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COVID-19: A Single-Center ICU Experience of the First Wave in the Philippines
Onion Gerald V Ubaldo1, Jose Emmanuel M Palo1, Jude Erric L Cinco1
1Acute and Critical Care Institute, The Medical City-Ortigas, Pasig City 1605, Philippines.
Insights
No COVID-19 treatments improved outcomes in a Philippine ICU. Higher SAPS-3 scores indicated worse prognosis for intensive care unit (ICU) patients with coronavirus disease 2019 (COVID-19).
Area of Science:
- Intensive Care Medicine
- Infectious Diseases
- Epidemiology
Background:
- The 2019 novel coronavirus (COVID-19) pandemic exposed global healthcare vulnerabilities.
- Limited data exists on the Philippine experience with COVID-19 patient management and outcomes.
- Understanding country-specific ICU data is crucial for refining treatment protocols.
Purpose of the Study:
- To describe the clinical and demographic characteristics of COVID-19 patients in a Philippine ICU.
- To evaluate the association between therapeutic interventions and ICU survival.
- To identify factors associated with mortality in critically ill COVID-19 patients.
Main Methods:
- Retrospective, descriptive study of 91 probable COVID-19 patients admitted to a COVID ICU.
- Data collected on clinical and demographic profiles, interventions, and outcomes.
- Statistical analysis to identify associations between interventions, severity scores, and survival.
Main Results:
- No observed therapeutic intervention was associated with improved ICU survival.
- Hydroxychloroquine, tocilizumab, and prone positioning showed trends favoring non-survivors.
- Higher Simplified Acute Physiology Score 3 (SAPS-3) was associated with COVID-19 positivity and non-survival.
Conclusions:
- Current therapeutic interventions showed no benefit for COVID-19 ICU patients in this cohort.
- Higher illness severity scores predict poorer outcomes in critically ill COVID-19 patients.
- Further research with more variables is recommended to understand Philippine COVID-19 ICU outcomes.
Abstract:
On January 30, 2020, the WHO declared the novel coronavirus of 2019 a pandemic, causing millions of cases and thousands of deaths worldwide, exposing the vulnerabilities of healthcare systems around the world with each country having its own experience. These ranged from patient clinical profiles to management recommendations and to government interventions. There is a paucity of published data regarding Philippine experience. This study is a retrospective, descriptive study of ninety-one COVID-19 probable patients admitted in the COVID ICU of The Medical City from March 16 to May 7, 2020. We described clinical and demographic characteristics amongst COVID-19-confirmed and -negative patients. Therapeutic interventions including COVID-19 investigational drug use and other organ failure strategies were noted and tested for association with ICU survivors and nonsurvivors. We observed that there was no therapeutic intervention that was associated with improved outcomes, with some interventions showing trends favoring the ICU nonsurvivor group. These interventions include, but are not limited to, the use of hydroxychloroquine and tocilizumab, and prone positioning. We also observed that a higher SAPS-3 score was associated with the COVID-19 positive group and the ICU nonsurvivor group. On PubMed search, there seems to be no Philippine-specific literature regarding COVID-19 ICU experience. Further investigations to include more variables are recommended.
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