic-oncologic and cardiac diseases. Most patients recovered with supportive management.
Subject(s)
Child , COVID-19 , SARS-CoV-2 , Registries , PhilippinesABSTRACT
Introduction@#Infection with HIV is multi-faceted and involves the interplay of medical, social, and economic factors thus, management of the disease continues to be a challenge to most physicians. The Philippines is experiencing a surge in cases since 2013. Understanding the local epidemiology of pediatric HIV may reveal opportunities to reduce or eliminate transmission through timely diagnosis. @*Objective@#This study was conducted to identify the features and outcome of children living with HIV in a hospital where a program for HIV treatment and monitoring was implemented. @*Methodology@#Medical records of all children Guidance Intervention Prevention (SAGIP) Unit were reviewed. Data was analysed using descriptive statistics. @*Results@#Thirty pediatric HIV patients were included in the study. The most common mode of acquisition is by sexual transmission (57%) and most patients were male (76%),bisexual (47%), and heterosexual (47%). Weight loss (50%),rash (50%), fever (37%) and cough (37%) were the most common clinical findings. The most common opportunistic infections were tuberculosis (47%) and oral candidiasis (34%). Only 27 of 30 patients were started on antiretroviral therapy within 6 months from diagnosis. One patient showed resistance to a non-nucleoside reverse transcriptase inhibitor (NNRTI). There were 11 children who died of various opportunistic infections and its complications, while 2 were transferred to a different treatment hub after 6 months, and 1 lost to follow-up. @*Conclusion@#Sexual means of HIV transmission among adolescents is evident in this study. Weight loss, cough, rash, fever, and lymphadenopathy are common presenting features. Tuberculosis and oral candidiasis are the most common opportunistic infections and should alert physicians on possible HIV infection. A mortality rate of 37% was noted mostly in the first 6 months of initiating ART treatment.