Epidemiological and clinical characteristics of the first 500 confirmed COVID-19 inpatients in a tertiary infectious disease referral hospital in Manila, Philippines.

BACKGROUND: The Philippines has been one of the most affected COVID-19 countries in the Western Pacific region, but there are limited data on COVID-19-related mortality and associated factors from this setting. We aimed to describe the epidemiological and clinical characteristics and associations with mortality among COVID-19-confirmed individuals admitted to an infectious diseases referral hospital in Metro Manila. MAIN TEXT: This was a single-centre retrospective analysis including the first 500 laboratory-confirmed COVID-19 individuals admitted to San Lazaro Hospital, Metro Manila, Philippines, from January to October 2020. We extracted clinical data and examined epidemiological and clinical characteristics and factors associated with in-hospital mortality. Of the 500 individuals, 133 (26.6%) were healthcare workers (HCW) and 367 (73.4%) were non-HCW, with HCW more likely presenting with milder symptoms. Non-HCW admissions were more likely to have at least one underlying disease (51.6% vs. 40.0%; p = 0.002), with hypertension (35.4%), diabetes (17.4%), and tuberculosis (8.2%) being the most common. Sixty-one (12.2%) died, comprising 1 HCW and 60 non-HCW (0.7% vs. 16.3%; p < 0.001). Among the non-HCW, no death occurred for the 0-10 years age group, but deaths were recorded across all other age groups. Compared to those who recovered, individuals who died were more likely to be older (p < 0.001), male (p = 0.015), report difficulty of breathing (p < 0.001), be HIV positive (p = 0.008), be intubated (p < 0.001), categorised as severe or critical (p < 0.001), have a shorter mean hospital stay (p < 0.001), or have an additional diagnosis of pneumonia (p < 0.001) or ARDS (p < 0.001). CONCLUSION: Our analysis reflected significant differences in characteristics, symptomatology, and outcomes between healthcare and non-healthcare workers. Despite the unique mix of cohorts, our results support the country's national guideline on COVID-19 vaccination which prioritises healthcare workers, the elderly, and people with comorbidities and immunodeficiency states.

Evaluation of nine serological rapid tests for the detection of SARS-CoV-2

[ABSTRACT]. Objective. To evaluate the operative capacity of nine serological rapid tests to detect the IgM/IgG antibodies response in serum from patients with SARS-CoV-2 in different clinical stages. Methods. A cross-sectional study of serological rapid tests was designed to compare the performance of the evaluated immunochromatographic tests for the diagnosis of SARS-CoV-2. A total of 293 samples was used, including negatives, asymptomatic, and symptomatic serum samples. Results. The sensitivity of the evaluated tests was low and moderate in the groups of asymptomatic serum samples and the group of serums coming from patients with less than 11 days since the onset of the symptoms. The specificity for the anti-SARS-CoV-2 antibodies tests ranged between 86.5%-99% for IgM and 86.5%-99.5% for IgG. The sensitivity and the likelihood ratio were different according to the study groups. The usefulness of these tests is restricted to symptomatic patients and their sensitivity is greater than 85% after 11 days from the appearance of symptoms. Conclusions. Serological tests are not an adequate strategy for the identification of asymptomatic and pre-symptomatic patients. Serological rapid tests for the detection of specific anti-SARS-CoV-2 antibodies can be used as a diagnostic aid, but diagnosis must be confirmed by RT-PCR. Rapid tests should be reserved for patients with symptoms lasting more than 11 days.

[RESUMEN]. Objetivo. Evaluar la capacidad operativa de nueve pruebas serológicas rápidas para detectar la respuesta de anticuerpos IgM/IgG en el suero de pacientes con SARS-CoV-2 en diferentes etapas clínicas. Métodos. Se diseñó un estudio transversal de las pruebas serológicas rápidas para comparar su rendimiento respecto del diagnóstico del SARS-CoV-2. Se utilizaron en total 293 muestras, inclusive muestras de suero de pacientes negativos, asintomáticos y sintomáticos. Resultados. La sensibilidad de las pruebas evaluadas fue baja y moderada en las muestras de suero del grupo de pacientes asintomáticos y en el grupo de pacientes con menos de 11 días desde el inicio de los síntomas. La especificidad de las pruebas de anticuerpos anti-SARS-CoV-2 varió entre 86,5%-99% para la IgM y 86,5%-99,5% para la IgG. La sensibilidad y la razón de verosimilitud (likelihood ratio) fueron diferentes según los grupos de estudio. La utilidad de estas pruebas se limita a los pacientes sintomáticos y su sensibilidad es superior al 85% después de 11 días de la aparición de los síntomas. Conclusiones. Las pruebas serológicas no son una estrategia adecuada para la identificación de los pacientes asintomáticos y presintomáticos. Las pruebas serológicas rápidas para la detección de anticuerpos específicos anti-SARS-CoV-2 pueden ser utilizadas como ayuda diagnóstica, pero el diagnóstico debe ser confirmado por RT-PCR. Las pruebas rápidas deben reservarse para los pacientes con síntomas que duren más de 11 días.