Effectiveness of Paxlovid, an Oral Antiviral Drug, Against the Omicron BA.5 Variant in Korea: Severe Progression and Death Between July and November 2022

Background@#Paxlovid is an oral antiviral drug that received emergency use authorization in South Korea for the treatment of patients with mild-to-moderate coronavirus disease 2019 (COVID-19) on January 14, 2022. Since the onset of the severe acute respiratory syndrome coronavirus 2 pandemic, the virus has continued to evolve. The emergence of new variants has raised concerns about possible reductions in the effectiveness of vaccines and drugs. The effectiveness of Paxlovid in patients infected with the omicron variant and subvariants has not yet been determined. This study assessed the effectiveness of Paxlovid at reducing the risk of severe/critical illness or death and death in patients with mild-to-moderate COVID-19 caused by omicron subvariant BA.5. @*Methods@#In this nationwide retrospective cohort study, data on 8,902,726 patients were collected from four sources (the Drug Utilization Review database, COVID-19 Patient Information Management System, confirmed patient information, and basic epidemiological investigation data) between July 1 and November 30, 2022. Multivariable logistic regression analysis was conducted, with adjustment for age, sex, severe acute respiratory syndrome coronavirus 2 immunity (vaccination), and comorbidities. @*Results@#A total of 1,936,925 patients with COVID-19 were included in the analysis, including 420,996 patients treated with Paxlovid, and 1,515,959 patients not treated with Paxlovid. Paxlovid treatment in patients aged ≥ 60 years of age was associated with significantly reduced risk of severe/critical illness or death (46.0%), and death rate (32.5%), and its effectiveness was high, regardless of vaccination status. @*Conclusion@#Paxlovid is effective at reducing the risk of death due to COVID-19 in patients with omicron BA.5 infection, especially in older patients, regardless of vaccination status. This suggests that older patients with COVID-19-related symptoms should be administered Paxlovid, regardless of their vaccination status, to reduce severity and risk of death.

Importation and Transmission of SARS-CoV-2 B.1.1.529 (Omicron) Variant of Concern in Korea, November 2021

In November 2021, 14 international travel-related severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) B.1.1.529 (omicron) variant of concern (VOC) patients were detected in South Korea. Epidemiologic investigation revealed community transmission of the omicron VOC. A total of 80 SARS-CoV-2 omicron VOC-positive patients were identified until December 10, 2021 and 66 of them reported no relation to the international travel.There may be more transmissions with this VOC in Korea than reported.

Correlation between C-MYC and HER2 Amplification in Non-selected Breast Cancers / 한국유방암학회지

PURPOSE: c-myc and HER2 have been reported be amplified in 20% to 30% of clinical breast cancers and appears to be related with poor clinical outcome. The relationship between amplification of c-myc and HER2 and other clinical and biological characteristics of the breast cancers, including clinical outcome, are described. METHODS: c-myc and HER2 amplification were analyzed on 225 consecutive non-selected breast cancers by fluorescence in situ hybridization using tissue microarray technology. RESULTS: c-myc was amplified in 33 cases (15.4%) and HER2 was amplified in 49 cases (23.3%). c-myc amplification was significantly increased with HER2 amplification (p<0.001) and closely linked with cell proliferative activity measured by Ki67 labeling index (p=0.010). In univariate survival analysis, lymph node status, tumor size, and histologic grade of the tumors were significant prognostic factors. However, lymph node status was the only significant prognostic factor for predicting patient survival in multivariate analysis. Patient survival was not different according to c-myc amplification status and c-myc amplification showed no significant correlation with clinco-pathologic parameters of the tumors. CONCLUSION: A strong correlation between c-myc and HER2 amplifications, and cell proliferative activity indicate a biologic link between c-myc and HER2 in breast cancer.

Multifocal Epithelioid Angiosarcoma of the Stomach: A Case Report

Angiosarcoma is a very rare neoplasm, and even more so in the gastrointestinal tract where its distinction from adenocarcinoma may be extremely difficult. We report a case of multifocal epithelioid angiosarcoma of the stomach in a 65-year-old woman. Histologically, the tumor foci were composed of haphazard, anastomosing channels lined by malignant endothelial cells with epithelioid features. Those neoplastic cells stained positive for CD31, CD34, and factor VIII-related antigen.