RESUMO
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.
Assuntos
Criança , COVID-19 , SARS-CoV-2 , Sistema de Registros , FilipinasRESUMO
Background@#Our country has the fastest growing number of HIV cases in the Asia-Pacific region with a 203% increase from 2010 to 2018. MTCT represents 6% of infections in children and interventions such as the PMTCT program are essential to help reduce new infant infections. @*Objective@#To determine the outcomes of HIV-exposed infants born in PGH from 2010 to 2018 enrolled in the PMTCT program. To analyze the association of maternal and neonatal clinicodemographic factors to MTCT of HIV.@*Methods@#A retrospective cohort study using data collected from medical records of HIV exposed infants enrolled in the program. @*Results@#Out of 117 mother-infant pairs, only 70 met the eligibility criteria. Maternal factors showed that majority have: timely antenatal visit (56/70), maternal HIV diagnosis (70/70) and ART initiation (67/70) prior to delivery, triple lifelong maternal ART (69/70), CD4 >200 prior to delivery (52/70) and cesarean delivery (67/70). Amongst the infant factors-early infant prophylaxis (60/62), >4weeks prophylaxis duration (62/70) and replacement feeding (62/70) were noted in the majority. 2/70 infants were HIV positive. Mortality rate was 1.4% and 50% for HIV infected infants. Overall LTFU rate was 33.3%. Logistic regression showed that maternal co-infection with Hepatitis B(p=0.0275) was a possible determinant of MTCT. Infant HIV prophylaxis duration of >4 weeks had higher survival proportion(p=.0001). @*Conclusion@#The HIV MTCT rate was 2.86% upon implementation of our PMTCT program, meeting the <5% goal of WHO, suggesting that the program was an effective health intervention strategy. The high LTFU rate though should be considered in the evaluation of the program effectiveness.