A Soft Power Challenge, or an Opportunity? A Big Data Analysis on Chinese Soft Power during COVID-19 Pandemic

The Chinese government's rigorous efforts to enhance its soft power have confronted a major challenge during the COVID-19 pandemic. This study aimed to look at how the Chinese soft power changed throughout the pandemic using English news articles that covered China. The research took a data science approach to investigate the contents of articles using machine-learning-based sentiment analysis and Dirichlet-Multinomial Regression (DMR) analysis. The results show a gradual downturn in overall sentiment and that the topics related to political issues made the most significant impact. Nevertheless, the major increase in referencing Chinese social media implied that the sources of Chinese soft power have been diversified throughout the pandemic. In addition, this research has aimed to engage in major debates around soft power theory. Providing a multi-disciplinary approach for analyzing soft power, this research has tackled the difficulties in the quantitative conceptualization of soft power.

Americans' COVID-19 risk perceptions and risk perception predictors changed over time

Identifying and understanding risk perceptions—"how bad are the harms” to humans or to what they value that people see as potentially or actually arising from entities or events—has been critical for risk analysis, both for its own sake, and for expected associations between risk perceptions and subsequent outcomes, such as risky or protective behavior, or support for hazard management policies. Cross-sectional surveys have been the dominant method for identifying and understanding risk perceptions, yielding valuable data. However, cross-sectional surveys are unable to probe the dynamics of risk perceptions over time, which is critical to do while living in a dynamically hazardous world and to build causal understandings. Building upon earlier longitudinal panel studies of Americans' Ebola and Zika risk perceptions using multi-level modeling to assess temporal changes in these views and inter-individual factors affecting them, we examined patterns in Americans' COVID-19 risk perceptions in six waves across 14 months. The findings suggest that, in general, risk perceptions increased from February 2020 to April 2021, but with varying trends across different risk perception measures (personal, collective, affective, affect, severity, and duration). Factors in baseline risk perceptions (Wave 1) and inter-individual differences across waves differed even more: baseline ratings were associated with how immediate the threat is (temporal distance) and how likely the threat would affect people like oneself (social distance), and following the United States news about the pandemic. Inter-individual trend differences were shaped most by temporal distance, whether local coronavirus infections were accelerating their upward trend, and subjective knowledge about viral transmission. Associations of subjective knowledge and risk trend with risk perceptions could change signs (e.g. from positive to negative) over time. These findings hold theoretical implications for risk perception dynamics and taxonomies, and research design implications for studying risk perception dynamics and their comparison across hazards. © 2023 Informa UK Limited, trading as Taylor & Francis Group.

Management of Neurological Complications

Critically ill patients with COVID-19 pneumonia in the intensive care unit (ICU) may develop neurological complications of their central nervous system (CNS) or peripheral nervous system (PNS) that may arise directly from the COVID-19 virus, indirectly as a complication of the COVID-19-related hospitalization, or by mechanisms that have not yet been elucidated. These include encephalopathy, delirium, ischemic stroke, intracranial hemorrhage, peripheral nerve injury, and critical illness myopathy. As the evidence of neurological complications in COVID-19 patients accumulate, we aim to provide a concise review on optimal management strategies of these complications. For the purpose of our review, we are excluding patients in the ICU who develop new neurological symptoms and are found to have otherwise asymptomatic SARS-CoV-2 PCR positivity. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.

Performance of Indicators Used in the Regular Risk Assessment for Covid-19

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

Central Line Associated Blood Stream Infection Reduction at an Academic Community Hospital During the COVID-19 Pandemic to Achieve Patient Safety

During the COVID-19 pandemic, many institutions saw an overall increase in central line associated blood stream infection (CLABSI) events. CLABSI events can be prevented by decreasing central line utilization, improving practices during central line insertion and maintenance phases, and daily surveillance for necessity. A belief that zero harm to patients is possible and development of a supportive organizational culture with visible leadership were key to reducing CLABSI events and creating long-lasting change, even during the pandemic.

Informing Decision-Makers on Preparedness and Response to Public Health Threats: Event-Based Surveillance and Rapid Risk Assessment of Infectious Diseases in the Republic of Korea

Intro: Event-based surveillance (EBS) and rapid risk assessment (RRA) are essential tools for the early warning system against outbreaks, especially in the initial stages of an incident of potential public health threat. Since the Middle East respiratory syndrome outbreak in 2015, Korea Disease Control and Prevention Agency (KDCA) established EBS and RRA systems. This paper described KDCA's implementation of EBS and RRA to support the decision-making process for acute public health events. Method(s): The process of EBS and RRA systems for potential public health threats occurring outside of Korea is described and potential barriers and challenges are discussed. Finding(s): EBS and RRA systems have been constantly utilized in Korea. One of the recent examples is the EBS and RRA activities for acute hepatitis of unknown etiology in children and the global monkeypox outbreak which provided the basis to establish timely surveillance and response systems. Discussion(s): EBS tends to rely heavily on access to timely information. The quality of information needs to be ensured through a verification process by trained personnel as the quality of information determines the credibility of EBS results. Efforts to strengthen the information coverage and enhance the quality of information are key elements of EBS and RRA. Standardized manuals and systematic implementation of the EBS and RRA enable a more accurate evaluation of the risk. The process of RRA also needs flexibility in the way the risk is estimated. Conclusion(s): Public health threats are more likely to be imported than before as exchanges among countries grow frequent due to the eased border control measures for COVID-19 in recent days. The EBS and RRA systems are essential tools for all countries to ensure a timely response. Efforts to improve access to timely information and to ensure the quality of information should be continuously made to improve EBS and RRA systems.Copyright © 2023

Tweets and PCR Test-based Analysis and Prediction of Social Response to a Future Pandemic. A Case Study

The COVID-19 pandemic has greatly affected our society badly. It has been a subject of discussion since 2019 due to the increased prevalence of social media and its extensive use, and it has been a source of tension, fear, and disappointment for people all over the world. In this research, we took data from COVID-19 tweets from 10 different regions from July 25, 2020, to August 29, 2020. Using the well-known word embedding technique count-vectorizer, we experimented with different machine learning classifiers on data to train deep neural networks to improve the accuracy of predicted opinions with a low elapsed time. In addition, we collected PCR results from these regions for the same time interval. We compared the opinions in the form of positive or negative responses with the results of the PCR tests per million people. With the help of the results, We figured out a real-time international measure to detect these regions' behaviors for any future pandemic. If we know how a region thinks about an upcoming pandemic, then we can predict the region's real-time behavior for the particular pandemic. This would happen if we had past case studies to compare, like in our proposed research. Copyrights © 2023 The Institute of Electronics and Information Engineers.

Effect of COVID-19-Induced Changes on Job Insecurity, Presenteeism, and Turnover Intention in the Workplace-An Investigation of Generalized Anxiety Disorder among Hotel Employees Using the GAD-7 Scale

In this study, we investigated COVID-19 ' s (coronavirus disease 2019's) effect on job insecurity, presenteeism, and turnover intention in hotel environments by measuring hotel staffs' generalized anxiety disorder (GAD-7) levels. We surveyed 351 hotel employees from the office, facilities, food and beverage, and cooking departments. Convenience sampling was performed from December 2021 to March 2022. Job insecurity was measured with seven items (easily annoyed, tension, anxiety, nervousness, a lot of worry, fear, uncontrollable worry, restlessness, and discomfort) and demonstrated a significantly positive effect on presenteeism and turnover intention in the high GAD-7 group compared with the low GAD-7 group. Our study contributes academic value to research on GAD-7 in the hotel industry. In addition, it provides a theoretical basis for the relationship between job insecurity and hotel employees' psychological response to the pandemic. Based on the findings, we recommend periodically implementing the GAD-7 scale for employee assessments. Consequently, hotel companies can create guidelines for human resource management post-COVID-19.

Anti-counterfeiting advertisements for luxury brands in the post pandemic era: Roles of message type, visual presentation mode, and self-construal

The COVID-19 pandemic has led to a significant increase in the demand for counterfeit luxury products, and the black market is expected to grow continuously in the post pandemic era. The present research aimed to examine how verbal and visual aspects of anti-counterfeiting advertising affect the purchase of counterfeit luxury brands. For the verbal element, we included two types of anti-counterfeiting messages: value-expressive and social-adjustive. For the visual element, two modes of visual presentation were compared;participants were presented either with images of counterfeit products only, or with images of both counterfeit and genuine products. The results from two experiments demonstrated that both variables interacted with consumers' self-construal in determining the effects of anti-counterfeiting advertising. Participants with independent self-construal expressed a lower intention to purchase counterfeit luxury products when a value-expressive message was used or when only an image of the counterfeit was included. In contrast, participants with interdependent self-construal exhibited a lower purchase intention when a social-adjustive message was utilized or when images of both the counterfeit and authentic brands were presented side-by-side. Moreover, anti-counterfeiting messages influenced participants' purchase intentions through the perceptions of social-adjustive and value-expressive benefits, whereas the effect of presentation mode was mediated by the fluency experienced by the participants when processing the advertisement. Our research findings contribute theoretically to the literature on social motives, evaluation mode, comparative advertising, and self-construal, and will assist practitioners in developing effective communication strategies to reduce the consumption of counterfeit luxury brands. © 2023 Elsevier Ltd

The Influence of Long-term Care Hospital Nurses' Nursing Professionalism and Knowledge of COVID-19 on Nursing Intentions for COVID-19 Patients

Purpose: This study attempted to identify the influence of long-term care hospital nurses' nursing professionalism and knowledge of coronavirus disease 2019 (COVID-19) on nursing intentions for COVID-19 patients. Methods: Data were collected from nurses who had worked for at least 6 months at long-term care hospitals with more than 100 beds located in North Gyeongsang Province from July 15 to 31, 2021. In total, 207 questionnaires were analyzed using the t-test, one-way analysis of variance, Pearson correlation coefficients, and multiple linear regression with SPSS for Windows version 25.0. Results: Among the sub-factors constituting nursing professionalism, self-concept of the profession (r=.22, p=.001) and professionalism of nursing (r=.23, p=.001) were correlated with nursing intention for COVID-19 patients, whereas there no correlation was found between knowledge of COVID-19 and nursing intention for COVID-19 patients. In addition, among the sub-factors of nursing professionalism, the only factor influencing nursing intention for COVID-19 patients was professionalism of nursing, which could explain approximately 6.0% of variance in nursing intention for COVID-19 patients (β=.58, p=.049). Conclusion: It is important to strengthen professionalism of nursing among various aspects of nursing professionalism in order to improve long-term care hospital nurses' nursing intention for COVID-19 patients. © 2023 Korean Academy of Fundamentals of Nursing.

Are they still determining? Analysis of associations among ethnicity, gender, socioeconomic status, neighborhood factors, and COVID-19 vaccination

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.

Holobot: Hologram based Extended Reality Telepresence Robot

Nowadays, telepresence systems based on the Extended Reality (XR) system are actively developed and used for remote collaboration due to COVID-19. Still, several issues, such as limited traversable space in Virtual Reality (VR) and require all participants to wear head-mounted display (HMD), stop these systems from being used in our daily life. On the other hand, telepresence robots have been used in various fields before the pandemic. However, these robots also have a limitation in that the current form is incapable of delivering non-verbal expressions, which is essential for social interaction. Therefore, we present a Holobot, a telepresence robot based on the XR system. A remote user connects to the Holobot through VR HMDs, and the Holobot augments a virtual avatar that projectsusers' facial and gesture expressions.We developed a prototype and conducted a simple field test in the exhibition to receive feedback. VR participants enjoyed exploring remote spaces and interacting with each other through Holobot. Furthermore, remote space participants mentioned that a 1:1 scale avatar helped to build co-presence with the VR user. Based on these insights, we think Holobot could provide design guideline for future telepresence robot. For further approach, we plan to improve our prototype and conduct user test for structured evaluation of our system. © 2023 IEEE Computer Society. All rights reserved.

Social Structural Prospects for the AI Era - Focusing on social structural problems

In this paper, I will detail the phenomenal problems involved in the AI era. Issues such as information bubble, post-truth, and digital prison will point to the problems that arise in an environment based on AI technology. This article will also show that, after Covid-19, the AI-based environment has changed not only as a technology as a tool for humans, but also as a condition for survival. From this, we diagnose the problems of control, monitoring, and subjection brought about by the development of AI technology and the changes to the living environment caused by the Covid-19 outbreak. Synthesizing these problematic situations, I argue that the AI-based environment is not designed to cause social change as a result of natural changes or technological progress, but as a kind of discipline mechanism. I believe that it is necessary to consider how this will affect the changes and development of human society, and that it is necessary to predict this through social structural changes. Through this process, I will discuss this concept by analogically applying them to the problems of the AI era. I would like to ask a fundamental question about whether the AI era will be able to achieve real progress for humans and human society. Moreover, through this comprehensive investigation, this article draws the conclusion that AI as a discipline device will play a critical role in producing new power. © 2022 University of Rijeka, Faculty of Medicine. All rights reserved.

Taste your way across the globe: a systematic review of gastronomy tourism literature (2000-2021)

Gastronomy tourism is a critical driver of regional economic development and socio-cultural renaissance. It has been advocated as part of the tourism recovery initiatives in regards to boosting the worldwide economy in the wake of the COVID-19 pandemic. Using the preferred reporting items for systematic reviews and meta-analyses (PRISMA) protocol, 397 empirical articles from leading hospitality and tourism journals were systematically examined. This review brought attention to significant developments by using a combination of descriptive analysis, conceptual framework, and topic modeling. Several salient literature gaps and future research directions were amalgamated by utilizing the theory, context, characteristics, and methodology (TCCM) framework. © 2023 Informa UK Limited, trading as Taylor & Francis Group.

Implantation from Short Term MCS to Durable VAD: Single Center Experience

The rising use of temporary mechanical circulatory support (tMCS) to stabilize patients with acute cardiogenic shock has resulted in an increased number of these patients being bridged to advanced therapies. While heart transplantation has become the favored path for these patients, durable VAD can be a safe option to recover these Intermacs I patients. All patients implanted with durable VAD at our center from 2017-2021 were reviewed retrospectively and included in this series. Thirty-three patients underwent VAD implantation during the study period. At the time of implant, 78.8% were INTERMACS 1 on tMCS (N=26) and 92.3% (N=24) were stabilized on an Impella (Abiomed, Danvers, MA), 3.8% (N=1) required Centrimag and 3.8% (N=1) required combined VA-ECMO and Impella. Mean age was 65.3 years, 88.4% were male and 39% (N=13) had nonischemic cardiomyopathy. Six patients were implanted with Heartmate II LVAD, while 27 received Heartmate 3 (Abbott, Abbott Park, IL). At the time of VAD implantation, 19% (n=5) of patients required RV mechanical support. Ninety-two percent of patients survived to discharge with a mean total length of stay of 56.23 days and mean post VAD length of stay 34.2 days. Sixty percent of these patients (N=15) survived at least 1-year, with 12 of the patients alive at 2 years. Of the early expirations, 80% died within the first 6 months post implant. Etiology of mortality included RV failure in 50% of patients, COVID-19 infection in 17% , and sepsis in 25%. Despite the high-risk of mortality in the cardiogenic shock population, those patients who can be stabilized with tMCS can have reasonable survival following durable VAD implantation. Following implant, the highest risk for mortality is within the first 6 months and is primarily related to worsening RV dysfunction. With recent data also showing that HM3 can extend life by 5 years, the concept of bridge to transplant LVAD should also be reconsidered for this very sick patient population. [ABSTRACT FROM AUTHOR] Copyright of Journal of Heart & Lung Transplantation is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Working in times of COVID-19: investigating the effect of daily risk perception of COVID-19 infection on goal progress

PurposeBased on the transactional theory of stress and coping, this study aims to understand the daily impact of coronavirus disease 2019 (COVID-19) on employee goal progress. In particular, the authors explore how COVID-19 induces anxiety related to task setbacks that consequently influences one's goal progress.Design/methodology/approachA daily diary study was conducted with a total of 558 observations from 60 participants. The data were analyzed using multilevel path analysis with random slopes.FindingsThe perceived risk of COVID-19 infection was positively associated with COVID-19 task setback anxiety, which in turn improved end-of-day goal progress. Lower employee conscientiousness strengthened the relationship between perceived risk of COVID-19 infection and COVID-19 task setback anxiety, and lower supervisor bottom-line mentality strengthened the relationship between COVID-19 task setback anxiety and end-of-day goal progress.Practical implicationsAlthough COVID-19 task setback anxiety results in higher end-of-day goal progress, the authors recommend caution as the cost of coping exists. Thus, supervisors should focus on supporting the employees rather than having a bottom-line mentality.Originality/valueThis study advances stress and coping literature by examining how employees appraise and cope with COVID-19 in work context. The authors demonstrate that a perceived risk of COVID-19 induces task setbacks related to anticipatory anxiety, which in turn influences employee outcomes. In addition, the authors identify employee conscientiousness and supervisor bottom-line mentality as a boundary condition of this process.

Vaccine effect on household transmission of omicron and delta SARS-CoV-2 variants in South Korea

Background. We aimed to evaluate household secondary attack rate (SAR) of SARS-CoV-2 variants, omicron and delta, based on index case and contact vaccination status, and antibody level effect of vaccinated index cases on household transmission. Methods. A prospective study of 92 index cases and 197 quarantined household contacts was performed. Tests for SARS-CoV-2 variant type and antibody level were conducted in index cases, and results of PCR tests (during the quarantine period) were collected from contacts. Association of antibody levels in vaccinated index cases and SAR was evaluated by multivariate regression analysis. To evaluate the association between antibody levels in vaccinated index cases and household transmission, the probability of transmission was calculated using the logistic regression model. We refit the model for the probability of transmission using the variables that could affect the household transmission (meal with index, contact with index case >=5/day, respiratory symptoms and immunocompromised status of index patients, and vaccination status of contacts). For this analysis, only vaccinated index cases who tested antibody levels within 7 days of symptom onset or diagnosis, whichever was earlier, were included. The link between index cases and household contacts according to their vaccination status is shown in Figure. A total of 40, 27, and 10 contacts were linked with 20 unvaccinated index cases, 14 booster-unvaccinated index cases, and 7 booster-vaccinated index cases with delta variant infection, respectively. Among the contacts of index cases with omicron variant infection, 20, 65, and 35 contacts were exposed to 7 unvaccinated, 25 booster-unvaccinated, and 9 booster-vaccinated index cases, respectively. Results. SAR was higher in households exposed to omicron variant than those exposed to delta variant. SAR was 35% and 23% for unvaccinated and vaccinated delta variant exposed contacts, respectively. SAR was 44% and 41% for unvaccinated and vaccinated omicron exposed contacts, respectively. Booster dose immunisation of contacts or vaccination of index cases reduced SAR of vaccinated omicron variant exposed contacts. In a model with adjustment, anti-receptor binding domain antibody levels in vaccinated index cases were inversely correlated with household transmission of both delta and omicron variants. Neutralising antibody levels had a similar relationship. When we performed sensitivity analyses using 3 day and 5 day thresholds for the period of antibody test, the results did not differ from the main analyses. In a model with adjustment for factors that could affect the household transmission, the estimated probabilities of SARS-CoV-2 infection among 132 contacts according to the level of anti-RBD antibodies (A) and neutralising antibodies (B) of 62 index cases. Serum samples for antibody tests were collected within 7 days of symptom onset or diagnosis, whichever was earlier, in vaccinated index cases. Shaded areas indicate 95% confidence intervals.

Treatment experience of regdanvimab for mild to moderate COVID-19 hospitalized patients in the Delta variant-predominant period in Korea

Background. Regdanvimab is the only monoclonal antibody available in Korea that targets the receptor-binding domain of SARS-CoV-2. Although the efficacy of regdanvimab against the original and beta variant viruses was demonstrated, it remains uncertain whether it has therapeutic effect on delta variant in the real world. Methods. We retrospectively evaluated the characteristics and clinical outcome of patients hospitalized for COVID-19 and treated with regdanvimab in two university-affiliated hospitals between September and December 2021, during the delta variant-predominant period in Korea. Results. A total of 374 mild to moderate COVID-19 patients treated with regdanvimab were included in this study. The median age was 65 (interquartile range, IQR 17-92) and 178 (47.6%) patients were male. A total of 322 (86.1%) patients had median 2 (IQR 1-3) risk factors for disease progression. The most common underlying disease was cardiovascular disease (198, 52.9%), followed by diabetes mellitus (95, 25.4%), cancer (40, 10.7%), chronic lung disease (34, 9.1%), immunosuppression (1 7, 4.5%), and chronic kidney disease (12, 3.2%). There were 43 (11.5%) patients with a body mass index >= 30. The median time to regdanvimab treatment from symptom onset was 4 (IQR 2-6) days. 226 (60.4%) patients were fully vaccinated, and 109 (29.1%) were not vaccinated at all. 185 (49.5%) patients had pneumonia. Most (342/374, 91.4%) patients improved without any other treatment for COVID-19 and were discharged. Only 32 (8.6%) patients required other therapeutic agents such as remdesivir, corticosteroids or oxygen therapy after regdanvimab administration. The time from regdanvimab infusion to addition of other therapeutic agents was median 5 days (IQR 3-6.5). When comparing the characteristics of 32 patients who needed other treatment with those who improved only with regdanvimab treatment, there was a significant difference in the presence of pneumonia (27/32, 84.4% vs. 158/ 342, 46.2%, P< 0.001) and there was no significant difference in vaccination status (15/ 32, 46.9% vs. 211/342 61.7% P=0.101). (Figure Presented) Conclusion. This study shows the potential clinical benefits of regdanvimab in mild to moderate COVID-19 patients in the real world during the delta variant predominant period in Korea.

Vaccine-induced antibody level predicts the clinical course of breakthrough infection of COVID-19 caused by delta and omicron variants: a prospective observational cohort study

Background. This study aimed to determine the effect of vaccine on clinical course of delta and omicron variant infection. Furthermore, we tried to evaluate the utility of antibody level against spike protein as a predictor of disease course of COVID-19 in vaccinated patients. Methods. Between December 11, 2021 and February 10, 2022, we performed a prospective observational cohort study in an institution of South Korea. Among adult patients admitted due to COVID-19, individuals with confirmed delta and omicron variant infection were included. Multivariable logistic regression analysis was performed to determine the association between antibody level and clinical course of breakthrough infection in vaccinated patients. The relationship between antibody level and cycle threshold (Ct) values was confirmed using a generalized linear model. We used the antibody titers collected within 7 days of symptom onset or diagnosis and the Ct values tested on days 5-7 days after initial diagnosis. Results. Of 161 patients with delta and omicron variant infection, 106 vaccinated patients (39 delta and 67 omicron) had available serum samples. The geometric mean titers of antibodies in patients who experienced the fever (>=37.5degreeC), hypoxia (<=94% of SpO2), pneumonia, C-reactive protein (CRP) elevation ( >8 mg/L) or lymphopenia (< 1,100 cells/muL) during hospitalization were 1201.5 U/mL, 98.8 U/mL, 774.1 U/mL, 1335.1 U/mL, and 1032.2 U/mL, respectively, which were lower compared with those who did not (p< 0.05 for all). Increase in antibody level of vaccinated patients with delta and omicron infection was associated with decrease in occurrence of fever (aOR, 0.23;95% CI, 0.12-0.51), hypoxia (aOR, 0.23;95% CI, 0.08-0.7), CRP elevation (aOR, 0.52;95% CI, 0.29-0.0.94), and lymphopenia (aOR, 0.57;95% CI, 0.33-0.98) during hospitalization, regardless of virus type or booster vaccination status. Data from 33 patients who had Ct values suitable for analysis showed a positive correlation between antibody levels and Ct values (p=0.02). This analysis included 106 patients with delta and omicron variant infections whose serum samples were collected within 7 days of symptom onset or diagnosis. Antibody levels are described as box plots of medians with interquartile ranges. BT, body temperature;SpO2, percutaneous oxygen saturation;w/o, without;CRP, C-reactive protein Data from 33 patients, with Ct values measured 5-7 days after diagnosis, showed a positive correlation between antibody levels and Ct values (slope: 0.0004, p=0.022) Abbreviations: Ct, cycle threshold;PCR, polymerase chain reaction Conclusion. Antibody levels are predictive of the clinical course of COVID-19 in vaccinated patients with delta and omicron variant infections. Our data highlight the need for concentrated efforts to monitor patients with SARS-CoV-2 infection who are at risk of low antibody levels.