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Introduction: SARS-CoV-2 is responsible for the current global pandemic. SARS-CoV-2 infection underlies the novel viral condition coronavirus disease 2019 (COVID-19). COVID-19 causes significant pulmonary sequelae contributing to serious morbidities. The pathogenesis of COVID-19 is complex with a multitude of factors leading to varying levels of injury numerous extrapulmonary organs. This review of 124 published articles documenting COVID- 19 autopsies included 1,142 patients. Method(s): A PubMed search was conducted for COVID-19 autopsy reports published before March 2021 utilizing the query COVID-19 Autopsy. There was no restriction regarding age, sex, or ethnicity of the patients. Duplicate cases were excluded. Findings were listed by organ system from articles that met selection criteria. Result(s): Pulmonary pathology (72% of articles;866/1142 patients): diffuse alveolar damage (563/866), alveolar edema (251/866), hyaline membrane formation (234/866), type II pneumocyte hyperplasia (165/866), alveolar hemorrhage (164/866), and lymphocytic infiltrate (87/866). Vascular pathology (41% of articles;771/1142 patients): vascular thrombi (439/771)-microvascular predominance (294/439)-and inflammatory cell infiltrates (116/771). Cardiac pathology (41% of articles;502/1142 patients): cardiac inflammation (186/502), fibrosis (131/502), cardiomegaly (100/502), hypertrophy (100/502), and dilation (35/502). Hepatic pathology (33% of articles;407/1142 patients): steatosis (106/402) and congestion (102/402). Renal pathology (30% of articles;427/1142 patients): renal arteries arteriosclerosis (111/427), sepsis-associated acute kidney injury (81/427) and acute tubular necrosis (77/427). Conclusion(s): This review revealed anticipated pulmonary pathology, along with significant extrapulmonary involvement secondary to COVID-19, indicating widespread viral tropism throughout the human body. These diverse effects require additional comprehensive longitudinal studies to characterize short-term and long-term COVID-19 sequelae and inform COVID-19 treatment.
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Introduction: During the COVID-19 pandemic, virtual interviews for resident and fellowship applicants became the standard. However, studies evaluating the experience of virtual interviews format are lacking. Accordingly, we sought to survey both gastroenterology fellowship applicants and interviewing faculty members about their experiences with the virtual interview process. Method(s): Interviewees and faculty at 13 different gastroenterology fellowship programs at academic medical centers across the United States completed a post-interview survey. The online survey was conducted during the 2020 ERAS fellowship interview season via Google Forms. The survey responses were anonymously collected and reported. Result(s): A total of 177 gastroenterology fellowship applicants and 83 faculty members completed the electronic surveys. Most participants reported a positive experience with 91% and 84% of applicants and faculty respectively, scoring at least 4 points on a 5-point scale. Eighty-8 percent and 85% of applicants and faculty respectively, reported that they had enough insight about the applicant or the fellowship program during the interview. Over 67% of applicants reported cost-savings of greater than $1,000 per interview. Thirty-6 percent of applicants reported that they missed the personal interaction with the current gastroenterology fellows in the respective programs and the experience of physically touring the facility. Twenty-7 percent and 25% of applicants and faculty experienced technical difficulties during the interview process, respectively. Thirty-one percent and 22% of applicants and faculty would like for the virtual interviews to be the standard of future fellowship interviews, while 35% and 42% of applicants and faculty would consider it in the future, respectively. Figure 1 shows the ranking process for both applicants and faculty. Conclusion(s): Virtual interviews were perceived as effective and cost-saving by both gastroenterology fellowship applicants and faculty members. The virtual experience was widely accepted by most applicants and faculty, with high potential to become the standard of fellowship interview process in the future. However, a substantial portion experienced technical difficulty. Further improvements in technology are needed to optimize the process and increase the acceptance of the virtual interview experience. (Figure Presented).
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Intro: Since November 2021, gradual changes in non-pharmaceutical interventions (NPI) had begun in consideration of the socio-economic cost and the high rate of COVID-19 vaccination. As an effort to monitor the COVID-19 situation and the effect of NPIs, regular risk assessment for COVID-19 has been conducted based on the input from the external advisory committee. This paper examines the correlation between the risk assessment results and other indicators, such as the incidence of COVID-19, public perception, community mobility, and the government policy from November 2021 to May 2022. Method(s): For weekly regular risk assessment of COVID-19, the data were collected from the National Infectious Disease Surveillance System website, which included incidence, mortality, and % of severe cases. Other indicators were from regular surveys on perceived risk among the public, community mobility from the Google website, and the government's response policy from The Oxford Stringency Index. The level of risk was classified into five levels from very low to very high. The level of COVID-19 risk and its correlation with the COVID-19 incidence, risk perception, community mobility, and government policy were examined. Finding(s): The result of the correlation analysis showed the highest positive correlation between the risk level and risk perception (r=0.86, CI 0.72-0.94). This indicates that the actual risk level and the risk perceived by the public are similar. Among the incidence-related indicators, the number of new severe cases of COVID-19 per week showed the highest correlation with the risk level (r=0.62, CI 0.33-0.80). Conclusion(s): The high correlation between the weekly severe cases and the overall COVID-19 risk level suggests that Korea's COVID-19 policy priority was mainly at protecting the high-risk populationCopyright © 2023
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Purpose - As a leading source of foreign exchange and investment, tourism has grown in importance as a component of international trade. Accordingly, in recent decades much attention has been directed toward attracting foreign tourists and, in turn, positively affecting the recommendation intentions of foreign tourists. Despite such interests, there remains a dearth of empirical research on this issue. Moreover, prior research has focused primarily on the simple main effect of a certain factor on recommendation intentions. Therefore, the present study aims to (1) investigate the effect of overall satisfaction on the recommendation intentions of foreign tourists, and (2) examine the potential moderating effects of personal factors (i.e., age and destination image) on the association between overall satisfaction and recommendation intention. Design/methodology - Using a moderated moderation analysis of the data drawn from the 2018 International Visitor Survey conducted by the Korea Tourism Organization, this study proposes the three-way interaction effects of overall satisfaction, age, and destination image on recommendation intention. Findings - The findings of the study indicate that overall satisfaction is positively associated with recommendation intention and this relationship becomes stronger among younger tourists. The findings further indicate that the moderating effect of age on the relationship between overall satisfaction and recommendation intention depends on changes in the image of the destination. Specifically, the destination image exerts a positive moderating impact on the influence of age that moderates the overall satisfaction and recommendation intention relationship. Originality/value - Considering that the tourism economy has been severely affected by the current COVID-19 pandemic, this study contributes to a more accurate understanding of the factors affecting the recommendation intention, especially in times of crisis.
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Type 1 diabetes mellitus (T1DM) and poor glycemic control are risk factors for severe coronavirus disease 2019 (COVID-19). Sotrovimab can treat mild-to-moderate COVID-19 in patients at a high risk of progression to severe COVID-19. However, its safety and efficacy in T1DM patients remain to be elucidated. We report the case of a 12-yr-old patient who was treated with sotrovimab for COVID-19 immediately after treatment for diabetic ketoacidosis (DKA) due to new-onset T1DM. He presented with nausea and sore throat and was diagnosed with severe DKA and COVID-19. A productive cough and sputum developed after admission. On the 3rd day of admission, the DKA resolved, and sotrovimab was administered to prevent exacerbation of COVID-19. Although the blood glucose levels increased after the administration of sotrobimab, there was no recurrence of DKA. Hyperglycemia may be a sotrovimab-related adverse event in T1DM patients. Nevertheless, the benefits of sotrovimab treatment may far outweigh the potential risks. Thus, sotrovimab was considered safe for patients with T1DM immediately after treatment of severe DKA.
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Introduction: This study explores associations among adult vaccination, ethnicity, gender, and socioeconomic variables such as educational attainment and income, as well as neighborhood factors. Methods: A telephone quota sample of New Jersey adults (N = 1,984) was used to text associations among proposed predictors of vaccination behaviors. Results: Our multivariate logistic regression analyses found that certain races/ethnicity, respondents' household income, and perceived safety of one's community were the strongest predictors of COVID-19 vaccination. The odds of COVID-19 vaccination were 52% lower for Black/African American respondents compared to white/Caucasian respondents (p = 0.001) and 44% lower for Hispanic/Latino respondents compared to white/Caucasian respondents (p = 0.001). Discussion: The results add new insights to public health communication research and suggest careful interventions across racial groups, considering existing racial disparities in vaccination. Copyright © 2023 Kim, Hong and Kim.
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The COVID-19 pandemic has negatively affected the tourism and services sector. Using the example of Airbnb's recent layoff of 25% of its workforce, we focused on the role of organizational justice in mitigating the negative psychological impacts of layoffs. Based on a unique survey of Airbnb employees who survived the layoffs, as well as those who left, we employed an ordinary least squares regression to show that employees' perceptions of organizational justice were positively related to their job satisfaction and trust in management, while being negatively related to their emotional exhaustion and cynicism. We discovered the crucial importance of interactional justice (i.e., interpersonal and informational justice). The respect, dignity, and politeness shown by management (i.e., interpersonal justice), as well as truthful and adequate communication about the procedure (i.e., informational justice) were pivotal to successfully conducting layoffs, especially during unprecedented economic uncertainty. © 2023 by the authors.
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Post-acute sequelae of SARS-CoV-2 infection (PASC) or Long COVID is an emerging medical condition that has been observed in several patients with a positive diagnosis for COVID-19. Historical Electronic Health Records (EHR) like diagnosis codes, lab results and clinical notes have been analyzed using deep learning and have been used to predict future clinical events. In this paper, we propose an interpretable deep learning approach to analyze historical diagnosis code data from the National COVID Cohort Collective (N3C)1 to find the risk factors contributing to developing Long COVID. Using our deep learning approach, we are able to predict if a patient is suffering from Long COVID from a temporally ordered list of diagnosis codes up to 45 days post the first COVID positive test or diagnosis for each patient, with an accuracy of 70.48%. We are then able to examine the trained model using Gradient-weighted Class Activation Mapping (GradCAM) to give each input diagnoses a score. The highest scored diagnosis were deemed to be the most important for making the correct prediction for a patient. We also propose a way to summarize these top diagnoses for each patient in our cohort and look at their temporal trends to determine which codes contribute towards a positive Long COVID diagnosis. © 2022 IEEE.
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Background. Pregnancy is one of the risk factor associated with the severity of Coronavirus Disease 2019 (COVID-19). The perinatal complications also known to be increased when pregnant women become infected with COVID-19. However, there were not enough studies involving pregnant women with severe COVID-19, especially in Korea. The purpose of this study was to analyze the cases of pregnant women with COVID-19 infection with various severities, and to compare and describe the clinical course and the effects on pregnancy and perinatal prognosis according to severity. Methods. We retrospectively analyzed the medical records of adults 18 years of age or older who were PCR-confirmed COVID-19 and proved pregnancy, from February 1, 2020 to January 31, 2022. Through the epidemiological investigation report, the patient's medical history, obstetric history, date of diagnosis and variants of COVID-19, and vaccination history were collected. Clinical symptoms, oxygen demand, chest imagings, treatment, perinatal complications, fetal conditions, delivery results, and complications were collected through medical records. Results. A total of 104 pregnant women with PCR-confirmed COVID-19 were hospitalized. The age at the time of diagnosis was 33 +/-4.24 (Mean +/- SD) years, and 4 patients (3.8%) were vaccinated with the COVID-19 vaccine. During hospital stay, the most common complaints were cough (99 patients, 95.2%) and fever (85 patients, 81.7%). Oxygen was applied in 40 patients (38.5%), and in 19 patients (18.3%) in severe cases. Thirty-seven patients (35.6%) delivered during isolation treatment. Critical COVID-19 patients group has statisticaly significant higher rate of preterm delivery compared with mild COVID-19 patient group (31.6 % versus 6.3 %, p=0.009). One patient died from septic shock caused by multidrug-resistant Acinetobacter baumannii during treatment. A total of 39 babies were born, of which 4 received postnatal oxygen therapy. Conclusion. Pregnant women with COVID-19 had higher mortality rates, aggravation rates, and premature birth rates compared to non-pregnant patients of the same age. In a situation where effective and safe COVID-19 treatments for pregnant women are limited, it is necessary to increase the vaccination rate to prevent undesired outcomes in both mother and child.
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Background: Digital literacy has gained growing importance in the health agenda. However, the level of digital information use and access among Korean older adults is still low at 54%. It is important to understand digital literacy among older adults to provide healthcare and social connectivity, especially during the COVID-19 pandemic. Objective: This study aims to explore the digital literacy and identify barriers to learning and using digital devices among community-dwelling older adults in urban South Korea. Methods: A qualitative study was conducted using a semi-structured interview guide according to the DigComp 2.0 framework which emphasizes the competencies for full digital participation in five categories: information, communication, content creation, safety, and problem solving. Our sample consisted of 14 older adults (age 68 – 79, 12 women). Results: Participants reported varying competency of using digital devices for search, communication, and self-management of lifestyle and health. They actively sought help from family and community members to troubleshoot issues related to installation, maintenance, setup software or applications. However, they were passive or evasive in the use of digital devices because of concerns about invasion of privacy or personal information. They struggled to use digital devices owing to physical and cognitive changes associated with aging. Conclusion: Our findings depict current state and barriers of digital literacy in urban older adults in Korea.
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Limits to in-person social interaction increased the risk of loneliness during the Covid-19 pandemic. This study examines how gender and previous information communication technologies (ICT) experience could stratify how ICT-mediated social interactions related to loneliness during the COVID-19 pandemic. We employed National Health & Aging Trends Study data collected in 2018 and 2020-2021 (N=2,962;27% age 85+;57% women;77% white) to examine how the email and video call use before and during the COVID-19 pandemic was associated with loneliness and how the degree of impact differed by gender and previous ICT experience. In total, 35% reported feeling lonely some days or more frequently during the COVID-19 pandemic. Preliminary analysis showed older adults using video calls during the COVID-19 pandemic were 1.24 times more likely to report loneliness. This association was stronger among men than women and those who did not use ICT preceding the pandemic than those who used.
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The coronavirus disease 2019 (COVID-19) pandemic has caused major psychological distress, mental health problems, sleep disturbances, anxiety, and depression. Among them, obstructive sleep apnea (OSA) is known as a comorbidity of diabetes, cardiovascular disease, asthma, obesity, high blood pressure, and chronic obstructive pulmonary disease, and these are poor prognostic factors for COVID-19 morbidity. Therefore, it is important to properly diagnose and treat sleep apnea during the COVID-19 pandemic. Due to the pandemic of COVID-19, in-lab sleep studies such as polysomnography (PSG) tend to slightly decrease, and alternative methods such as home sleep apnea tests (HSAT) and telemedicine tend to emerge relatively. In the post-COVID-19 era, HSAT with a technically adequate device and telemedicine may become an important modality for the diagnosis and treatment of OSA. In addition, the protection of PSG technicians and the disinfection of equipment and the environment of in-lab sleep studies are emphasized. If COVID-19 is ruled out, the use of positive airway pressure devices for therapeutic purposes is not restricted, but efforts should be made to minimize the risk of aerosol generation. Infection and quality control in PSG are important and inevitable issues, and regulation within each institution will be required during and after the COVID-19 pandemic. © 2022 Korean Academy of Sleep Medicine.
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While the Republic of Korea coped well with COVID-19 prior to the development of the vaccines, the major outbreaks of the virus in the country were largely caused and/or facilitated by several controversial Christian groups. There have also been many cases of smaller local churches spreading the virus due to their refusal to follow the government's guidelines for religious gatherings. Meanwhile, major Korean media outlets have mostly focused on cases of uncooperative churches with the short disclaimer 'the majority of Protestant churches are following the rules.' What kind of experiences did those 'cooperative' churches have to go through then? This paper is a micro in-depth case study which explores a megachurch in South Korea that has supported the government's safety measures. It pays particular attention to the church's struggles, perceived challenges and positive discoveries while practicing what can be called 'online Christianity.' It concludes with some theological questions to reflect upon for future Protestant Christianity in a time when religion may always have to be ready to be practiced in a highly technologically mediated fashion.
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Besides the great burden that has been placed on the world by the COVID-19 pandemic, radical climate change is causing natural disasters in every corner of the world. According to the IPCC's most recent report, rising global temperatures already have very negative impacts beyond our expectation. The main cause of this lies in human activities that drive global population growth, ongoing urbanization, excessive use of natural resources, and so on. Every minute, the environment in islands and oceans is changing in different directions and angles. This forum is to have an in-depth discussion on how climate crisis including pandemic and climate change and sprawling development by humans etc., can affect cultures and ecosystem in islands and seascapes and which direction identity of islands will be heading in the future. For this matter, the theme of this forum is fixed as "Changes and Chaos in Islands and Seascapes". © 2022 Institution for Marine and Island Cultures, Mokpo National University.
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Relationship satisfaction (RS) is one of the major components of mental health that is often ignored due to cultural reasons. Moreover, numerous studies had indicated that when individuals have insecure attachment styles (insecurity in loving someone else), they would never develop any RS with anyone, including friends, spouses, parents, children, and relatives. The coronavirus disease 2019 (COVID-19) pandemic had triggered different social patterns among individuals all over the world, and studies during the pandemic indicated the significance of some factors such as the sense of mattering and perceived life satisfaction (LS) to the mental health of the general adults. Our references led us to hypothesize that interpersonal mattering (IM) significantly predicted RS, mediated by LS, under the condition of low secure attachment style (SAS). Randomly selected 405 adults from Kuala Lumpur and Selangor, Malaysia, were financially compensated to complete the scales of IM, satisfaction with life, SAS section of measure of attachment style (MOAS), and RS index. The results indicated that the mediation of LS on the link between mattering and RS was only significant when the level of SAS is at the low and moderate levels. Further implications, limitations, and suggestions are discussed. © 2022, Intelektual Pustaka Media Utama. All rights reserved.
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Background: There is still controversy about the efficacy of COVID-19 vaccination and its extent in lowering immunogenicity of Rheumatoid Arthritis (RA) patients. The guideline in whether immunosuppressive agents need to be discontinued before the vaccination is continuously updated because it is considered to lower immunogenicity. Furthermore, there is great discussion on the effectiveness of the COVID-19 booster vaccine and interest in antibody generation in different types of vaccine, as in South Korea there are many patients who were prescribed the mRNA booster vaccine after two doses of ChAdOx1-S nCoV-19 vaccine. Objectives: Thus, we investigated the differences of antibody production between patients who received only two doses of ChAdOx1-S nCoV-19 and those who received the mRNA booster vaccine. Also, antibody production under different types of immunosuppressive agents was analyzed. Methods: From October 14, 2021 to January 21, 2022 at a tertiary referral center, two patient groups diagnosed with RA were studied prospectively;one group that completed 1st and 2nd doses of ChAdOx1-S nCoV-19 vaccine, second group that completed mRNA booster vaccine as well as two doses of ChAdOx1-S nCoV-19 vaccine. SARS-CoV-2 antibody testing on the semiquantitative anti-SARS-CoV-2 S enzyme immunoassay was done, and differences in antibody titers were analyzed in patients who received different immunosup-pressive agents such as csDMARD, TNF inhibitor, JAK inhibitor, Tocilizumab, Abatacept and Corticosteroid. Statistical analysis with a multivariate logistic regression model was performed. Results: In a total of 261 patients, 153 patients had completed two doses of ChAdOx1-S nCoV-19, 108 patients had completed third mRNA booster vaccine. Anti-SARS-CoV-2 RBD antibody positive rate (titer>0.8U/mL) was 97%(149/153) and 99%(107/108) respectively, and only 5 patients showed negative result. In the aspect of high antibody titer(>250U/mL), which is the upper limit of the RBD antibody immunoassay, the result showed rate of 31% (47/153) in the non-booster group and 94%(102/108) in the booster group respectively. Among the different immunosuppressive agents and other clinical aspects, multivariate analysis revealed that corticosteroid use (OR 0.91;95% CI: 0.86-0.98), older age(OR 4.33;95% CI: 1.34-13.91), and male gender(OR 0.35;95% CI 0.16-0.75) were signifcantly associated with low rate of high antibody titer. Furthermore, out of 14 patients who underwent antibody test twice before and after the mRNA booster vaccine, other than four patients who already showed high titer of >250U/mL before the mRNA booster vaccine, 10 patients showed an increase in titer after the booster vaccine and 7 patients were acquired high titer of >250U/mL. Conclusion: Anti-SARS-CoV-2 RBD antibody positive rate was 97% or more regardless of the mRNA booster vaccination. However, patients who received the mRNA booster vaccine after two doses of ChAdOx1-S nCoV-19 vaccine showed high antibody titer (>250U/mL) three times more than those who did not receive the booster shot. Our fndings also showed that corticosteroid use, old age, and male gender is signifcantly associated with low rate of acquiring high antibody titer.