New Research Papers

Cecilia A. Jimeno, Ma. Cecile Anonuevo-Cruz, Adrian Oscar Bacena, Angelique Love Tiglao-Gica, Angelique Bea Uy, Mark David Francisco, Dianne Grace Corpuz
Philippine General Hospital
University of the Philippines Manila

UP Philippine General Hospital Division of Endocrinology, Diabetes & Metabolism Consensus Recommendations for In-Patient Management of Diabetes Mellitus among Persons with COVID-19

There have been many management guidelines for blood sugar control in the hospital that have been published. However, the occurrence of COVID-19 among persons with diabetes has led to some difficulty of blood sugar control among those with severe infection, which is worsened by the use of certain drugs that are known to be diabetogenic such as steroids. Thus, not only do international guideline have to be adapted in our country, but the specific set-up of the hospitals which are admitting patients with COVID-19 needs to be considered. In the Philippine General Hospital, patients are admitted to COVID wards and when critically ill, to the COVID Intensive care units. Thus, these set of guidelines took into consideration some of our currently available practices such as using the modified Yale insulin protocols, and incorporated some of the best practices from other countries.

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Cherica A Tee, Evelyn O Salido, Michael Tee
College of Medicine, University of the Philippines Manila

Patrick Wincy C Reyes
School of Statistics, University of the Philippines Diliman

Psychological State and Associated Factors During the 2019 Coronavirus Disease (COVID-19) Pandemic Among Filipinos with Rheumatoid Arthritis or Systemic Lupus Erythematosus

Patients with systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) are perceived to be more vulnerable to worse COVID-19 infection outcome. Furthermore, severe shortage in hydroxychloroquine supply was experienced. We examined the psychological responses of Filipino SLE and RA patients to the COVID-19 pandemic and shortage of hydroxychloroquine supply.

A total of 512 SLE and RA patients completed an online surveys from May 19 to 26, 2020. The online survey collected data on socio-demographics, health status, contact history, health service utilization, use of hydroxychloroquine, COVID-19 knowledge and concerns, precautionary measures, information needs, the validated Impact of Events Scale-Revised (IES-R) and Depression, Anxiety and Stress Scales (DASS-21) ratings.

The psychological impact of COVID-19 outbreak was at least moderate in 20%. Stress, anxiety and depression were moderate to severe in 12.3%, 38.7%, and 27.7% of respondents. The risk factors for adverse mental health during the COVID-19 pandemic include the presence of comorbidity of hypertension and asthma; being a healthcare worker; and presence of specific symptoms of myalgia, cough, breathing difficulty, dizziness and sore throat. The protective factors for mental health during the pandemic include satisfaction with available health information and wearing of face masks.

In the third month of the pandemic in the Philippines, 20% of the respondents with lupus and RA experienced moderate to severe psychological impact. There was moderate to severe anxiety in 38.7% and moderate to severe depression in 27%. Identification of factors that affect mental health in lupus and RA is useful in implementation of effective psychological support strategies.

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Rowena Natividad S. Flores-Genuino, Evelyn Osio-Salido
College of Medicine
University of the Philippines Manila

Use of Renin-Angiotensin System Antagonists in Patients with Hypertension and COVID-19 Infection: A Rapid Review and Meta-analysis

With the declaration of the COVID-19 pandemic in early 2020 by the World Health Organization, guidelines for management of comorbidities are much needed. Hypertension is a leading comorbidity in patients with COVID-19 infection. Renin-angiotensin-aldosterone (RAS) antagonists are a group of medications commonly used in patients with hypertension and renal disease. Due to their varying effects on certain cells in the lungs, they may have both protective and deleterious effects on patients with COVID-19.

We summarized 13 retrospective cohort studies that compared the clinical outcomes of COVID-19 infection in patients who took RAS antagonist medications to those who did not. We found out that it is still uncertain whether they have beneficial or detrimental effects in terms of more severe COVID disease or deaths. This is in agreement with current recommendations by medical organizations such as the CDC, Infectious Disease Society of America, International Society of Hypertension, which do not recommend discontinuation of these medications in patients with COVID-19.

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Jomar F. Rabajante
Institute of Mathematical Sciences and Physics
University of the Philippines Los Baños

Insights from early mathematical models of 2019-nCoV Acute Respiratory Disease (COVID-19) Dynamics

The insights that can be drawn from early models of COVID-19 were discussed in this paper. The results of the models published around January 2020 can serve as inputs for designing early strategies to control the epidemic/pandemic. A proposed model on how to prevent the spread of the disease in local setting, such as during social gatherings, was also presented. The simulations are based on a modified SEI model. The model shows that the exposure time is a significant factor in spreading the disease. As the density of the crowd in an area increases, the higher the chance an infected person could infect other people. An infected person staying in the event for long hours could become a super-spreader of the virus. The  attendees of the social gathering  should  practice effective protection or preventive measures to minimize further disease transmission. The crowd density and level of protection of the people are essential to be monitored during social gatherings.

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