Our study aimed to determine the effects of new-onset neurological symptoms (NNS) on clinically relevant outcomes in hospitalized patients with COVID-19 infection. We conducted a nationwide, comparative, retrospective, cohort study among adult, hospitalized COVID-19 patients involving 37 hospital sites from various regions in the Philippines. We included a total of 10,881 patients with confirmed COVID-19 infection (2008 had NNS while 8873 did not have NNS). The adjusted hazard ratios (aHRs) for mortality among the mild and severe cases were significantly higher by 1.660 (95% CI 1.132–2.435) and by 1.352 (95% CI 1.042–1.752), respectively, in the NNS group compared to those in the non-NNS group. The aHRs for respiratory failure in the NNS group were significantly increased by 1.914 (95% CI 1.346–2.722), by 1.614 (95% CI 1.260–2.068), and by 1.234 (95% CI 1.089–1.398) among the mild, severe, and critical cases, respectively. The aHRs for ICU admission in the NNS group were still significantly higher by 1.973 (95% CI 1.457–2.673) and by 1.831 (95% CI 1.506–2.226) among the mild and severe cases, respectively. Patients who had NNS were not significantly associated with a longer duration of ventilator dependence (adjusted odds ratio (aOR) 0.954, 95% CI 0.772–1.179), longer ICU stay (aOR 0.983, 95% CI 0.772–1.252) and longer hospital admission (aOR 1.045, 95% CI 0.947–1.153). The presence of NNS significantly increases the risk of mortality, respiratory failure and ICU admission among COVID-19 patients. Registration and associated protocol publication: ClinicalTrials.gov website (NCT04386083); Espiritu AI, Sy MCC, Anlacan VMM, Jamora RDG. The Philippine COVID-19 Outcomes: a Retrospective study Of Neurological manifestations and Associated symptoms (The Philippine CORONA study): a protocol study. BMJ Open. 2020;10:e040944.

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A 308 nm excimer laser has been used with a fiber delivery system to perform ablation of the human lens. Preliminary results demonstrate the system's ability to ablate lens nucleus and cortex selectively, preserving the anterior and posterior capsules. The total delivered energy necessary to ablate a human lens ranged from 35 to 63 joules. Laser tissue interaction and ablation rates were computed for the different components of the human lens (capsule, cortex, nucleus) for the operatively useful energy densities (fluences). Operative experience suggests that cortex and nucleus can be ablated while preserving the capsule if an adequate irrigation and aspiration system is developed. These results also suggest that this modality may be adequate for performing endocapsular cataract extraction. Laser tissue interactions were also computed at variable distances between the fiber tip and tissue. As this distance increased, the spread of the beam increased and a significant increase in energy was necessary to induce tissue ablation. This was due to the decrease in fluence with increasing distance to the target tissue and/or the absorption and scattering of the delivered energy within a short distance from the fiber tip by the ablated material. Evidence of a sonic effect was also present.

With emerging amyloid therapies, documentation of the patient’s amyloid status to confirm the etiology of a clinical diagnosis is warranted prior to instituting amyloid-based therapy. The Multimer Detection System-Oligomeric Amyloid-β (MDS-OAβ) is a noninvasive blood-based biomarker utilized to measure Aβ oligomerization tendency. We determined the difference in MDS-OAβ ratio across the groups: (a) no cognitive impairment or subjective cognitive impairment (NCI/SCI), (b) Alzheimer’s disease (AD), (c) non-AD, and (d) mixed Alzheimer’s disease-Vascular dementia (AD-VaD). MDS-OAβ level was not significantly different between AD and mixed AD-VaD, but both groups were significantly different from the NCI/SCI and from the non-AD group. An MDS-OAβ level of >1 could potentially indicate clinical variants of AD or mixed pathology (AD-VaD).

Background A growing body of evidence has described neuropsychiatric symptoms (NPS) as early markers of cognitive decline and may precede onset of measurable neurocognitive changes.1,2 NPS have been associated with accelerated cognitive decline and higher dementia conversion rates.3 The repeated observation that individuals with NPS are at increased risk of further cognitive decline delineates this group as high risk and suitable for early interventions to prevent cognitive and functional loss.4 The objectives are to determine the prevalence and compare the demographic and cognitive profiles of non‐demented individuals with NPS in a Filipino cohort. Method A total of 435 patients with no cognitive impairment (NCI) and Mild Cognitive Impairment (MCI) from St. Luke’s Medical Center Memory Clinic were included. NPS were assessed by administration of the Neuropsychiatric Inventory Questionnaire (NPI‐Q) to a reliable caregiver. Participants were administered the Mini‐Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and Alzheimer’s Disease Assessment Scale Cognitive Subscale (ADAS‐Cog). Result Compared to patients without NPS, patients with NPS have more impaired cognition with lower MMSE (25 + 4 vs 27 + 3, p=0.001); MoCA (21 + 5 vs 23 + 5, p=0.002) and higher ADAS‐Cog scores (12.4.6 + 6 vs 10.6 + 6, p=0.01). A fully adjusted model showed NPS to be significantly associated with MMSE (‐0.8, 95% CI ‐1.6 to ‐0.02, p=0.04) and MoCA scores (‐1.2, 95% CI ‐2.3 to ‐0.2, p=0.02). Conclusion This study shows that non‐demented individuals with NPS have more cognitive impairment suggesting the importance of NPS as a potential marker for early cognitive decline and a need for further trials that targets treatment for NPS even at an early stage to prevent cognitive impairment.