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Background@#We aimed to investigate the factors associated with neurological manifestations of post-coronavirus disease 2019 (COVID-19) conditions. @*Methods@#We retrospectively collected data from 440 patients who visited our post-COVID-19 clinic more than 4 weeks after severe acute respiratory syndrome coronavirus 2 infection. We analyzed the prevalence of different neurological symptoms (brain fog, memory impairment, headache, and dizziness) and assessed the associated factors. @*Results@#Brain fog was the most common symptom, observed in 170 patients (38.6%), followed by headaches (n = 137, 31.1%), dizziness (n = 128, 29%), and memory impairment (n = 104, 23.6%). Brain fog was associated with hyposmia or hypogeusia (odds ratio [OR], 2.54; P < 0.001), Fatigue Severity Scale (FSS) (OR, 1.06; P < 0.001), and Hospital Anxiety and Depression Scale-Anxiety (OR, 1.09; P = 0.037). Memory impairment was associated with sleep problems (OR, 2.83; P < 0.001), FSS (OR, 1.05; P < 0.001), and age (OR, 1.02; P = 0.015). Headache was associated with sleep problems (OR, 2.28; P= 0.001), sex (OR, 1.68; P = 0.042), and FSS (OR, 1.04; P < 0.001). Dizziness was associated with sleep problems (OR, 2.88; P < 0.001), and FSS (OR, 1.04; P < 0.001). The incidence of brain fog ( P < 0.001), memory impairment ( P < 0.001), dizziness (P = 0.007), and headache (P = 0.045) accompanied by hyposmia and hypogeusia was higher in patients with the aforementioned symptoms than in those without. @*Conclusion@#This study suggests that there is a relationship between neurological symptoms and other clinical factors, such as fatigue, depression, anxiety, hyposmia, and hypogeusia.
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Background@#We aim to compare the clinical characteristics and subjectively reported symptoms of the acute coronavirus disease (COVID) phase and those of the post-acute COVID phase to examine varying factors that affect the number of persistent symptoms and their categories. @*Methods@#We categorized 1,122 patients who visited the post coronavirus disease 2019 (COVID-19) clinic into two groups: “acute group” ( 4 weeks following diagnosis of COVID-19). We statistically compared clinical characteristics between the two groups and determined which factors are associated with the number of persistent symptoms and their categories. @*Results@#The persistent symptoms of post COVID-19 conditions were classified into three categories as follows: Category A (the prevalence of symptoms is higher in the acute-visit group than in the post-acute-visit group), Category B (the prevalence of symptoms is not different between the two groups) and Category C (the prevalence of symptoms is higher in the post-acute-visit group than in the acute-visit group). Category A mainly included respiratory symptoms. Category B had generalized weakness, weight loss, cardiologic symptoms, hypogeusia, hyposmia, anxiety, and various gastrointestinal symptoms. Category C included fatigue, decreased attention, depression, blurred vision, hair loss, and sexual dysfunction.Anxiety, depression, fatigue and age were also associated with the number of symptoms and their categories, and anxiety is the most correlated factor (P < 0.001) among them. @*Conclusion@#The persistent symptoms of post COVID-19 condition involve multi-organ and continue for four weeks or greater. Therefore, long-term observation and multidisciplinary interventions are essential for patients with post COVID-19 conditions.
ABSTRACT
Amid the coronavirus disease 2019 (COVID-19) crisis, the core functions of an acute care hospital are to continuously provide essential clinical care services to patients from community at large. The dual track healthcare system (DTHS) is a strategy for preventing the hospital infection and allocating the resources of an acute care hospital to treat COVID-19 patients while simultaneously providing indispensable clinical care services for non-COVID-19 patients. The key elements of DTHS include compartmentalizing the space within independent buildings, allocating buffer zones for patients who have not been confirmed for COVID-19 infection but require inpatient treatment, delegating manpower with appropriate support, establishing competent in-house laboratory that enables universal COVID-19 screening via reverse transcriptase polymerase chain reaction and employing real-time communication technology. The effectiveness of DTHS was confirmed through the results of questionnaire surveys of hospital patients and the research on the qualitative and quantitative changes in the provision of fundamental care services including both acute and continuous clinical care after the care for COVID-19 patients in the hospital. With a potential for subsequent explosive community infections, the pandemic public health crisis rendered by COVID-19 will be prolonged. Therefore, each acute care hospital should prepare its measures and strategies to mimic the DTHS for the maintenance of the hospital’s core functions in anticipation of a revisit of the situation
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Background/Aims@#As the global impact of the novel coronavirus disease 2019 (COVID-19) has been severe, many countries have intensified containment activities to eliminate virus transmission, through early detection and isolation strategies. To establish a proper quarantine strategy, it is essential to understand how easily the virus can spread in the communities. @*Methods@#In this study, we collected detailed information on the circumstances in which human-to-human transmission occurred in the tertiary transmission cases of COVID-19 in the community. @*Results@#On January 26, 2020, an imported case of COVID-19 was confirmed, and by February 10, 2020, one secondary transmission and three tertiary transmissions were identified. Secondary transmission occurred on the first day of illness of the infector, and his symptoms were suggestive of a common cold. The transmission occurred during a 90-minute long meal together in a restaurant. The people were sitting within one meter of each other, and had no direct contact. The tertiary transmission also occurred on the first-day illness of the other infector, and his only symptom was slight chills. The transmission occurred at a church during 2-hour-long worship, and two rows separated them. @*Conclusions@#Our findings suggest that mildly symptomatic patients with COVID-19 could transmit the virus from the first day of illness through daily activities in the community. Early detection and isolation of patients with COVID-19 may be challenging.
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Since mid-December of 2019, coronavirus disease 2019 (COVID-19) infection has been spreading from Wuhan, China. The confirmed COVID-19 patients in South Korea are those who came from or visited China. As secondary transmissions have occurred and the speed of transmission is accelerating, there are rising concerns about community infections. The 54-year old male is the third patient diagnosed with COVID-19 infection in Korea. He is a worker for a clothing business and had mild respiratory symptoms and intermittent fever in the beginning of hospitalization, and pneumonia symptoms on chest computerized tomography scan on day 6 of admission. This patient caused one case of secondary transmission and three cases of tertiary transmission. Hereby, we report the clinical findings of the index patient who was the first to cause tertiary transmission outside China. Interestingly, after lopinavir/ritonavir (Kaletra, AbbVie) was administered, β-coronavirus viral loads significantly decreased and no or little coronavirus titers were observed.
Subject(s)
Humans , Male , China , Clothing , Commerce , Coronavirus , Fever , Hospitalization , Korea , Pneumonia , Thorax , Viral LoadABSTRACT
Since mid-December of 2019, coronavirus disease 2019 (COVID-19) infection has been spreading from Wuhan, China. The confirmed COVID-19 patients in South Korea are those who came from or visited China. As secondary transmissions have occurred and the speed of transmission is accelerating, there are rising concerns about community infections. The 54-year old male is the third patient diagnosed with COVID-19 infection in Korea. He is a worker for a clothing business and had mild respiratory symptoms and intermittent fever in the beginning of hospitalization, and pneumonia symptoms on chest computerized tomography scan on day 6 of admission. This patient caused one case of secondary transmission and three cases of tertiary transmission. Hereby, we report the clinical findings of the index patient who was the first to cause tertiary transmission outside China. Interestingly, after lopinavir/ritonavir (Kaletra, AbbVie) was administered, β-coronavirus viral loads significantly decreased and no or little coronavirus titers were observed.
ABSTRACT
Since mid-December of 2019, coronavirus disease 2019 (COVID-19) infection has been spreading from Wuhan, China. The confirmed COVID-19 patients in South Korea are those who came from or visited China. As secondary transmissions have occurred and the speed of transmission is accelerating, there are rising concerns about community infections. The 54-year old male is the third patient diagnosed with COVID-19 infection in Korea. He is a worker for a clothing business and had mild respiratory symptoms and intermittent fever in the beginning of hospitalization, and pneumonia symptoms on chest computerized tomography scan on day 6 of admission. This patient caused one case of secondary transmission and three cases of tertiary transmission. Hereby, we report the clinical findings of the index patient who was the first to cause tertiary transmission outside China. Interestingly, after lopinavir/ritonavir (Kaletra, AbbVie) was administered, β-coronavirus viral loads significantly decreased and no or little coronavirus titers were observed.
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No abstract available.
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PURPOSE: In order to prepare long-term alternatives to surgical residency training and workforce policies in Korea, objective data are needed; in addition, determination of the status of surgical procedures being performed is also needed. METHODS: Cases of surgeries performed by board-certified Korean surgeons for 1 year, from July 2009 to June 2010 were reviewed and analyzed. Variation of the last five years was also investigated against the number of surgery cases of the same item and for data on status of population, medical institutions, and surgeons. RESULTS: Difficulty in distribution of a given surgery varied according to the classification of medical institution types, and performance of highly difficult surgeries occurred more in tertiary hospitals. The number of surgeries has increased over the last 5 years (28.1%). The number of surgeries among elderly patients (41.5%), high difficulty (41.8%), and tertiary hospitals (34.9%) has especially increased. There has been no increase in the number of diagnosis related group claim cases for the last 5 years (-0.8%). 43.3% of surgeons working at private clinics in Korea did not present surgery as an indicating item of their clinics. CONCLUSION: While the demand for surgeons in high risk and highly difficult surgeries is continuously increasing, stagnation is expected in the traditional area. Considering the proportion and current status of surgeons working at private clinics, the need for a realistic reduction in the quota of surgical residents and reconsideration of personnel policies is raised.
Subject(s)
Aged , Humans , Internship and Residency , Korea , Republic of Korea , Tertiary Care CentersABSTRACT
No abstract available.
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Recently, The Ministry of Health and Welfare(MOHW) introduced a new bill called the Law of Personal Care for the Elderly People(LPCEP). The bill has several important problems. First, the bill of LPCEP contains no comprehensive care but only personal care. Basically, the elderly would be in need of comprehensive care because they are weakened or in ill-health and must always be provided with medical treatment and personal care. However, MOHW has reduced the basic concept of services for the elderly from comprehensive care to personal care. Second, the design of the longterm care insurance scheme is distorted. Principles of insurance are not adopted making eligibility equal to the burden of insurance contribution. In addition, the burden of the nation is insufficient compared with that of Japan. Third, medical longterm care facilities(LTCF) are no longer provided for the elderly. It is inadequate for the elderly to be provided only non-medical LTCF. Fourth, in the beginning, the National Health Insurance Corporation would manage the LTC system, but in the long run, local government should manage it. Fifth, the assessment of eligibility scale is not estimated by professional medical man power. Half of the estimation committee is composed of public officers who have no professional knowledge or skills in simulative demonstration of long-term care insurance. Sixth, care management of core man power for LTC is not designed to adequately supply for the elderly. A personal caregiver only would be supplied. Therefore, the bill has to be put on hold. In case of a revision, the bill, which is designed inappropriately, should be reformed fully.
Subject(s)
Aged , Humans , Caregivers , Insurance , Insurance, Long-Term Care , Japan , Jurisprudence , Local Government , Long-Term Care , National Health ProgramsABSTRACT
No abstract available.
ABSTRACT
We have performed a retrospective analysis of 42 patients with Crohn's disease operated at the Department of Surgery, Seoul National University College of Medicine between 1978 and 1997. The most frequently involved site was ileocecum(40.5%) and small bowel(40.5%), whereas the large bowel and anorectum occupied only 2.4% and 7.1% rutspectively. In 39 patients with bowel involvement, 35 patients(90%) required resection as primary surgical operations(small bowel 18, right colon 11, ileocecum 6). The remaining 7 patients underwent intaabdominal abscess drainage(2), perianal abscess drainage(2), appendectomy(1), and exploration only(1). Two cases of small bowel resection were combined with multiple stricturoplasties. After mean follow-up period of 46 months(range 1~180, median 22 months) after primary operation, the cumulative reoperative recurrence rate was 25% at 3 years,47% at 5 years, and 79% at 10 years, respectively. The ileocecal type had higher cumulative reoperative recurrence rate than small bowel type(50% compared to 34% at 5 years). The age at symptom onset, age at time of first operation, duration between symptom onset and operation, and the indication for operation had no effect on reoperative recurrence rate. Despite short follow-up period and limited number of patients, our results confirmed that Crohn's disease is associated with high rate of recurrence requiring re-operations.