Epidemiological and clinical characteristics of 5,628 patients with coronavirus disease 2019 in South Korea: A nationwide multicenter study

Purpose@#There are limited data on the epidemiological and clinical characteristics and outcomes in Korean patients with laboratory-confirmed coronavirus disease 2019 (COVID-19). We aimed to describe the epidemiological and clinical characteristics and outcomes of patients with COVID-19 using the Korean nationwide multicenter database. @*Methods@#In this nationwide multicenter study, we included all confirmed patients of COVID-19 in South Korea from February 1 to April 30, 2020. Subjects were classified into 3 age groups: those at younger than 10 years (children), 10 to 20 years (adolescents), and 20 years or more (adults). Cases were confirmed by laboratory testing using real-time reverse transcriptase-polymerase chain reaction assay and analyzed for epidemiological and clinical features and outcomes. Patents were followed up until April 30, 2020. @*Results@#Of 5,628 patients with COVID-19 (2,320 males [41.2%] and 3,308 females [58.8%]), there were 66 children (1.2%), 206 adolescents (3.7%), and 5,356 adults (95.2%). The common comorbidities were hypertension (1,201, 21.3%), diabetes (691, 12.3%), dementia (224, 4.0%), chronic heart disease (179, 3.2%), cancer (145, 2.6%), and asthma (128, 2.3%). The common presenting symptoms were cough (2,341, 41.6%), sputum (1,619, 28.8%), fever (1,305, 23.2%), headache (967, 17.2%), myalgia (926, 16.5%), and pharyngodynia (881, 15.7%). One hundred sixty-five patients (2.1%) were confirmed as having moderate or severe COVID-19 and 118 (2.1%) as having severe COVID-19. @*Conclusion@#Our descriptive study provides the epidemiological and clinical characteristics and outcomes of patients with laboratory-confirmed COVID-19 in South Korea.

Removal of Amikacin in Patients Undergoing Continuous Venovenous Hemodiafiltration / 대한신장학회잡지

BACKGROUND: The purpose of this study was to investigate the pharmacokinetics of amikacin in critically ill patients undergoing continuous venovenous hemodiafiltration (CVVHDF). METHODS: Pharmacokinetic parameters in each of six renal failure patients were estimated by measurement of amikacin levels in serum and effluent samples. RESULTS: Average clearance of amikacin by CV VHDF was 28.5+/-4.6 mL/min (mean+/-standard deviation). The sieving coefficient was 0.62+/-0.2 in the hemodiafiltration system of Gambro AN69 membrane set. Volume of distribution of amikacin was estimated to be 0.47+/-0.08 L/kg lean body weight. The half-life of amikacin was significantly reduced by hemodiafiltration to 11.4+/-1.6 hr. 40% of the administered amikacin was removed by CVVHDF over the 24 hour study period. CONCLUSION: We recommend that 10 mg/kg of amikacin should be given i.v. every 48 hours to critically ill patients during CVVHDF. However, individualized approach based on therapeutic drug monitoring of plasma amikacin concentration is necessary for optimum amikacin therapy during CVVHDF due to the varying nature of critically ill patients.

A Case of Adult-Onset Minimal Change Nephrotic Syndrome Relapsed after 15-year of Complete Remission / 대한신장학회잡지

We report an unusual case of adult minimal change nephrotic syndrome relapsed after 15-year of complete remission. In this case, the disease had occurred to the patient for the first time when he was 52 years old; relatively high age, and had been remitted with steroid therapy. After 15 years of complete remission, he visited our hospital with the symptoms of the generalized edema and the pitting edema of both lower extremities that occurred 15 days ago. Massive proteinuria(15, 865 mg/day) and hypoalbuminemia(1.7 g/dL) were detected. The pathologic evaluation of the biopsied specimen of the kidney showed the global sclerosis in 19% of glomeruli in light microscopic finding and the fusion of epithelial foot processes in electron microscopic finding. He was treated with pulse steroid therapy (methylprednisolone 500 mg/day iv for 3 days) and then, with oral prednisolone (60 mg/day). Generalized edema and proteinuria disappeared after 14 days of treatment, and there has been no relapse ever since. Adult-onset minimal change nephrotic syndrome relapses within 4 years after complete remission in 90 % of relapsed patients. The relapse after more than 5 years of complete remission, like this case, is very rare, especially in the case of late-onset disease. However, the possibility of relapse of the minimal change nephrotic syndrome after several years of its remission should be considered constantly and the long-term follow-up more than 10 years may be needed.

A Case of Duodenal Intramural Hematoma Associated with Henoch-Sch nlein Purpura / 대한소화기내시경학회지

Henoch-Sch nlein purpura is a systemic small-vessel IgA dominant vasculitis involoving the capillaries, arterioles, or venules. It is characterized by the classic tetrad of abdominal pain, arthralgia, typical rash, and renal involvement, all of which can occur in any order and at any time over several days to weeks. The central nervous system and lungs may be involved. The gastrointestinal tract is involved in more than 50 percent of patients, manifested most commonly by abdominal pain and gastrointestinal bleeding. And rarely may occur intussusception, bowel nerosis, perforation and intramural hematoma of the duodenum. We report a case of intramural hematoma of the duodenum with Henoch-Sch nlein purpura in 48 year old female patient which was demostrated by upper gastrointestinal endoscopy, abdominal CT scan, hypotonic duodenography and histologic finding of duodenal biopsy. She was treated with supportive care and improved rapidly without any serious gastrointestinal complications.