Outcomes and Risk Factors of Patients With COVID-19 and Cancer (ONCORONA): Findings from The Philippine CORONA Study.

Background: A study conducted in China on patients with coronavirus disease 2019 (COVID-19) showed that cancer conferred a five times increased risk for needing intensive care admission and mortality; No data has yet been collected and published from the Philippines. Thus, the investigators conducted this substudy to determine the association of having a history of cancer with clinical outcomes among patients included in the Philippine CORONA Study. Methodology: Multi-center, retrospective cohort design. Results: A total of 244 patients had a history of cancer, out of 10,881 COVID-19 hospital admissions. After adjusting for different confounding variables of interest, having cancer was significantly associated with a 75% increased odds of having severe/critical COVID-19 at nadir (CI 95% 1.32, 2.33; p < 0.001). After adjusting for different confounding variables of interest, having cancer was significantly associated with the following time-to-event outcomes: 72% increase in hazard of in-hospital mortality (CI 95% 1.37, 2.16; p < 0.001), 65% increase in hazard of respiratory failure (CI 95% 1.31, 2.08; p < 0.001), and 57% increase in hazard of being admitted to ICU (CI 95% 1.24, 1.97; p < 0.001). Conclusion: A history of cancer conferred poorer clinical outcomes on adult, hospitalized COVID-19 patients.

Outcomes of nutritionally at-risk Coronavirus Disease 2019 (COVID 19) patients admitted in a tertiary government hospital: A follow-up study of the MalnutriCoV study.

BACKGROUND AND AIMS: The prevalence of malnutrition among adult Filipino patients with COVID 19 is 71.83%. Malnutrition has long been associated with poor outcomes among patients with pneumonia. This may be due to the increased risk of malnourished patients to develop impaired muscle and respiratory function. We aimed to determine the outcomes of adult COVID 19 patients admitted in a tertiary government hospital accordingly to nutrition status and risk. METHODS: Retrospective study on the adult COVID 19 patients admitted from July 15 to September 15, 2020 who were screened using the Philippine Society for Parenteral and Enteral Nutrition modified Subjective Global Assessment Grade tool. Chi-square or Fisher exact test, as well as Mann-Whitney U test or Kruskal-Wallis with post-hoc Dunn test, as appropriate were done. Survival analysis for mortality was done with right-censored data length of initial admission in days. Cox proportional hazard regression was done to determine the association of the main variables of interest with mortality with a 95% confidence interval. RESULTS: Malnourished patients were 30% less likely to be discharged [HR 0.70 95% CI (0.50, 0.97)]; malnutrition was also associated with length of hospital stay as those who were malnourished had longer lengths of hospital stay of about 4 days on the average [HR 3.55 95% CI (0.83, 6.27)]. High nutrition risk was significantly associated with length of hospital stay [HR 4.36 95% CI (0.89, 7.83)]. CONCLUSION: The only risk factor for mortality shown in this study is ICU transfer. Malnutrition, moderate nutrition risk, and high nutrition risk were risk factors of having longer lengths of hospital stays. While only malnutrition was the risk factor for being less likely to be discharged. We reiterate that nutrition assessment and support are important in mitigating the effects of COVID 19.

The prevalence of malnutrition and analysis of related factors among adult patients with the Coronavirus Disease 2019 (COVID 19) in a tertiary government hospital: The MalnutriCoV study.

BACKGROUND AND AIMS: As of November 2020, the Coronavirus Disease 2019 (COVID 19) has infected more than 396,000 people in the Philippines. Although no study has been done on malnutrition among a general cohort of patients with COVID 19, it has long been associated with increased mortality and poor long-term outcomes. We aimed to determine the prevalence of malnutrition among patients with COVID 19 admitted in a tertiary government hospital. METHODS: Cross-sectional study on COVID 19-confirmed patients admitted to the COVID 19 wards from July 15 to September 15, 2020. Nutritional status was assessed using the Philippine Society for Parenteral and Enteral Nutrition (PhilSPEN) modified Subjective Global Assessment Grade (SGA) tool. Malnutrition was defined as those with SGA grades B and C. Chi-square test or Fisher exact test of association, as appropriate, was used to identify factors that have a significant association with malnutrition. Furthermore, logistic regression was done on factors with significant association. RESULTS: Among the 355 adult patients in the study, 71.83% (255/355) were malnourished [SGA B: 67.84% (173/255); SGA C: 32.16% (82/255)]. The following were shown to have significant association with malnutrition: community-acquired pneumonia (CAP) [p-value < 0.001], hospital-acquired pneumonia (HAP) [p-value 0.002], and chronic kidney disease (p-value 0.033). Multivariable logistic regression revealed that age [OR 1.02, CI 95% 1.00, 1.04, p-value 0.027] and CAP-Moderate Risk (MR) [OR 3.02, CI 95% 1.73, 5.27, p-value < 0.001] are significant predictors of malnutrition. All patients with CAP- High Risk and HAP were malnourished. CONCLUSION: The prevalence of malnutrition was high (71.83%) in a general cohort of COVID 19 patients as measured by the modified SGA tool. The following are risk factors of malnutrition among patients with COVID 19: age, CAP, and HAP. Nutritional support and management of comorbidities are of paramount importance in the care of patients with COVID 19.

Takayasu Arteritis Presenting as Bilateral Ocular Ischemic Syndrome.

A 26-year-old female came in with progressive blurring of vision. She had developed memory loss and complained of headache, significant weight loss, and exertional left calf pain after prolonged walking. Pertinent physical findings included light perception on visual acuity examination, and the brachial and radial pulses of both arms were not appreciable. Thoracic and abdominal aortic imaging by computed tomography with contrast revealed narrowing along the thoracic aorta and its branches. Carotid Doppler showed bilaterally thickened walls in the common carotid arteries, with near total occlusion of the left carotid artery. These findings were consistent with bilateral ocular ischemic syndrome in Takayasu arteritis. She was given methylprednisolone 500 mg intravenously daily for 3 days with noted improvement in vision. She was discharged and showed improvement on prednisone 35 mg/day and aspirin 80 mg/day. On follow-up two weeks post-discharge, she reported being able to see silhouettes of persons and objects.