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BackgroundUnderstanding the dynamics of humoral immunity after COVID-19 vaccination is crucial in developing vaccination strategies. Antibody response patterns are more complex in patients with rheumatoid arthritis (RA) because of their underlying autoimmunity and immunosuppressive medications. The kinetics of vaccine response in RA patients are not well understood.ObjectivesTo construct a model of antibody response to COVID-19 vaccination in patients with RA.MethodsTwo patient groups were included for the study. The first group was composed of RA patients who were enrolled for influenza vaccination study between Oct 6, 2021 and November 3, 2021, in whom serial serum samples were obtained 0, 4, 16 weeks after vaccination. The second group was consecutively enrolled from outpatient clinic between October 6, 2021 and June 3, 2022, in whom serum sample was obtained once. After collecting data on demographics, vaccination and infection history of COVID-19 were obtained by self-report via questionnaire and data from Korean center for disease control. We then measured antibody titers against receptor binding domain of spike protein (anti-RBD) and nucleocapsid (anti-N), using Chemiluminescence microparticle immunosaasy (Abbott, USA) and Electrochemiluminescence immunoassay (Roche, Germany) respectively. The anti-RBD titer was log-transformed to improve normality. Time from vaccination and log of anti-RBD titer was modeled using fractional polynomial. Covariates including age, sex, BMI, underlying disease and immunosuppressive drugs were analyzed using Generalized Estimating Equations to account for repeated measured from a subject.ResultsA total of 736 patients (1042 samples) were enrolled. After excluding patients who experienced COVID-19 infection before sampling (n=84), those unvaccinated (n=44) and uncertain COVID-19 infection history (n=59), the data on 778 samples from 549 patients were analyzed (Group 1: 125, Group 2: 424). Antibody titer reached peak at 12 days after vaccination and decreased exponentially (Figure 1) which fell to 36.5% from peak after 2 months. Compared to the first vaccination, the 3rd and 4th vaccination significantly shifted anti-RBD antibody response curve (28 times, 95% CI 4~195;32 times 95% CI 4~234, respectively). However, there was no significant shift after the 4th vaccination from the 3rd vaccination (p=0.6405). Multivariable analysis showed that number of vaccinations and sulfasalazine (coefficient: 0.40, 95% CI 0.12~0.68) increased vaccine response but age (coefficient: -0.03, 95% CI -0.04~-0.02), abatacept (coefficient: -2.07, 95% CI -3.30~-0.84) and, JAK inhibitor (coefficient: -0.82, 95% CI -1.34~-0.31) decreased vaccine response.ConclusionAnti-RBD response to COVID-19 vaccination showed a peak at 12 days after vaccination and then exponentially decreased in patient with RA. The antibody response is affected by age and medications used for the treatment of RA.Table 1.ln[RBD (U/ml)]coefficient (univariable)95% CIp-valuecoefficient (multivariable)95% CIp-valuesex (female)0.17-0.22, 0.550.393---age-0.02-0.03, -0.01<.001**-0.03-0.04, -0.02<.001**DM0.11-0.27, 0.500.568---HTN-0.38-0.69, -0.070.018*---CKD0.680.07, 1.290.030*---RA duration (yr)-0.04-0.06, -0.010.001**---Pd (mg/d)-0.06-0.11, 0.000.035*---MTX use-0.23-0.52, 0.050.105---HCQ use0.01-0.28, 0.290.965---SSZ use0.450.07, 0.840.022*0.400.12,0.680.005**LEF use0.00-0.37, 0.370.988---TNF inhibitors use0.29-0.16, 0.730.208---Abatacept use-2.07-3.14, -0.99<.001**-2.07-3.30, -0.840.001**JAK inhibitors use-0.88-1.52, -0.240.007**-0.82-1.34, -0.310.002**Time (months)log(t)-1.96-2.37, -1.54<.001**-1.90-2.29, -1.50<.001**t
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We investigated the impact of human activity during COVID-19 on the tropospheric nitrogen dioxide vertical column density (NO2 TropVCD) at three urban sites (Gwangju and Busan in Korea and Yokosuka in Japan) and one remote site (Cape Hedo in Japan) from Multi-Axis Differential Optical Absorption Spectroscopy (MAX-DOAS) and Pandora. Compared to the monthly mean NO2 TropVCD from 2015 to 2018 and in 2019, the values were lower in 2020 due to social distancing in Korea and Japan. High negative relative changes were observed from May to September (-30% to -18%) at the three urban sites;Cape Hedo, a remote site, did not show a significant difference in relative changes between previous years and 2020, suggesting that only anthropogenic emission sources decreased dramatically. In the case of Yokosuka, the 15-day moving average of the NO2 TropVCD exhibited a good relationship with transportation (R = 0.48) and industry (R = 0.54) mobility data. In contrast, the NO2 TropVCD at the Korean sites showed a moderate to low correlation with the industrial sector and insignificant correlations with transportation. The differences in correlations might be caused by the different social distancing policies in Korea (voluntary) and Japan (mandatory). By applying generalized boosted models to exclude meteorological and seasonal effects associated with NO2 TropVCD variations, we revealed that the decreasing trend from 2019 to 2020 was much steeper than that from 2015 to 2020 (a factor of two), and a significant change was identified in January 2020, when the first cases of COVID-19 were observed in both Korea and Japan. This result confirmed that the reduction in NO2 can be largely explained by the NOx emission reduction resulting from social distancing for COVID-19 rather than annual meteorological differences;however, in December 2020, NO2 recovered suddenly to its previous level due to an increase in human activities.
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Background: This study analyzed the causes of death in the Korean population in 2020. Method(s): Cause-of-death data for 2020 from Statistics Korea were examined based on the Korean Standard Classification of Diseases and Causes of Death, 7th revision and the International Statistical Classification of Diseases and Related Health Problems, 10th revision. Result(s): In total, 304,948 deaths occurred, reflecting an increase of 9,838 (3.3%) from 2019. The crude death rate (the number of deaths per 100,000 people) was 593.9, corresponding to an increase of 19.0 (3.3%) from 2019. The 10 leading causes of death, in descending order, were malignant neoplasms, heart diseases, pneumonia, cerebrovascular diseases, intentional self-harm, diabetes mellitus, Alzheimer disease, liver diseases, hypertensive diseases, and sepsis. Cancer accounted for 27.0% of deaths. Within the category of malignant neoplasms, the top 5 leading organs of involvement were the lung, liver, colon, stomach, and pancreas. Sepsis was included in the 10 leading causes of death for the first time. Mortality due to pneumonia decreased to 43.3 (per 100,000 people) from 45.1 in 2019. The number of deaths due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was 950, of which 54.5% were in people aged 80 or older. Conclusion(s): These changes reflect the continuing increase in deaths due to diseases of old age, including sepsis. The decrease in deaths due to pneumonia may have been due to protective measures against SARS-CoV-2. With the concomitant decrease in fertility, 2020 became the first year in which Korea's natural total population decreased.Copyright © Korean Medical Association.
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Purpose of Study: Ethnic disparities are associated with increased risk for severe disease in pediatric patients with COVID-19. Identifying the underlying social determinants of health are necessary to lead to improved health care utilization and mitigation strategies. Methods Used: This is an observational cohort study of children with COVID-19 in Colorado (the CCC study) from March 15 2020-October 31 2020. Pediatric patients between 2-20 years of age with positive SARS-CoV-2 PCR were included. Multivariable logistical regression models were fitted to identify demographic, socioeconomic, and comorbid health conditions as predictors of severe COVID-19 disease, as defined by hospital admission and need for respiratory support. Summary of Results: We identified 1572 pediatric patients with COVID-19 (45% Hispanic, 54% Medicaid or uninsured, 16% non-English language, and 20% obese). In univariable analyses, Hispanic ethnicity was associated with severe outcomes, including hospital admission (OR 2.4, CI: 1.57, 3.80, p<0.01) and respiratory support (OR 2.4, CI: 1.38, 4.14, p<0.01). Patients who identified as Hispanic or Latino had significantly increased rates of obesity (28% vs. 14%, p<0.01), preferred non-English language (31% vs. 3%, p<0.01), and had Medicaid or no insurance (79% vs. 33%, p<0.01) when compared to non-Hispanic or Latino children. After adjusting for covariables, ethnicity was no longer associated with hospital admission (OR 0.9, CI: 0.53, 1.63, p=0.79) or respiratory support (OR 0.6, CI: 0.29, 1.21, p=0.15). Obesity (OR 1.9, CI: 1.15, 3.08, p=0.01), non-English language (OR 2.4, CI: 1.35, 4.23, p<0.01), and Medicaid insurance (OR 2.0, CI: 1.10, 3.71, p=0.02) were identified as independent risk factors for severe disease. Conclusion(s): Severe COVID-19 disease observed in Hispanic or Latino patients early in the pandemic appears to be secondary to underlying comorbid conditions, such as obesity, and socioeconomic disadvantages that may have influenced access to care, such as language and insurance status. Pediatric healthcare providers and public health officials should use this knowledge to tailor resource allocation to better target this underserved patient population.
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Background: This study analyzed the causes of death in the Korean population in 2020.Methods: Cause-of-death data for 2020 from Statistics Korea were examined based on the Korean Standard Classification of Diseases and Causes of Death, 7th revision and the International Statistical Classification of Diseases and Related Health Problems, 10th revision.Results: In total, 304,948 deaths occurred, reflecting an increase of 9,838 (3.3%) from 2019. The crude death rate (the number of deaths per 100,000 people) was 593.9, corresponding to an increase of 19.0 (3.3%) from 2019. The 10 leading causes of death, in descending order, were malignant neoplasms, heart diseases, pneumonia, cerebrovascular diseases, intentional self-harm, diabetes mellitus, Alzheimer disease, liver diseases, hypertensive diseases, and sepsis. Cancer accounted for 27.0% of deaths. Within the category of malignant neoplasms, the top 5 leading organs of involvement were the lung, liver, colon, stomach, and pancreas. Sepsis was included in the 10 leading causes of death for the first time. Mortality due to pneumonia decreased to 43.3 (per 100,000 people) from 45.1 in 2019. The number of deaths due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was 950, of which 54.5% were in people aged 80 or older.Conclusion: These changes reflect the continuing increase in deaths due to diseases of old age, including sepsis. The decrease in deaths due to pneumonia may have been due to protective measures against SARS-CoV-2. With the concomitant decrease in fertility, 2020 became the first year in which Korea's natural total population decreased.
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This study was conducted in order to ascertain what role government and individuals should play in the event of a pandemic such as Coronavirus occurring in Korea in the future, using information deriving from news articles available at the Bigkinds news portal site in Korea. The analysis period ran from 11 March 2020, when the pandemic was declared by the World Health Organization, to 31 January 2023, almost three years later. Text mining analysis was conducted on all the articles, as a result of which six important roles that individuals should play, and ten roles that government should play, in a pandemic situation were suggested. © 2022, European Alliance for Innovation. All rights reserved.
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For the extended duration of the coronavirus disease 2019 (COVID-19) pandemic, reports emerged that mother-to-child transmission rates were low. However, the pandemic protocols including strict isolation, testing for severe acute respiratory syndrome coronavirus 2, and negative pressure isolation remained in Korea. Recently, the guideline for the management of neonates born to mothers with COVID-19 have been revised based on guidelines in other countries. Here, we introduce this newly developed guideline and review the foreign guidelines that were used for reference.Copyright © 2022 The Korean Society of Pediatric Infectious Diseases.
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This paper focuses on an important problem of early misinformation detection in an emergent health domain on social media. Current misinformation detection solutions often suffer from the lack of resources (e.g., labeled datasets, sufficient medical knowledge) in the emerging health domain to accurately identify online misinformation at an early stage. To address such a limitation, we develop a knowledge-driven domain adaptive approach that explores a good set of annotated data and reliable knowledge facts in a source domain (e.g., COVID-19) to learn the domain-invariant features that can be adapted to detect misinformation in the emergent target domain with little ground truth labels (e.g., Monkeypox). Two critical challenges exist in developing our solution: i) how to leverage the noisy knowledge facts in the source domain to obtain the medical knowledge related to the target domain? ii) How to adapt the domain discrepancy between the source and target domains to accurately assess the truthfulness of the social media posts in the target domain? To address the above challenges, we develop KAdapt, a knowledge-driven domain adaptive early misinformation detection framework that explicitly extracts rel-evant knowledge facts from the source domain and jointly learns the domain-invariant representation of the social media posts and their relevant knowledge facts to accurately identify misleading posts in the target domain. Evaluation results on five real-world datasets demonstrate that KAdapt significantly outperforms state-of-the-art baselines in terms of accurately detecting misleading Monkeypox posts on social media. © 2022 IEEE.
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Background: Domestic violence (DV) shelters are an essential service for survivors and their children. While research has demonstrated global increases in DV during COVID-19, little is known about the experiences of DV shelter staff. This study aimed to understand DV shelter staff's experiences and how they navigated the early stages of the pandemic. Methods: Researchers disseminated a cross-sectional online survey, first to state DV coalitions and then directly to DV shelters. Univariate and bivariate analyses were used for multiple-choice items, and patterns were identified using thematic analysis for open-ended responses. Results: Survey participants included 368 DV staff (180 leadership, 167 direct services, and 21 other roles) from 48 states. They reported little change to their schedules and mixed feelings of shelter preparedness for the pandemic. Participants described shelter methods for preventing the spread of COVID-19, changes in shelter policies and satisfaction with such policies, and the impacts of the pandemic on themselves and survivors. Balancing survivor autonomy with the health and safety of staff and other residents proved to be one of the most consistently challenging tasks. Participants also described how programs adapted to changing regulations and continued to serve survivors throughout this challenging time. Conclusion: Several innovative practices were implemented by staff throughout the pandemic, including expansions in technology use and non-residential services. Most reported feeling prepared for a similar crisis in the future. We offer five recommendations for DV shelters and their funders, including increased mental health support for staff and greater transparency in policies for both shelter residents and staff.
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Major media outlets have run many articles on the COVID-19 pandemic. Since the public suffers cognitive and emotional effects related to COVID-19 from such reports, we analyzed and reviewed the topics of news reports. We searched newspaper articles with the term ‘COVID-19' term in four Korean daily newspapers from January 20, 2020, when the first patient in Korea was found, to June 15, 2020. Topic modeling analysis was conducted through text mining using R. Five themes were found: "Changes in people's everyday life,” "Socio-economic shock,” "Trends in infection,” "Role of the government and business,” and "Increased psychological anxiety,” which all showed sharp increases in articles from mid-February to early March and then decreased. Despite the increased psychological anxiety people suffered from the COVID-19 pandemic, this topic showed the fewest articles. "Changes in people's everyday life” showed the most, focusing attention on stimulating lifestyle articles of general interest. Since the COVID-19 pandemic can lead to mental health problems due to severe changes and isolation in everyday life, a comprehensive response to the news focusing on the impact on the mental health of the population around the world should be made. © 2023, Tech Science Press. All rights reserved.
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Acoustical measurements and speech intelligibility tests were carried out to investigate the effects of masks on speech communication experienced in real Covid-secure university classrooms during the pandemic. Face-masked speech levels and noise levels were measured to understand the acoustical effects of masks on speech sounds during 15 multiple lectures in 3 university classrooms. The speech intelligibility scores were also evaluated for lower and higher SNR (signal-to-noise ratio) conditions, and for with and without the presence of visual information conditions to investigate the effects of both the acoustic and visual signals in understanding speech communication in actual classroom situations. In the 3 active university classrooms the students experienced on average: speech levels of 55.1 dBA (σ = 5.5 dBA), noise levels of 42.3 dBA (σ = 3.9 dBA), and a speech-to-noise ratio of 12.8 dBA σ = 5.2 dBA). The mean SNR values at the listener's position for the 15 lectures varied from 3.6 dBA to 20.0 dBA. The use of a portable sound amplification system increases the face-masked speech levels mostly at mid and high frequencies (500–4 kHz), thus it can be more useful for achieving higher SNR values in classrooms. The presence of visual cues have little effect on achieving more higher speech intelligibility scores in higher SNR conditions. The present results show that visual obstruction of the talker's mouth decreases speech intelligibility scores by a maximum of 10% in lower SNR conditions, particularly at a SNR of 6 dBA or lower. © 2023 Elsevier Ltd
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This article explores the nexus between migration, citizenship, and curriculum, placing global citizenship education at the center of its discussion. Through a review of theoretical and empirical studies on global citizenship education, this article examines what theoretical discourses on citizenship education have emerged in the context of the escalation of global migration, and if and how global citizenship has been positioned in official curriculum across many parts of the world. In the midst of the COVID-19 pandemic, which has been accompanied by a dramatic change in the realities of human mobility and interactions in recent years, questions, challenges and complexities layered on the already contentious field of global citizenship education are addressed as future agenda. © 2023 Elsevier Ltd. All rights reserved.
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For the extended duration of the coronavirus disease 2019 (COVID-19) pandemic, reports emerged that mother-to-child transmission rates were low. However, the pandemic protocols including strict isolation, testing for severe acute respiratory syndrome coronavirus 2, and negative pressure isolation remained in Korea. Recently, the guideline for the management of neonates born to mothers with COVID-19 have been revised based on guidelines in other countries. Here, we introduce this newly developed guideline and review the foreign guidelines that were used for reference. © 2022 The Korean Society of Pediatric Infectious Diseases.
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Purpose: This study aimed to explore the nursing management experience of Korean nurse managers during the coronavirus disease 2019 (COVID-19) pandemic. Methods: This exploratory qualitative study used individual semi-structured interviews. Data were collected from 10 nurse managers working in tertiary general hospitals in Korea from October 2020 to September 2021. Thematic analysis methods were employed to analyze interview transcripts. Results: The following four themes were derived: difficulty due to an unexpected and sudden disaster, being the center with a sense of calling and responding resolutely, gratitude toward health workers who work and endure together, and striving and rising to the challenge of preparing for future infection. Conclusion: During the COVID-19 pandemic, Korean nurse managers made an effort to overcome the crisis based on the sense of calling, despite many changes and challenges. Furthermore, managers expressed their gratitude to the department members working together, and they confirmed the need for system improvement to prepare for upcoming epidemics. © 2022 Korean Academy of Nursing Administration.
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OBJECTIVE: There is a lack of pediatric studies that have analyzed trends in mean body mass index (BMI) and the prevalence of obesity and overweight over a period that includes the mid-stage of the COVID-19 pandemic. Thus, we aimed to investigate trends in BMI, overweight, and obesity among Korean adolescents from 2005 to 2021, including the COVID-19 pandemic. SUBJECTS AND METHODS: We used data from the Korea Youth Risk Behavior Web-based Survey (KYRBS), which is nationally representative of South Korea. The study included middle- and high-school students between the ages of 12 and 18. We examined trends in mean BMI and prevalence of obesity and/or overweight during the COVID-19 pandemic and compared these to those of pre-pandemic trends in each subgroup by gender, grade, and residential region. RESULTS: Data from 1,111,300 adolescents (mean age: 15.04 years) were analyzed. The estimated weighted mean BMI was 20.48 kg/m2 (95% CI, 20.46-20.51) between 2005 and 2007, and this was 21.61 kg/m2 (95% CI, 21.54-21.68) in 2021. The prevalence of overweight and obesity was 13.1% (95% CI, 12.9-13.3%) between 2005 and 2007 and 23.4% (95% CI, 22.8-24.0%) in 2021. The mean BMI and prevalence of obesity and overweight have gradually increased over the past 17 years; however, the extent of change in mean BMI and in the prevalence of obesity and overweight during the pandemic was distinctly less than before. The 17-year trends in the mean BMI, obesity, and overweight exhibited a considerable rise from 2005 to 2021; however, the slope during the COVID-19 pandemic (2020-2021) was significantly less prominent than in the pre-pandemic (2005-2019). CONCLUSIONS: These findings enable us to comprehend long-term trends in the mean BMI of Korean adolescents and further emphasize the need for practical prevention measures against youth obesity and overweight.
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COVID-19 , Overweight , Adolescent , Humans , Child , Body Mass Index , Pandemics , Obesity , Republic of KoreaABSTRACT
Tri-plane corrective Lapidus surgery has been described as advantageous with respect to its anatomic basis and outcomes. Because the procedure has been broadly publicized, changes in overall Lapidus procedure rates due to increased numbers of patients opting for the tri-plane approach could have occurred. Data supporting this possibility appears lacking. We employed official personnel and health records of the total active-duty US military to conduct a retrospective cohort study of Lapidus surgery rates before and after the advent of the tri-plane corrective Lapidus procedure. Least-squares and locally-weighted scatterplot smoother regression functions were used to confirm time trends. Sociodemographic and occupational traits of Lapidus patients were compared using 2-sided t tests and chi square tests. Lapidus surgery rates among hallux valgus patients decreased during 2014 to 2016 and increased during 2017 to 2021. While multiple factors might explain these trends, they coincide with the advent of and advocacy for tri-plane Lapidus surgery. The results support the possibility that its rise influenced overall Lapidus rates in this population. As these findings represent limited evidence of such an influence, further research is required to confirm a causal link. If such a link is found, and if the ongoing research suggests that superior outcomes are associated with tri-plane Lapidus surgery, substantial implications could exist for this population. Benefits might include enhanced medical readiness due to the importance of lower extremity function during military duties. Additional research is needed to confirm the impact of the procedure and to determine whether Lapidus surgery rate patterns in civilian populations mirror these findings.
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Purpose: This study aims to assess how airline companies can frame their message strategies given the effects of the COVID-19 pandemic. Design/methodology/approach: Message forms used in empirical tests included message framings, regulatory focuses and benefit types. A total of 450 participants were recruited through an online survey. Findings: Promotion-focused behavioral intention was more effective when personal economic benefit was negatively framed. However, prevention-focused behavioral intention was more effective where social benefit was positively framed. The results were moderated by personal traits such as the level of perceived COVID-19 threat. Originality/value: The findings of this study can help create new communication strategies during risky or critical situations. © 2023, Emerald Publishing Limited.
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The purpose of this research is to examine how the COVID-19 pandemic has impacted the luxury goods industry. The authors hypothesize that pandemic threats drive consumers toward luxury consumption to increase their perceptions of control. The article reports results of three experimental studies conducted in the United States. In Study 1, after participants read an article about COVID-19, they respond favorably to an advertisement for a luxury brand. The comparative control participants read an article about a tofu dish and respond less favorably to the luxury advertisement. Study 2 provides further evidence that perceived control acts as a mediator, while ruling out alternative explanations. Study 3 indicates that threat evokes luxury preferences only when advertisements for both luxury and nonluxury products use messages, as opposed to concrete messages. The findings provide practical insights showing that the most effective advertising strategy for luxury brand managers is to use rather than concrete messages for targeting consumers who feel highly threatened by COVID-19. © 2023 John Wiley & Sons Ltd.
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Introduction: Tocilizumab, a monoclonal anti-interleukin- 6 receptor antibody, has been widely used as a treatment for rheumatoid arthritis. Gastrointestinal perforation is a rare but critical complication that occurs in patients treated with tocilizumab. In the COVID-19 pandemic, tocilizumab has been recently highlighted for its beneficial effect in reducing the risk of death in severely ill COVID-19 patients. In this current study, we report the ileal perforation in a COVID-19 confirmed patient who had received tocilizumab for the treatment of rheumatoid arthritis. Case Presentation: A 57-year- old woman with a medical history of rheumatoid arthritis and hypertension presented to our emergency room with abrupt onset of severe abdominal pain and nausea. Physical examination revealed direct and indirect tenderness of the whole abdomen. She had a history of COVID-19 infection 1 month ago and recovered without severe complications. She also has been treated for rheumatoid arthritis, and the disease activity has been maintained low with the administration of tocilizumab since 2019. The latest administration of tocilizumab to the patient was 2 weeks ago. The plain radiograph of the abdomen showed intraperitoneal free air suggesting pneumoperitoneum. The abdominal computed tomography was also conducted to find the origin of free extraluminal air, and it revealed heterogenous wall enhancement of the ileal loop and the mesenteric haziness. The emergency surgery was performed, and the ileal perforation was noted. The small bowel segmental resection was performed through the surgical procedure. Conclusion(s): COVID-19 has been founded to cause gastrointestinal inflammation. The use of tocilizumab in COVID-19 patients should be carefully conducted because it could act as a permissive of gastrointestinal perforation. Furthermore, the physician should be aware of the possible complication of tocilizumab because early diagnosis and timely management are crucial to preventing high mortality complications.
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For the extended duration of the coronavirus disease 2019 (COVID-19) pandemic, reports emerged that mother-to-child transmission rates were low. However, the pandemic protocols including strict isolation, testing for severe acute respiratory syndrome coronavirus 2, and negative pressure isolation remained in Korea. Recently, the guideline for the management of neonates born to mothers with COVID-19 have been revised based on guidelines in other countries. Here, we introduce this newly developed guideline and review the foreign guidelines that were used for reference. Copyright © 2022 The Korean Society of Pediatric Infectious Diseases.