Unusual Causes of Nasal Septal Abscess Including a COVID-19 Swab Test After Nasal Surgery.

A nasal septal abscess is a rare lesion that usually results from a nasal septal hematoma after nasal trauma or surgery, although it can occur unexpectedly. Nasal septal abscesses should be prevented and treated immediately. The authors describe 2 unusual cases: 1 caused by sudden loosening of the quilting suture of the nasal septum and the other by a nasopharyngeal swab test for coronavirus disease-2019. The authors also provide an intraoperative video and a literature review.

Spatial relationship between COVID-19 and previous infectious disease outbreaks: Evidence from South Korea.

As the novel coronavirus disease (COVID-19) has been rapidly spreading across the world, scholars have started paying attention to risk factors that affect the occurrence of the infectious disease. While various urban characteristics have been shown to influence the outbreak, less is known about whether COVID-19 is more likely to be transmitted in areas with a greater number of incidents of previous infectious diseases. This study examines a spatial relationship between COVID-19 and previous infectious diseases from a spatial perspective. Using the confirmed cases of COVID-19 and other types of infectious diseases across South Korea, we identified spatial clusters through regression and spatial econometric models. We found that COVID-19-confirmed case rates tended to be clustered despite no similarity with the spatial patterns of previous infectious diseases. Existing infectious diseases from abroad were associated with the occurrence of COVID-19, while the effect diminished after controlling for the spatial effect. Our findings highlight the importance of regional-level infectious disease surveillance for the effective prevention and control of COVID-19.

A framework for nationwide COVID-19 vaccine safety research in the Republic of Korea: the COVID-19 Vaccine Safety Research Committee.

With the introduction of coronavirus disease 2019 (COVID-19) vaccines, the Korea Disease Control and Prevention Agency (KDCA) commissioned the National Academy of Medicine of Korea to gather experts to independently assess post-vaccination adverse events. Accordingly, the COVID-19 Vaccine Safety Research Committee (CoVaSC) was launched in November 2021 to perform safety studies and establish evidence for policy guidance. The CoVaSC established 3 committees for epidemiology, clinical research, and communication. The CoVaSC mainly utilizes pseudonymized data linking KDCA's COVID-19 vaccination data and the National Health Insurance Service's claims data. The CoVaSC's 5-step research process involves defining the target diseases and organizing ad-hoc committees, developing research protocols, performing analyses, assessing causal relationships, and announcing research findings and utilizing them to guide compensation policies. As of 2022, the CoVaSC completed this research process for 15 adverse events. The CoVaSC launched the COVID-19 Vaccine Safety Research Center in September 2022 and has been reorganized into 4 divisions to promote research including international collaborative studies, long-/short-term follow-up studies, and education programs. Through these enhancements, the CoVaSC will continue to swiftly provide scientific evidence for COVID-19 vaccine research and compensation and may serve as a model for preparing for future epidemics of new diseases.

Seroprevalence of severe acute respiratory syndrome coronavirus 2 antibodies during the third wave of coronavirus disease in the Seoul metropolitan area of Korea.

Objectives: After the third wave of coronavirus disease (COVID-19), by mid-February 2021, approximately 0.16% of the population was confirmed positive, which appeared to be one of the lowest rates worldwide at that time. However, asymptomatic transmission poses a challenge for COVID-19 surveillance. Therefore, a community-based serosurvey of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was conducted to understand the effectiveness of Korea's strong containment strategy. Methods: We collected 5,002 residual sera samples from January 30 to March 3, 2021 from 265 medical facilities in Seoul, 346 in Kyunggi-do' and 57 in Incheon. Among them, 60 samples from tertiary institutions were excluded. We defined the sub-regions according to the addresses of the medical facilities where the specimens were collected. Elecsys Anti-SARS-CoV-2 was used for the screening test, and positivity was confirmed using the SARS-CoV-2 sVNT Kit. Prevalence was estimated using sampling weight and the Wilson score interval for a binomial proportion with a 95% confidence interval. Results: Among the 4,942 specimens, 32 and 25 tested positive for COVID-19 in the screening and confirmatory tests, respectively. The overall crude prevalence of SARS-CoV-2 antibody was 0.51%. The population-adjusted overall prevalence was 0.55% in women and 0.38% in men. The region-specific estimation was 0.67% and 0.30% in Gyeonggi-do and Seoul, respectively. No positive cases were detected in Incheon. Conclusion: The proportion of undetected cases in South Korea remains low. Therefore, an infection control strategy with exhaustive tracing and widespread pre-emptive testing appears to be effective in containing the spread of the virus in the community.

Exploring spatial distribution of social vulnerability and its relationship with the Coronavirus disease 2019: the Capital region of South Korea.

BACKGROUND & OBJECTIVE: The ongoing coronavirus disease 2019 (COVID-19) pandemic continues to cause death and socioeconomic problems worldwide. This study examined the spatial distribution of social vulnerability to COVID-19 and its relationship with the number of confirmed COVID-19 cases in 2020, focusing on the Capital region of South Korea. METHODS: A traditional social vulnerability index (SVI), healthy SVI, and the difference of each SVI were constructed in 2015 and 2019. The traditional SVI was constructed across five domains: age, socioeconomic disadvantage, housing, income, and environment. The healthy SVI domains were: prevention, health-related habits, chronic disease, healthcare infrastructure, and mortality. The spatial distribution of the traditional SVI, healthy SVI, and confirmed cases of COVID-19 was explored using ArcGIS 10.5. Pearson correlation was used to identify the relationship between confirmed COVID-19 cases and the two SVIs and their changes between 2015 and 2019. Four multiple linear regression models were used to identify the impact of the changes of the two SVIs on the confirmed COVID-19 cases for the three episodes and total period with control of population using STATA/MP 16.1. RESULTS: Confirmed COVID-19 cases were concentrated in a specific area of the Capital region. The traditional SVI was more vulnerable in the outer regions of the Capital region, and some central, western, and eastern areas reflected an increase in vulnerability. Healthy SVI was more vulnerable in the northern part of the Capital region, and increase in vulnerability showed in some central areas above Seoul. By multiple regression with the population controlled, the difference of the traditional SVI between 2015 and 2019 showed a positive relationship with the confirmed COVID-19 cases in all models at a significance level of 0.05, and the 2019 integrated SVI showed a negative relationship with confirmed COVID-19 cases in all models. CONCLUSIONS: The results of this study showed that the confirmed COVID-19 cases are associated with increased traditional SVI vulnerability between 2015 and 2019 and have a high positive relationship with the spread of COVID-19. Policy efforts are needed to reduce confirmed COVID-19 cases among the vulnerable in regions with relatively increased traditional SVI.

Epidemic Vulnerability Index for Effective Vaccine Distribution against Pandemic.

COVID-19 vaccine distribution route directly impacts the community's mortality and infection rate. Therefore, optimal vaccination dissemination would appreciably lower the death and infection rates. This paper proposes the Epidemic Vulnerability Index (EVI) that quantitatively evaluates the subject's potential risk. Our primary aim for the suggested index is to diminish both infection rate and death rate efficiently. EVI was accordingly designed with clinical factors determining the mortality and social factors incorporating the infection rate. Through statistical COVID-19 patient dataset analysis and social network analysis with an agent-based model that is analogous to a real-world system, we define and experimentally validate the capability of EVI. Our experiments consist of nine vaccination distribution scenarios, including existing indexes which estimate the risk and stochastically proliferate the contagion and vaccine in a 300,000 agent-based graph network. We compared the outcome and variation of the three metrics in the experiments: infection case, death case, and death rate. Through this assessment, vaccination by the descending order of EVI has shown to have a significant outcome with an average of 5.0% lower infection cases, 9.4% lower death cases, and 3.5% lower death rate than other vaccine distribution routes.

Seroprevalence of SARS-CoV-2 antibodies in the community based on participants in the 2020 Korea National Health and Nutrition Examination Survey.

OBJECTIVES: The Korea National Health and Nutrition Examination Survey (KNHANES) is a nationwide cross-sectional surveillance system that assesses the health and nutritional status of the Korean population. To evaluate the occurrence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the community, we investigated the prevalence of anti-SARS-CoV-2 antibodies in the sera of KNHANES participants. METHODS: Subjects were recruited between April 24 and December 12, 2020. In total, 5,284 subjects aged 10-90 years from 17 regions participated. SARS-CoV-2 antibodies were screened using the Elecsys Anti-SARS-CoV-2 assay. Positive samples were verified using 4 different SARS-CoV-2 antibody assays and the plaque reduction neutralizing test. The final seropositivity criteria were a positive screening test and at least 1 positive result from the 5 additional tests. RESULTS: Almost half (49.2%; 2,600/5,284) of participants were from metropolitan areas, 48.9% were middle-aged (40-69 years), and 20.5% were in their 20s or younger. The seropositivity rate was 0.09% (5/5,284). Three of the 5 antibody-positive subjects had a history of infection, of whom 2 were infected abroad and 1 was infected in a local cluster outbreak. CONCLUSIONS: The low SARS-CoV-2 antibody seroprevalence in Korea indicates that there have been few coronavirus disease 2019 (COVID-19) cases due to successful COVID-19 management measures (e.g., diagnostic tests for overseas arrivals, national social distancing, and strict quarantine measures). Moreover, asymptomatic infections were uncommon due to active polymerase chain reaction testing. However, hidden infections may exist in the community, requiring the continuation of quarantine and vaccination measures.

Satisfaction with the walking-related environment during COVID-19 in South Korea.

This study aimed to examine the satisfaction level differences between urban and rural areas with regard to their walking environment during the COVID-19 pandemic in South Korea. This online cross-sectional research was conducted using a mobile health application. Overall, 1,032 local residents who participated in the mobile healthcare program of a public health center were classified as being from either urban (n = 481, 46.6%) or rural areas (n = 551, 53.4%) for the purpose of this study. The Walkability Checklist, which includes sociodemographic information, was employed using a Chi-square test and a multivariate logistic regression to investigate whether or not the participants were satisfied with the environmental factors associated with walking. It was found that both urban and rural areas were more likely to be unsatisfied with walking comfort (adjusted OR: 24.472, 95% CI: 14.937-40.096). Regarding the walking comfort aspects of the walking environment, urban residents chose poor landscape ("needed more grass, flowers, or trees"; aOR: 13.561, 95% CI: 3.619-50.823) as their primary dissatisfaction, and rural residents chose messy streets ("dirty, lots of litter or trash"; aOR: 29.045, 95% CI: 6.202-136.015). Compared with urban residents, rural residents were more discontented with the walking environment. Thus, to promote walking activities at the community level, it is necessary to focus on walking comfort, and implement efforts related to environmental beautification.

A Regional Economy’s Resistance to the COVID-19 Shock: Sales Revenues of Micro-, Small-, and Medium-Sized Enterprises in South Korea

The coronavirus disease 2019 (COVID-19) is a global pandemic that has heavily impacted not only the health sector, but also the economic sector in general. Many countries have projected a negative economic impact, and the effect on micro-, small-, and medium-sized enterprises (MSMEs) is predicted to be significantly large. This study estimated the regional resistance of MSME sales revenues and identified the regional economic factors that affect resistance by analyzing South Korea, a country with one of the lowest economic impact projections from COVID-19. Resistance was estimated by comparing sales revenues and changes in resistance observed during the early COVID-19 period to those recorded in the same weeks (weeks 6 to 9) of 2019. The factors that affect regional resistance were determined by conducting robust regression and spatial regression analyses. The results show that the number of confirmed COVID-19 cases, a direct risk factor, is negatively related to regional resilience, while diversity is positively related to regional resistance. To improve the regional resistance against uncertain events, this study recommends increased diversity among regional industrial structures to reduce the duration of the early shock of an unexpected adverse event.

Serum Levels of Proinflammatory Lipid Mediators and Specialized Proresolving Molecules Are Increased in Patients With Severe Acute Respiratory Syndrome Coronavirus 2 and Correlate With Markers of the Adaptive Immune Response.

BACKGROUND: Specialized proresolution molecules (SPMs) halt the transition to chronic pathogenic inflammation. We aimed to quantify serum levels of pro- and anti-inflammatory bioactive lipids in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) patients, and to identify potential relationships with innate responses and clinical outcome. METHODS: Serum from 50 hospital admitted inpatients (22 female, 28 male) with confirmed symptomatic SARS-CoV-2 infection and 94 age- and sex-matched controls collected prior to the pandemic (SARS-CoV-2 negative), were processed for quantification of bioactive lipids and anti-nucleocapsid and anti-spike quantitative binding assays. RESULTS: SARS-CoV-2 serum had significantly higher concentrations of omega-6-derived proinflammatory lipids and omega-6- and omega-3-derived SPMs, compared to the age- and sex-matched SARS-CoV-2-negative group, which were not markedly altered by age or sex. There were significant positive correlations between SPMs, proinflammatory bioactive lipids, and anti-spike antibody binding. Levels of some SPMs were significantly higher in patients with an anti-spike antibody value >0.5. Levels of linoleic acid and 5,6-dihydroxy-8Z,11Z,14Z-eicosatrienoic acid were significantly lower in SARS-CoV-2 patients who died. CONCLUSIONS: SARS-CoV-2 infection was associated with increased levels of SPMs and other pro- and anti-inflammatory bioactive lipids, supporting the future investigation of the underlying enzymatic pathways, which may inform the development of novel treatments.

Elimination of Aicardi-Goutières syndrome protein SAMHD1 activates cellular innate immunity and suppresses SARS-CoV-2 replication.

The lack of antiviral innate immune responses during severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections is characterized by limited production of interferons (IFNs). One protein associated with Aicardi-Goutières syndrome, SAMHD1, has been shown to negatively regulate the IFN-1 signaling pathway. However, it is unclear whether elevated IFN signaling associated with genetic loss of SAMHD1 would affect SARS-CoV-2 replication. In this study, we established in vitro tissue culture model systems for SARS-CoV-2 and human coronavirus OC43 infections in which SAMHD1 protein expression was absent as a result of CRISPR-Cas9 gene KO or lentiviral viral protein X-mediated proteosomal degradation. We show that both SARS-CoV-2 and human coronavirus OC43 replications were suppressed in SAMHD1 KO 293T and differentiated THP-1 macrophage cell lines. Similarly, when SAMHD1 was degraded by virus-like particles in primary monocyte-derived macrophages, we observed lower levels of SARS-CoV-2 RNA. The loss of SAMHD1 in 293T and differentiated THP-1 cells resulted in upregulated gene expression of IFNs and innate immunity signaling proteins from several pathways, with STAT1 mRNA being the most prominently elevated ones. Furthermore, SARS-CoV-2 replication was significantly increased in both SAMHD1 WT and KO cells when expression and phosphorylation of STAT1 were downregulated by JAK inhibitor baricitinib, which over-rode the activated antiviral innate immunity in the KO cells. This further validates baricitinib as a treatment of SARS-CoV-2-infected patients primarily at the postviral clearance stage. Overall, our tissue culture model systems demonstrated that the elevated innate immune response and IFN activation upon genetic loss of SAMHD1 effectively suppresses SARS-CoV-2 replication.

Characteristics of ultrafine particles emitted from 3D-pens and effect of partition on children's exposure during 3D-pen operation.

A three-dimensional (3D) printing pen is a popular writing instrument that uses a heated nozzle, and is similar to a 3D-printer. Processing thermoplastic filaments with a 3D-pen can emit ultrafine particles (UFPs). 3D-pen education sessions were held with "∏"-shaped partitions for the prevention of coronavirus disease (COVID-19). This study aimed to characterize UFP emissions from two types of 3D-pens and evaluate the influence of "∏"-shaped partitions on UFP exposure. Measurements of UFP emission rates and the size distribution of particles emitted from 3D-pens were conducted in a chamber (2.5 m3 ). The partition's influence on UFP exposure was evaluated with and without a "∏"-shaped partition on a desk. A scanning mobility particle sizer (SMPS) and an optical particle spectrometer (OPS) were used to measure the particle number concentration (PNC) and size distribution. For both 3D-pen A and B, the average emission rates were statistically significantly highest for acrylonitrile butadiene styrene (ABS) filament (8.4 × 106 [3.4] particles/min and 1.1 × 106 [1.8] particles/min), followed by polylactic acid (PLA) (2.8 × 105 [1.5] particles/min and 4.8 × 104 [1.8] particles/min) and polycaprolactone (PCL) filaments (1.4 × 104 [2.8] particles/min and 2.0 × 104 [2.8] particles/min). For all filaments, particles in the Aitken mode (30-100 nm) accounted for the highest proportion. In 3D-pen A, PNCs were higher with the partition than without it for ABS (1.2 × 106 [1.15] particles/cm3 vs. 1.4 × 105 [1.29] particles/cm3 ) and PLA (6.2 × 105 [1.38] particles/cm3 vs. 8.9 × 104 [1.12] particles/cm3 ), whereas for 3D-pen B, they were higher with the partition for ABS (9.6 × 105 [1.13] particles/cm3 vs. 4.9 × 105 [1.22] particles/cm3 ) only. With the partition installed, PNCs decreased to the background level after the operation ended, whereas it took 2-6 min without the partition. However, the mass concentrations of PLA and PCL with 3D-pen A were not statistically significantly different with respect to the partition status. The use of 3D-pens with a partition can lead to high UFP exposure. Therefore, guidelines are required for the safe use of 3D-pens and partitions.

Factors associated with the difference between the incidence and case-fatality ratio of coronavirus disease 2019 by country.

Coronavirus disease (COVID-19) has been spreading all over the world; however, its incidence and case-fatality ratio differ greatly between countries and between continents. We investigated factors associated with international variation in COVID-19 incidence and case-fatality ratio (CFR) across 107 northern hemisphere countries, using publicly available COVID-19 outcome data as of 14 September 2020. We included country-specific geographic, demographic, socio-economic features, global health security index (GHSI), healthcare capacity, and major health behavior indexes in multivariate models to explain this variation. Multiple linear regression highlighted that incidence was associated with ethnic region (p < 0.05), global health security index 4 (GHSI4) (beta coefficient [ß] 0.50, 95% Confidence Interval [CI] 0.14-0.87), population density (ß 0.35, 95% CI 0.10-0.60), and water safety level (ß 0.51, 95% CI 0.19-0.84). The CFR was associated with ethnic region (p < 0.05), GHSI4 (ß 0.53, 95% CI 0.14-0.92), proportion of population over 65 (ß 0.71, 95% CI 0.19-1.24), international tourism receipt level (ß - 0.23, 95% CI - 0.43 to - 0.03), and the number of physicians (ß - 0.37, 95% CI - 0.69 to - 0.06). Ethnic region was the most influential factor for both COVID-19 incidence (partial [Formula: see text] = 0.545) and CFR (partial [Formula: see text] = 0.372), even after adjusting for various confounding factors.

Visualizing the regional patterns of two crises: The COVID-19 outbreak and decreasing MSME sales during three different phases of 2020 in Korea

The coronavirus disease 2019 (COVID-19) pandemic has caused various socioeconomic problems as well as deaths. The featured graphic depicts the COVID-19 outbreak and the accompanying decrease in sales of micro, small, and medium enterprises (MSMEs) from week 2 to week 53 in 2020 as well as its regional patterns during three different phases in Korea. The geovisualization shows that the MSMEs? economic crisis occurred during the COVID-19 outbreak period. The COVID-19 crisis witnessed the emergence of pandemic management strategies, including mitigation and reinforcement of lockdowns repeatedly, which weakened the effectiveness of policies for controlling the spread of infectious diseases. This research sheds further light on the prioritization of policy-related decision making for controlling infectious diseases by utilizing economic shutdowns.

MXene-Graphene Field-Effect Transistor Sensing of Influenza Virus and SARS-CoV-2.

An MXene-graphene field-effect transistor (FET) sensor for both influenza virus and 2019-nCoV sensing was developed and characterized. The developed sensor combines the high chemical sensitivity of MXene and the continuity of large-area high-quality graphene to form an ultra-sensitive virus-sensing transduction material (VSTM). Through polymer linking, we are able to utilize antibody-antigen binding to achieve electrochemical signal transduction when viruses are deposited onto the VSTM surface. The MXene-graphene VSTM was integrated into a microfluidic channel that can directly receive viruses in solution. The developed sensor was tested with various concentrations of antigens from two viruses: inactivated influenza A (H1N1) HA virus ranging from 125 to 250,000 copies/mL and a recombinant 2019-nCoV spike protein ranging from 1 fg/mL to 10 pg/mL. The average response time was about ∼50 ms, which is significantly faster than the existing real-time reverse transcription-polymerase chain reaction method (>3 h). The low limit of detection (125 copies/mL for the influenza virus and 1 fg/mL for the recombinant 2019-nCoV spike protein) has demonstrated the sensitivity of the MXene-graphene VSTM on the FET platform to virus sensing. Especially, the high signal-to-viral load ratio (∼10% change in source-drain current and gate voltage) also demonstrates the ultra-sensitivity of the developed MXene-graphene FET sensor. In addition, the specificity of the sensor was also demonstrated by depositing the inactivated influenza A (H1N1) HA virus and the recombinant 2019-nCoV spike protein onto microfluidic channels with opposite antibodies, producing signal differences that are about 10 times lower. Thus, we have successfully fabricated a relatively low-cost, ultrasensitive, fast-responding, and specific inactivated influenza A (H1N1) and 2019-nCoV sensor with the MXene-graphene VSTM.