Clinical characteristics of patients with asymptomatic and symptomatic COVID-19 admitted to a tertiary referral centre in the Philippines

Abstract

Objectives We aimed to describe the clinical profile and outcomes of hospitalized patients with COVID-19 across the spectrum of disease activity. Methods This was a retrospective study of adult patients with confirmed COVID-19 infection admitted in a referral hospital. Descriptive statistics, tests for trend, Kaplan-Meier curve and log-rank test were used to compare characteristics and outcomes across disease activity. Results Of 1500 patients, 14.8% had asymptomatic, while 85.2% had mild (13.5%), moderate (36.6%), severe (12.3%), and critical (22.7%) COVID-19. Asymptomatics were admitted for concurrent condition or for isolation. Age >60 years, male gender, and patients with comorbidities had more severe disease. Fever, cough, shortness of breath, malaise, gastro-intestinal symptoms, and decreased sensorium were more frequent with severe disease. Bilateral pulmonary infiltrates were common (51.1%), with sicker patients having more abnormal findings. Overall mortality rate was 15.1%. Adopting a symptom-based strategy shortened hospitalization from a median of 13 days (IQR 7,21) to 9 days (IQR 5,14). Conclusion The clinical profile and outcomes of our COVID-19 cohort is consistent with published reports. Asymptomatic infection is common, and universal testing may be a valuable strategy in the right context, given infection control implications. Symptom-based strategy considerably shortens the duration of hospitalization.

Utility of laboratory and immune biomarkers in predicting disease progression and mortality among patients with moderate to severe COVID-19 disease at a Philippine tertiary hospital

“…Our study showed that high D-dimer, high LDH, low ALC, and low albumin levels were associated with disease progression, while elevated D-dimer and LDH were associated with in-hospital mortality. These findings are consistent with other international and local reports on COVID-19 (11,(42)(43)(44)(45). The finding of high D-dimer also provided evidence for SARS-CoV-2 infection as a hypercoagulable state (46), which further supports the use of prophylactic anticoagulation among patients with moderate to severe COVID-19.…”

“…The cohort in this study consists predominantly of patients with severe to critical COVID-19 disease (69%). This is higher compared to published data from the same institution (48.9%) and another tertiary referral center in Metro Manila (54.1%) even after excluding mild and asymptomatic patients (11,35). The recorded mortality rate of 18% closely approximates the data from both reports, 15.1% in UP-PGH (11) and 20.8% in San Lazaro Hospital (35).…”

“…Data from a large cohort of patients admitted to a tertiary COVID-19 referral center in the Philippines reported the following factors to be predictive of severe disease: increasing age, diabetes mellitus (DM), chronic kidney disease (CKD), chronic obstructive pulmonary disease (COPD), hypertension, coronary artery disease, or metabolic syndrome. Likewise, patients with severe disease had significantly higher LDH, ferritin, D-dimer, and CRP (11). With the massive effect of cytokines in the development of cytokine storms and other complications in COVID-19, its utility as a predictive biomarker has been explored by several studies.…”

Cyclical Student Shifting Models in a Limited Face-to-Face Learning Modality in the time of COVID-19 Pandemic in the Philippines

“…Since the model assumes that the infected cases among students are asymptomatic [18, 19, 20, 21] and undetected [22], hence, there are no isolation for infected and exposed students. We assume that the student population is fixed with no deaths.…”

Psychosocial Distress among Family Members of COVID-19 Patients Admitted to Hospital and Isolation Facilities in the Philippines: A Prospective Cohort Study

“…Further psychosocial distress is likely to impact those directly affected by COVID-19 by either contracting the disease or having to take care of a family member who has been infected with COVID-19. Furthermore, COVID-19 severely affects the elderly, who require more attention and care [ 12 , 13 , 14 ].…”