Genome sequencing and detection of Philippine SARS-CoV-2 infections with viruses classified under the B.1.1.7 lineage

We report the sequencing and detection of 39 Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) samples containing lineage-defining mutations specific to viruses belonging to the B.1.1.7 lineage (UK variant) in the Philippines.

Genome sequencing and analysis of an emergent SARS-CoV-2 variant characterized by multiple spike protein mutations detected from the Central Visayas Region of the Philippines

The emergence of SARS-CoV-2 variants of concern such as the B.1.1.7, B.1.35 and the P.1 have prompted calls for governments worldwide to increase their genomic biosurveillance efforts. Globally, quarantine and outbreak management measures have been implemented to stem the introduction of these variants and to monitor any emerging variants of potential clinical significance domestically. Here, we describe the emergence of a new SARS-CoV-2 lineage, mainly from the Central Visayas region of the Philippines. This emergent variant is characterized by 13 lineage-defining mutations, including the co-occurrence of the E484K, N501Y, and P681H mutations at the spike protein region, as well as three additional radical amino acid replacements towards the C-terminal end of the said protein. A three-amino acid deletion at positions 141 to 143 (LGV141_143del) in the spike protein was likewise seen in a region preceding the 144Y deletion found in the B.1.1.7 variant. A single amino acid replacement, K2Q, at the N-terminus of ORF8 was also shared by all 33 samples sequenced. The mutation profile of this new virus variant warrants closer investigation due to its potential public health implications. The current distribution of this emergent variant in the Philippines and its transmission are being monitored and addressed by relevant public health agencies to stem its spread in nearby islands and regions in the country.

A descriptive study on the factors affecting the length of stay in the emergency department of a tertiary private hospital in the Philippines

@#<p><strong>OBJECTIVE:</strong> The study aims to describe factors that contribute to the Length of Stay (LOS) in the Emergency Department (ED) patients of a Tertiary Private Hospital in Philippines.</p><p><strong>METHODS:</strong> This is a retrospective descriptive study from September 1, 2015 to March 31, 2016 on the factors of ED consultations specifically on demographics (age and sex), payment schemes (Out of Pocket (OOP) and third party payer), shift times (morning, afternoon and night) and triage-levels were associated with LOS.</p><p><strong>RESULTS:</strong> Our ED consultations with age (mean 40.75 years, SD 16.8, N 20,687, range 95) were dominated by females (56%), two age-range, 21-30 (28.4%) & 31-40 and third party payer (57%). LOS (mean of 4,40 hours, SD 3,89, N 18540, range 68) was significantly higher (p<0.001) on OOP patients, older age-range; 71-80, (3.5%) and 81-90, (2.3%). Emergent cases had higher incidence (X2= 30.2, p<0.001) on morning shift, urgent cases on afternoon shift and trauma cases on evening shift. Non-urgent cases were consistent on all time frames. LOS was significantly higher (X2=p<0.001) on urgent and emergent cases and on morning and afternoon shifts and significantly lowest, (p<0.001) on night shifts.</p><p><strong>CONCLUSION:</strong> Higher LOS was associated on the following: urgent and emergent triage- levels, older age range, OOP, and morning and afternoon shifts.</p>

A descriptive study on the factors affecting the length of stay in the Emergency Department of a tertiary private hospital in the Philippines

Objective@#The study aims to describe factors that contribute to the Length of Stay (LOS) in the Emergency Department (ED) patients of a Tertiary Private Hospital in Philippines.@*Methods@#This is a retrospective descriptive study from September 1, 2015 to March 31, 2016 on the factors of ED consultations specifically on demographics (age and sex), payment schemes (Out of Pocket (OOP) and third party payer), shift times (morning, afternoon and night) and triage-levels were associated with LOS.@*Results@#Our ED consultations with age (mean 40.75 years, SD 16.8, N 20,687, range 95) were dominated by females (56%), two age-range, 21-30 (28.4%) & 31-40 and third party payer (57%). LOS (mean of 4,40 hours, SD 3,89, N 18540, range 68) was significantly higher (p<0.001) on OOP patients, older age-range; 71-80, (3.5%) and 81-90, (2.3%). Emergent cases had higher incidence (X2= 30.2, p<0.001) on morning shift, urgent cases on afternoon shift and trauma cases on evening shift. Non-urgent cases were consistent on all time frames. LOS was significantly higher (X2=p<0.001) on urgent and emergent cases and on morning and afternoon shifts and significantly lowest, (p<0.001) on night shifts.@*Conclusion@#Higher LOS was associated on the following: urgent and emergent triage- levels, older age range, OOP, and morning and afternoon shifts.

A cost-effectiveness study of sequential therapy using levofloxacin versus cefuroxime in the treatment of moderate risk community-acquired pneumonia (ATS III) in adults

OBJECTIVE: This study was undertaken to investigate the clinical effectiveness and cost-effectiveness of sequential therapy in adults with moderate-risk community-acquired pneumonia. To our knowledge, this is the first such study to be undertaken in a country where healthcare was paid for out-of-pocket.METHODS: This randomized open-label intention-to-treat costeffectiveness study was taken from the society viewpoint comparing patients randomized to sequential therapy of either levofloxacin alone or cefuroxime with or without erythromycin. Generally accepted guidelines on Good Clinical Practice were observed throughout the study period.RESULTS: Protocol-guided sequential therapy using levofloxacin as monotherapy demonstrated a total cost advantage over cefuroxime axetil with or without erythromycin. Drug acquisition costs were also statistically significantly lower (p CONCLUSIONS: Employment of sequential therapy by the protocol employed supplied physicians with unambiguous determinants of response of their patients and provided clearer foundations for discharge. While sequential therapy using either of the study treatment regimens did not differ in efficacy at the end of treatment, study results suggest that sequential therapy using a respiratory fluoroquinolone for these patients may afford a shorter duration of hospital stay, less adverse events and, ultimately, a reduction of out-of-pocket expenses that would have gone to hospital expenses (room and board, visits by healthcare personnel) had patients remained confined.