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

• Published in: Tropical Medicine and Health
• Main Authors: Kristal An Agrupis, Chris Smith, Shuichi Suzuki, Annavi Marie Villanueva, Koya Ariyoshi, Rontgene Solante, Elizabeth Freda Telan, Kelly Anne Estrada, Ann Celestyn Uichanco, Jocelyn Sagurit, Joy Calayo, Dorcas Umipig, Zita dela Merced, Fe Villarama, Efren Dimaano, Jose Benito Villarama, Edmundo Lopez, Ana Ria Sayo
• Format: Article in Journal/Newspaper
• Language: English
• Published: BMC 2021
• Subjects: COVID-19; Philippines; Epidemiology; Low-resource setting; Healthcare workers; Mortality; Arctic medicine. Tropical medicine; RC955-962; Arctic; Pacific
• Online Access: https://doi.org/10.1186/s41182-021-00340-0; https://doaj.org/article/2eb60f6f382c469f860d9b1ab8b0d5ca

Abstract 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, ...