Asian Pacific Journal of Tropical Medicine

145-156

Authors: Weiyong Sheng, Biao Chen, Shanjie Fan, Zhuanglin Zeng, Ying Zhou, Kunpeng Huang, Xing Cheng, Chunyan Cao, Banghong Da, Ning Zhou, Qidi Zhou, Qinghua Wang, Jun Guo, Peng Sun, Chuanzhu Lv, Xiaoling Fu, Jinxiang Zhang

The outbreak of coronavirus disease 2019 (COVID-19) was declared a global public health emergency on 31 January 2020. Emergency medicine procedures in Emergency Department should be optimized to cope with the current COVID-19 pandemic by providing subspecialty services, reducing the spread of nosocomial infections, and promoting its capabilities to handle emerging diseases. Thus, the Chinese Society of Emergency Medicine and Wuhan Society of Emergency Medicine drafted this consensus together to address concerns of medical staffs who work in Emergency Department. Based on in-depth review of COVID-19 diagnosis and treatment plans, literatures, as well as management approval, this consensus proposes recommendations for improving the rationalization and efficiency of emergency processes, reducing the risk of nosocomial infections, preventing hospital viral transmission, and ensuring patient safety.

159-164

Authors: Giao Huynh, Thien Thuan Tran, Han Thi Ngoc Nguyen, Le An Pham

Objective: To assess the acceptance of coronavirus disease (COVID-19) vaccine among healthcare workers at two general hospitals in Vietnam when it is available. Methods: A cross-sectional study was conducted using a convenience sampling from January to February 2021 among 410 healthcare workers at two general hospitals in Vietnam via a selfadministered questionnaire. A multivariable regression analysis was performed to determine predictors of vaccine acceptance including the demographic factors, COVID-19 knowledge, and vaccine beliefs based on the domains of Health Belief Model. Results: Among 410 healthcare workers, 76.10% showed vaccination willingness. Predictors of acceptance were determined that the group reporting as “vaccine acceptance” was more likely to be positive towards the perceived susceptibility and severity of COVID-19 (OR 2.45; 95% CI 1.48-4.06, P<0.05), perceived benefits of vaccination, and cues to action (OR 4.36; 95% CI 2.35- 8.09, and OR 5.49; 95% CI 2.84-10.61, respectively, all P<0.001), but less likely to have the perceived barriers to vaccination (OR 0.19; 95% CI 0.09-0.38; P<0.001) compared with the no acceptance group. Besides, people who had a good knowledge regarding the severity of illness were 3.37 times more likely to have identified as vaccine acceptance (OR 3.37; 95% CI 1.04-10.86, P<0.05). The demographic factors were also associated with willingness to receive the vaccine, with participants who were staff and received COVID-19 information from relatives were less likely to accept the vaccine over those who were doctors and not receiving information from relatives (OR 0.36; 95% CI 0.13-0.96, and OR 0.37; 95% CI 0.17-0.78, respectively, all P<0.05). Conclusions: A rate of willingness to get vaccinated against COVID-19 was relatively high with discrepancies between occupation, receiving information from relatives, knowledge toward the severity of illness, and the elements of Health Belief Model. The findings will provide information for the management authorities to develop relevant interventions to promote COVID-19 vaccination uptake.

176-182

Authors: Zubia Jamil, Samreen Khalid, Shahid Mumtaz Abbasi, Yasir Waheed, Jamal Ahmed

Objective: To evaluate the in-hospital outcome of moderate to severe COVID-19 patients admitted in High Dependency Unit (HDU) in relation to invasive vs. non-invasive mode of ventilation. Methods: In this study, the patients required either non-invasive [oxygen ≤10 L/min or >10 L/min through mask or nasal prongs, rebreather masks and bilevel positive airway pressure (BiPAP)] or invasive ventilation. For analysis of 30-day in hospital mortality in relation to use of different modes of oxygen, Kaplan Meier and log rank analyses were used. In the end, independent predictors of survival were determined by Cox regression analysis. Results: Invasive ventilation was required by 15.1% patients while 84.9% patients needed non-invasive ventilation. Patients with evidence of thromboembolism, high inflammatory markers and hypoxemia mainly required invasive ventilation. The 30- day in hospital mortality was 72.7% for the invasive group and 12.9% for the non-invasive group (1.8% oxygen <10 L/min, 0.9% oxygen >10 L/min, 3.6% rebreather mask and 4.5% BiPAP). The median time from hospital admission to outcome was 7 days for the invasive group and 18 days for the non-invasive group (P<0.05). Age, presence of co-morbidities, number of days requiring oxygen, rebreather, BiPAP and invasive ventilation were independent predictors of outcome. Conclusions: Invasive mechanical ventilation is associated with adverse outcomes possibly due to ventilator associated lung injury. Thus, protective non-invasive ventilation remains the necessary and safe treatment for severely hypoxic COVID-19 patients.

187-190

Authors: Renan GM Diniz, Elaine C dos Santos, Gabriel CL Chagas, Elizabeth F Daher

Rationale: Dengue is the most important human arboviral disease. Neurological manifestations occur rarely in dengue. To the best of our knowledge, there is only one reported case of dengue-associated sudden sensorineural hearing loss (SSNHL) in Brazil untill now. Patient concerns: A 42-year-old man was presented to the emergency department with unconsciousness and generalized tonicclonic seizures. Diagnosis: Dengue-associated aseptic meningitis, acute kidney injury, and SSNHL. Interventions: The patient was treated with anticonvulsants and thiamine and underwent mechanical ventilation. He received combined ceftriaxone and acyclovir, which were later switched to meropenem, acyclovir and ampicillin empirically until culture results became available. He also required hemodialysis and plasmapheresis sessions and fresh frozen plasma and buffy coat transfusions until definitive diagnosis. Outcomes: The patient was discharged after improvement of his general condition and of his blood test results, but hearing loss remained. A six-month follow-up visit showed persistent deafness. Lessons: Dengue should be included in the differential diagnosis of patients from dengue-endemic areas presenting an acute febrile disease with neurological manifestations. To the best of our knowledge, this is the second reported case of dengueassociated SSNHL, suggesting an association between dengue and development of SSNHL.