Descriptive analysis of the incidence rate of postacute COVID-19 syndrome in the Republic of Korea Army.

Background: This study aimed to identify the incidence rate of post-coronavirus disease-2019 (COVID-19) conditions in the Republic of Korea (ROK) Army and to investigate the trend of the incidence rate according to changes in dominant variants. Method(s): We used the results of a 19-item, self-completed survey of those who had recovered from COVID-19 in the ROK Army between March 24, 2020, and April 30, 2022. We used both descriptive and multiple logistic regression analyses to identify factors associated with the incidence rate of post-COVID-19 conditions. Result(s): Among the total of 48,623 COVID-19 episodes in the ROK Army, the overall incidence rate of post-COVID-19 conditions was 32.9%. Based on the survey, the incidence of cough was the highest at 15.4%, followed by fatigue (15.1%) and sputum (13.8%). The delta variant had the highest incidence rate of post-COVID-19 conditions at 50.7%, whereas the omicron variant had the lowest at 19.7%. Concerning the type of post-COVID-19 condition, the neuropsychiatric symptoms had the highest incidence at 27.4% when the delta variant was dominant, and the respiratory symptoms were highest at 37.3% when the omicron variant was dominant. In the case of smell and taste symptoms, the incidence rate was high at 21.1% only when the delta variant was predominant. Conclusion(s): The overall incidence rate of post-COVID-19 conditions in the ROK Army was 32.9%. When the delta variant was dominant, the overall incidence as well as the proportion of neuropsychiatric symptoms were high. However, as the omicron variant became dominant, the overall incidence decreased, but the proportion of respiratory symptoms increased.Copyright © Korean Medical Association.

COVID-19 OUTCOMES IN KOREAN PATIENTS WITH GOUT

BackgroundPatients with autoimmune inflammatory rheumatic diseases are at higher risk for coronavirus disease (COVID)-19 hospitalization and worse clinical outcomes compared with the general population. However, data on the association between COVID-19 outcomes and gout, or gout-related medications are still lacking.ObjectivesWe aimed to compare COVID-19 related clinical outcomes in gout vs. non-gout patients.MethodsWe conducted a retrospective cohort study using the electronic health record-based databases of Seoul National University hospital (SNUH) from January 2021 to April 2022 mapped to a common data model. Patients with gout and without gout were matched using a large-scale propensity score (PS) algorithm. The clinical outcomes of interest were COVID-19 infection, severe COVID-19 outcomes defined as the use of mechanical ventilation, tracheostomy or extracorporeal membrane oxygenation, and death within 30 days of COVID-19 diagnosis. The hazard ratio (HR) for gout vs. non-gout patients derived by Cox proportional hazard models were estimated utilizing a 1:5 PS-matched cohort.Results2,683 patients with gout and 417,035 patients without gout were identified among the patients who visited SNUH. After 1:5 PS matching, 1,363 gout patients and 4,030 non-gout patients remained for the analysis. The risk of COVID-19 infection was not significantly different between patients with gout and those without gout (HR 1.07 [95% CI 0.59-1.84]). Within the first month after the COVID-19 diagnosis, there was also no significant difference in the risk of hospitalization (HR 0.57 [95% CI 0.03-3.90], severe COVID-19 outcomes (HR 2.90 [95% CI 0.54-13.71]), or death (HR 1.35 [95% CI 0.06-16.24]).ConclusionPatients with gout did not have an increased risk of COVID-19 infection or worse clinical outcomes. Updates of temporal trends of COVID-19 outcomes in gout patients are yet warranted as new SARS-CoV-2 variants emerge.References[1]Shin YH, et al. Autoimmune inflammatory rheumatic diseases and COVID-19 outcomes in South Korea: a nationwide cohort study. Lancet Rheumatol. 2021 Oct;3(10):e698-e706.[2]Topless RK, et al. Gout and the risk of COVID-19 diagnosis and death in the UK Biobank: a population-based study. Lancet Rheumatol. 2022 Apr;4(4):e274-e281.[3]Xie D, et al. Gout and Excess Risk of Severe SARS-CoV-2 Infection Among Vaccinated Individuals: A General Population Study. Arthritis Rheumatol.2023 Jan;75(1):122-132.Table 1.Clinical outcomes of COVID-19 infection in patients with goutOutcomesUnmatched populationPopulation with PS stratification using 10 strata1:5 PS matched populationHazard ratio (95% CI)p-valueHazard ratio (95% CI)p-valueHazard ratio (95% CI)p-valueCOVID-19 infection1.68 (1.03-2.57)0.031.20 (0.72-1.87)0.461.07 (0.59-1.84)0.82Hospitalization due to COVID-191.92 (0.32-6.05)0.391.63 (0.26-5.77)0.540.57 (0.03-3.90)0.66Severe COVID-19 infection4.72 (1.44-11.28)<0.014.22 (1.17-12.21)0.022.90 (0.54-13.71)0.20Death due to COVID-191.15 (0.07-5.18)0.900.77 (0.04-3.81)0.821.35 (0.06-16.24)0.84Acknowledgements:NIL.Disclosure of InterestsNone Declared.

The effect of pandemic-related stress on the decision-making process for individual outdoor leisure activities

This study investigates the decision-making process for outdoor leisure activities of the Chinese people in the context of COVID-19. An online survey of residents of Heilongjiang Province was conducted in September and October 2020. In total, 441 questionnaires were returned for empirical analysis. The results reveal that fears of contamination and compulsory checking/reassurance-seeking have had a significant impact on the respondents' goal-directed behavior for nature-based outdoor leisure activities during the pandemic. The theoretical contribution is that extended goal-directed behavior expands with the inclusion of emotional variables and can be used to predict individual outdoor activity intention and decision-making process in the COVID-19 situation relating to leisure. This study provides useful insights for public health ministries and local governments in any country to encourage nature-based outdoor leisure activities as a public health policy for the mental health of the people.

Descriptive analysis of the incidence rate of postacute COVID-19 syndrome in the Republic of Korea Army

Background: This study aimed to identify the incidence rate of post-coronavirus disease-2019 (COVID-19) conditions in the Republic of Korea (ROK) Army and to investigate the trend of the incidence rate according to changes in dominant variants. Method(s): We used the results of a 19-item, self-completed survey of those who had recovered from COVID-19 in the ROK Army between March 24, 2020, and April 30, 2022. We used both descriptive and multiple logistic regression analyses to identify factors associated with the incidence rate of post-COVID-19 conditions. Result(s): Among the total of 48,623 COVID-19 episodes in the ROK Army, the overall incidence rate of post-COVID-19 conditions was 32.9%. Based on the survey, the incidence of cough was the highest at 15.4%, followed by fatigue (15.1%) and sputum (13.8%). The delta variant had the highest incidence rate of post-COVID-19 conditions at 50.7%, whereas the omicron variant had the lowest at 19.7%. Concerning the type of post-COVID-19 condition, the neuropsychiatric symptoms had the highest incidence at 27.4% when the delta variant was dominant, and the respiratory symptoms were highest at 37.3% when the omicron variant was dominant. In the case of smell and taste symptoms, the incidence rate was high at 21.1% only when the delta variant was predominant. Conclusion(s): The overall incidence rate of post-COVID-19 conditions in the ROK Army was 32.9%. When the delta variant was dominant, the overall incidence as well as the proportion of neuropsychiatric symptoms were high. However, as the omicron variant became dominant, the overall incidence decreased, but the proportion of respiratory symptoms increased.Copyright © Korean Medical Association.

Descriptive analysis of the incidence rate of post-acute COVID-19 syndrome in the Republic of Korea Army

Background: This study aimed to identify the incidence rate of post-coronavirus disease-2019 (COVID-19) conditions in the Republic of Korea (ROK) Army and to investigate the trend of the incidence rate according to changes in dominant variants.Methods: We used the results of a 19-item, self-completed survey of those who had recovered from COVID-19 in the ROK Army between March 24, 2020, and April 30, 2022. We used both descriptive and multiple logistic regression analyses to identify factors associated with the incidence rate of post-COVID-19 conditions.Results: Among the total of 48,623 COVID-19 episodes in the ROK Army, the overall incidence rate of postCOVID-19 conditions was 32.9%. Based on the survey, the incidence of cough was the highest at 15.4%, followed by fatigue (15.1%) and sputum (13.8%). The delta variant had the highest incidence rate of postCOVID-19 conditions at 50.7%, whereas the omicron variant had the lowest at 19.7%. Concerning the type of post-COVID-19 condition, the neuropsychiatric symptoms had the highest incidence at 27.4% when the delta variant was dominant, and the respiratory symptoms were highest at 37.3% when the omicron variant was dominant. In the case of smell and taste symptoms, the incidence rate was high at 21.1% only when the delta variant was predominant.Conclusion: The overall incidence rate of post-COVID-19 conditions in the ROK Army was 32.9%. When the delta variant was dominant, the overall incidence as well as the proportion of neuropsychiatric symptoms were high. However, as the omicron variant became dominant, the overall incidence decreased, but the proportion of respiratory symptoms increased.

University students' perceptions of remote laboratory courses necessitated by COVID-19: differences in emergent teaching strategies at a Korean university

In 2020, the COVID-19 pandemic swept the globe and caused formal educational sites to shift from in-person instruction to remote learning. University laboratory courses that were previously hands-on were also transformed into remote courses. This study investigates how university students perceived their experiences of remote laboratory courses across various disciplines. This study was conducted at a large public university in the Republic of Korea that offers a variety of laboratory courses. Adopting a mixed-methods approach, we collected online survey responses from 338 students and conducted in-depth interviews with 18 students. The analysis of variance (ANOVA) and Bonferroni post hoc tests of survey responses found that students' perceptions of their remote laboratory courses differed significantly (p <.05) by discipline (physics, chemistry, biology, earth sciences, etc.). Student interviews revealed that these differences in perceptions were attributable to the different emergent teaching strategies used in each course. Based on these findings, for remote laboratory courses in the post-COVID-19 era, we suggest that course instructors clearly set learning objectives, carefully design videos of experiments, offer collaborative and synchronous online sessions, provide guidance and feedback on lab report writing, and introduce supportive assessments. © 2023, Education Research Institute, Seoul National University.

National trends in suicide-related behaviors among youths between 2005-2020, including COVID-19: a Korean representative survey of one million adolescents.

OBJECTIVE: It is difficult to conclude that COVID-19 is associated with a decrease in the suicide attempts rate by comparing only a short-term period. Therefore, it is necessary to examine attempted suicide rates through a trend analysis over a longer period. This study aimed to investigate an estimated long-term trend regarding the prevalence of suicide-related behaviors among adolescents in South Korea from 2005 to 2020, including COVID-19. SUBJECTS AND METHODS: We sourced data from a national representative survey (Korea Youth Risk Behavior Survey) and analyzed one million Korean adolescents aged 13 to 18 years (n=1,057,885) from 2005 to 2020. The 16-year trends regarding the prevalence of sadness or despair and suicidal ideation and attempt and the trend changes before and during COVID-19. RESULTS: Data of 1,057,885 Korean adolescents was analyzed (weighted mean age, 15.03 years; males, 52.5%; females, 47.5%). Although the 16-year trend in the prevalence of sadness or despair and suicide ideation and attempt consistently decreased (prevalence of sadness or despair between 2005-2008, 38.0% with 95% confidence interval [CI], 37.7 to 38.4 vs. prevalence in 2020, 25.0% [24.5 to 25.6]; suicide ideation between 2005-2008, 21.9% [21.6 to 22.1] vs. prevalence in 2020, 10.7% [10.3 to 11.1]; and suicide attempt between 2005-2008, 5.0% [4.9 to 5.2] vs. prevalence in 2020, 1.9% [1.8 to 2.0]), the downward slope decreased during COVID-19 (ßdiff in sadness, 0.215 with 95% CI 0.206 to 0.224; ßdiff in suicidal ideation, 0.245 [0.234 to 0.256]; and ßdiff in suicide attempt, 0.219 [0.201 to 0.237]) compared with pre-pandemic period. CONCLUSIONS: This study found that the observed risk of suicide-related behaviors during the pandemic was higher than expected through long-term trend analysis of the prevalence of sadness/despair and suicidal ideation and attempts among South Korean adolescents. We need a profound epidemiologic study of the change in mental health due to the pandemic's impact and the establishment of prevention strategies for suicide ideation and attempt.

The Effects of Depression and Optimism on Academic Stress in Korean University Students in COVID-19 Situation

This study confirmed the degree of depression, optimism, academic stress, and COVID-19 life change of college students in the COVID-19 situation. An attempt was made to provide basic data for the development and application of programs to reduce the learning stress of college students. Data collection was conducted from January 1 to February 28, 2022, with the consent of the subjects, and the number of participants used for the final analysis was 170. The collected data were analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation, and multiple regression using the SPSS 26.0 statistical program. There was a significant difference according to department satisfaction and personality in the difference in depression according to general characteristics. The optimism of college students was significantly different depending on the department satisfaction and personality. There was a significant difference in the academic stress of college students according to their department satisfaction and personality. When examining the correlation between depression, optimism, and academic stress of the subjects, the depression of college students had a statistically significant negative correlation with optimism. The subject's academic stress had a statistically significant positive correlation with depression and a statistically significant negative correlation with optimism. The degree of life change of college students after COVID-19 was found to be an average of 2.33 points (out of four points). As factors affecting academic stress of college students, department satisfaction and depression showed statistically significant results. Explanatory power of academic stress caused by these factors was 37.3%. Under the COVID-19 situation, academic stress, depression, and optimism of college students had a significant effect on department satisfaction and personality. As academic stress increased, depression also increased, and as academic stress decreased, optimism increased. In other words, it was confirmed that academic stress is an important influencing factor on depression and optimism. Reduction of academic stress seems to be essential to lead a positive daily life such as optimism of college students, and it seems that it is necessary to develop various educational programs to reduce the learning stress of college students in the context of COVID-19. © 2022,Journal for ReAttach Therapy and Developmental Diversities. All Rights Reserved.

DIGITAL DIVIDE AND DIFFICULTIES IN ACQUIRING HEALTH RESOURCES IN DISABLED OLDER ADULTS DURING THE PANDEMIC

The digital divide refers to the gap between those who are connected and those who are not connected to the internet and technologies. Although COVID-19 worsens the digital divide and health inequality, few studies have focused on the relationship between digital divide and difficulties in acquiring of health resources during the pandemic. This study aimed to identify the relationship between internet use and difficulties in acquiring health resources among older adults with disabilities during the COVID-19 pandemic. This secondary analysis study included 4,871 older adults aged 55 and older among 7,025 total responders of the 2020 survey of people with disabilities in South Korea. As the results, only 23.7% of older adults with disabilities used the internet. Non-internet users are more likely to have difficulties in acquiring COVID-19-related information (aOR 1.59) and buying and using personal protective equipment (aOR 1.36). However, difficulties in using medical services (aOR 1.21) was not statistically significant. Considering that older adults with disabilities have triple burdens from old age, disabilities, and the digital divide amid COVID-19, healthcare providers need to pay more attention to mitigate gaps between internet users and non-non users among this population. By narrowing the digital divide, decreasing health gaps and increasing well-being among older adults with disabilities will be guaranteed.

Effect of 2021-2022 vaccination on the seroprevalence of antibodies to Influenza A and B strains in kidney transplant recipients and health-care workers*

Background: Since the beginning of the coronavirus 2 pandemic in 2019, incidence of influenza infections has significantly decreased mainly due to the COVID-19-related protective measures. We aimed to evaluate the prevalence of serum antibodies against Influenza A and B in kidney transplant recipients (KTRs) and health-care workers (HCWs) before and after receiving the 2021-2022 season vaccine. Methods or Case description: In prospectively collected preand postvaccination sera from KTRs (n = 75) and HCWs (n = 28), vaccinated with Fluarix tetra, IgG antibodies against influenza hemagglutinins of the strains included in the 2021-2022 vaccine (A/Victoria/H1N1;A/Cambodia/H3N2;B/Washington;B/PHUKET) were measured by ELISA. Same measurements were performed in the sera from unvaccinated KTRs (n = 28) and HCWs (n = 11) at 3-month interval during the same season. The half maximal effective dilution (ED50) was measured for all sera and fold-change variation of ED50 values before and after vaccination were calculated. Results or Learning points: ED50 values of IgG against each strain from the serially collected sera are shown in Figure 1. Almost all study participants showed antibodies to all four strains prior to vaccination, whereby the ED50 values were mostly higher in the HCWs. There was no significant increase of ED50 values after vaccination in both KTRs and HCWs, and the increase was comparable in KTRs and HCWs. Unvaccinated subjects, especially HCWs, showed a slight increase of ED50 values over a 3-month interval, although this variation was not significant. During the study period no influenza infection was selfreported or diagnosed in all the enrolled subjects. Conclusion(s): In our cohorts of KTRs and HCWs, we were able to show a wide prevalence of pre-vaccination antibodies against influenza vaccine strains of 2021-2022 season. IgG levels were significantly higher in HCWs compared to KTRs. There was no significant increase of antibodies after vaccination in both KTRs and HCWs.

Breakthrough Omicron Infections in Booster Vaccinated Healthcare Workers

Background. There are few data on immune correlation of protection from breakthrough Omicron (B.1.1.529) infection in individuals who received booster vaccines. We thus compared a neutralizing antibody titers against Omicron within the first month after the mRNA booster at the time before omicron wave between healthcare works (HCWs) who experienced Omicron breakthrough infections and HCWs without Omicron infections. Methods. We enrolled HCWs without the history of SARS-CoV-2 infection who agreed with blood sampling 2 weeks after booster vaccination at Asan Medical Center, Seoul, South Korea, between November 2021 and December 2022 (Delta dominant era). We identified breakthrough infections by performing SARS-CoV-2 RT-PCR though nasopharyngeal swab specimen in HCWs who had COVID-19-related symptoms or had known exposure to confirmed SARS-CoV-2-infected patients, between 1 February and 25 April 2022 (Omicron dominant era). SARS-CoV-2 S1-specific IgG antibody titers were measured using enzyme-linked immunosorbent assay (ELISA). Plasma levels of live-virus neutralizing antibodies were measured using a microneutralization assay with SARS-CoV-2 omicron variants. Results. Among 134 HCWs, 69 (52%) received two-dose ChAdOx1 nCoV-19 followed by BNT162b2, 50 (37%) three-dose BNT162b2, and 15 (11%) 3-dose mRNA-1273. Of them, 57 (43%) experienced breakthrough Omicron infection at median 121 days (IQR 99-147) after booster vaccination (breakthrough group), and the remaining 77 (57%) did not experience Omicron infection (non-breakthrough group). There was no significant different in 'peak' SARS-CoV-2 S1-specific IgG level between breakthrough group (median 4484.4 IU/mL) and non-breakthrough group (median 4194.9 IU/mL, p value=0.39). In addition, there was no significant difference in 'peak' neutralizing antibody titer (ID50) against Omicron between breakthrough group (median 2597.9) and non-breakthrough group (median 2597.9, p value=0.86). (Table Presented) Serum samples were obtained from 134 healthcare workers 2 weeks after booster vaccination. Samples were analysed for SARS-CoV-2 S1-specific IgG antibody titers using enzyme-linked immunosorbent assay (ELISA) and plasma levels of live-virus neutralizing antibodies using a microneutralization assay with SARS-CoV-2 omicron variants. There was no significant difference in 'peak' SARS-CoV-2 S1-specific IgG level (A) and 'peak' neutralizing antibody titer (ID50) against Omicron (B) between breakthrough group and non-breakthrough group. Conclusion. We did not find the correlation of neutralizing antibody titers about several months before infection with breakthrough Omicron infections. These data suggest rapidlywaning neutralizing titers to protect mild illnesses or asymptomaticOmicron infections several months after current booster COVID-19 vaccination in HCWs.

Clinical Characteristics and Vertical Transmission of Pregnant Women with SARS-CoV-2 Infection and Their Neonates

Background. Pregnant women with SARS-CoV-2 infection are known to have a poor prognosis. In addition, the previous meta-analysis revealed that SARS-CoV-2 infection in neonates born from pregnant women with SARS-CoV-2 infection is about 2%. However, there are limited data on the clinical characteristics of pregnant women with SARS-CoV-2 infection and their neonates and the vertical transmission rate in South Korea. Methods. Pregnant women confirmed as SARS-CoV-2 infection were retrospectively reviewed in Asan Medical Center from September 1 2020 to April 26 2022. All neonates from SARS-CoV-2-infected women underwent SARS-CoV-2 PCR within 24 hours after the birth and 48-hour interval if he or she stayed in the hospital. Results. A total of 60 pregnant women gave birth by cesarean section (n=40, 67%) or vaginal delivery (n=20, 33%). Among them, three women gave birth to twins (63 neonates). Delivery was carried out at the average gestational age of 268 days (+/- 14.0), and 9 patients (15%) had underlying diseases. Of these 60 patients, 11 (18%) received COVID-19 vaccination. Pneumonia was confirmed by chest radiograph in 7 patients (12%), and 2 patient (3%) required supplemental oxygen therapy who eventually recovered. The mean weight of 63 newborns was 3137 g (+/- 558), and 8 neonate (13%) was a low-birth weight (< 2500 g), and 12 neonate (19%) was premature (< gestational age 37 weeks). Apgar score was 8.1 points (+/- 1.2) at 1 minute and 9.1 points (+/- 0.8) at 5 minutes. Five neonates (8%) required mechanical ventilation, who eventually recovered. All 63 neonates revealed negative SARS-CoV-2 PCR results with 24 hours after the birth. After 48 hours, 45 newborns exhibited negative SARS-CoV-2 PCR results. So, there was no vertical transmission among 63 neonates (0%, 95% CI 0-6). Conclusion. Our experiences about pregnant women with SARS-CoV-2 infection revealed that obstetric outcomes were favorable and the vertical transmission risk was low. Balancing risks about the infection control of pregnant women and their neonates during the COVID-19 pandemic are needed.

Clinical scoring system to predict viable viral shedding in patients with COVID-19

Background. Centers for Disease Control and Prevention (CDC) recommends 5 to 20 days of isolation for COVID-19 patients depending on symptom duration and severity regardless of genomic PCR results or vaccination history. However, in real clinical practice, more individualized approach is required. We thus developed clinical scoring system to predict viable viral shedding in a given patient by using various factors affecting viable viral shedding. Methods. We prospectively enrolled adult patients with SARS-CoV-2 infection admitted to tertiary hospital and day care center between February 2020 and January 2022. The daily dense respiratory sampling (i.e. saliva, sputum, or nasopharyngeal swabs) during the hospital and day care center stay were obtained. Genomic RNA viral load and viral culture were performed for these samples. Clinical predictors of negative viral culture results were identified using survival analysis and multivariable analysis. Results. A total of 612 samples from 121 patients of varying degrees of severity were obtained. Of these, 494 (81%) samples were saliva, 63 (10%) were nasopharyngeal swab, and the remaining 55 (9%) were sputum. Of these 612 specimens, 154 (25%) samples revealed positive viral culture results. Univariate and multivariable Cox's time varying proportional hazard model revealed that symptom onset day, viral copy number, disease severity, organ transplant recipient, gender, and vaccination status were independently associated with viral culture results. We thus developed the 5-factor model from -3 to 3 points: viral copy number (-3 to 3 points depending on copy number), disease severity (1 point to moderate to critical diseases), organ transplant recipient (2 points), gender (-1 points to male), and vaccination status (-2 points to fully vaccinated status). The predictive culture-negative rates were calculated through the symptom onset day and the score of the day the sample was collected. Conclusion. Our clinical scoring system can provide objective probability of negative culture results in a given COVID-19 patient with genomic viral load, and appears to be useful to decide de-isolation policy depending on individualized factors associated with viable viral shedding beyond simple symptom-based isolation strategy by CDC.

Comparison of the causes of death in patients with delta variant versus omicron variant infections

Background. Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) variant strain B.1.1.529 (omicron) has been less virulent than SARS-CoV-2 B.1.617.2 variant (delta), but there are limited data on the comparison of the cause of death between delta variant and omicron variant infections. We thus compared the causes of death in COVID-19 patients with the delta variant and omicron variant. Methods. We retrospectively reviewed the medical records of adult patients with COVID-19 who were admitted at Asan Medical Center, Seoul, South Korea, between July 2021 and March 2022. We divided into delta-variant dominant period (from July 2021 to December 2021) and omicron-dominant period (from February 2022 to March 2022) with the exclusion of January 2022 because this period was overlapping of delta and omicron variant. The causes of death were classified into COVID-19-associated pneumonia, other causes, and indeterminate cause. Results. A total of 654 patients with COVID-19 were admitted and 42 (6.4%) died during the omicron dominant period (between February and March 2022), while a total of 366 patients with COVID-19 were hospitalized and 42 (11.5%) died during the delta dominant period (between July and December 2021). The primary cause of death was COVID-19-associated pneumonia in 64% (27/42) during the omicron era whereas that was COVID-19-associated pneumonia in 88% (37/42) during the delta era (p value=0.01) (Table 1). Conclusion. We found that about two thirds of patients with omicron variant infection died due to COVID-19, while the majority of patients with delta variant infection died due to COVID-19.

Bacterial Co-infection and Empirical Antibiotic Therapy in Patients with COVID-19

Background. Understanding the rate and composition of bacterial co-infection is important to determine antibiotic therapy in SARS-CoV-2 infection, but those vary according to healthcare settings and regional differences. We evaluated the rate of bacterial co-infection in hospitalized patients with COVID-19 in a single tertiary hospital in South Korea. Methods. In this retrospective study, all the adult patients with COVID-19 hospitalized between Feb 2020 and Dec 2021 were included. Bacterial co-infection rate was assessed by results of sputum cultures, blood cultures, pneumococcal urinary antigen, Legionella urinary antigen, sputum Legionella pneumophilia PCR, and sputum multiplex PCR for Mycoplasma pneumoniae and Chlamydia pneumoniae. Characteristics and outcomes of patients were evaluated according to antibiotics exposure prior to hospitalization. Results. Of 367 adult patients, 300 (81.7%) patients having sputum culture results were included in the analysis. Of these, 127 (42.3%) had a history of antibiotic exposure within 1 month before hospitalization. The coinfection rate within 48 hours of hospitalization was confirmed in 8.3% (25/300): 6.4% (11/163) of patients without prior antibiotic exposure and 11% (14/127) of patients with prior antibiotic exposure. In the group without prior antibiotic exposure, pathogens responsible for community-onset infections were isolated, whereas nosocomial pathogens were predominantly isolated in the antibiotic-exposed group. Empirical antibiotics were used in 144 (66%) of 275 patients without positive results for microbiological tests. Empirical antibiotic use in patients without positive results for microbiological tests was not significantly associated with 30-day mortality or in-hospital mortality after adjusting covariates including age, sex, comorbidity, anti-inflammatory treatment, and COVID-19 severity. Conclusion. In this study with a high rate of microbiological testing, bacterial coinfection was not frequent, and the results varied depended on previous exposure to antibiotics. Given the rarity of bacterial co-infection and the lack of potential benefits of empirical antibiotic therapy, the antibiotic use in patients with COVID-19 should be restricted as an important target of antibiotic stewardship. (Table Presented).

Data Driven Models for Contact Tracing Prediction: A Systematic Review of COVID-19

The primary objective of this research is to identify commonly used data-driven decision-making techniques for contact tracing with regards to Covid-19. The virus spread quickly at an alarming level that caused the global health community to rely on multiple methods for tracking the transmission and spread of the disease through systematic contact tracing. Predictive analytics and data-driven decision-making were critical in determining its prevalence and incidence. Articles were accessed from primarily four sources, i.e., Web of Science, Scopus, Emerald, and the Institute of Electrical and Electronics Engineers (IEEE). Retrieved articles were then analyzed in a stepwise manner by applying Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISM) that guided the authors on eligibility for inclusion. PRISM results were then evaluated and summarized for a total of 845 articles, but only 38 of them were selected as eligible. Logistic regression and SIR models ranked first (11.36%) for supervised learning. 90% of the articles indicated supervised learning methods that were useful for prediction. The most common specialty in healthcare specialties was infectious illness (36%). This was followed closely by epidemiology (35%). Tools such as Python and SPSS (Statistical Package for Social Sciences) were also popular, resulting in 25% and 16.67%, respectively. © 2023 by the authors. Licensee ESJ, Italy.

Trends in body mass index changes among Korean adolescents between 2005-2020, including the COVID-19 pandemic period: a national representative survey of one million adolescents.

OBJECTIVE: The impact of the coronavirus disease 2019 (COVID-19) pandemic on weight gain in children and adolescents remains unknown. We aimed to identify an estimated 15-year trend in mean body mass index (BMI) changes and prevalence of obesity and overweight among Korean adolescents from 2005 to 2020, including the period of the COVID-19 pandemic. PATIENTS AND METHODS: We analyzed data taken from a nationwide survey (Korea Youth Risk Behavior Survey), between 2005 and 2020. Representative samples of one million Korean adolescents aged 13-18 years (n=1,057,885) were examined. The 15-year trends in mean BMI and proportion of obesity or overweight, and the changes due to the COVID-19 pandemic were analyzed. RESULTS: The data of 1,057,885 Korean adolescents were analyzed (mean age: 14.98 years; females, 48.4%). The estimated weighted mean BMI was 20.5 kg/m2 [95% confidence interval (CI), 20.4-20.5] from 2005 to 2008 and 21.5 kg/m2 (95% CI, 21.4-21.6) in 2020 (during the COVID-19 pandemic). Although the 15-year trend of mean BMI gradually increased, the change in mean BMI before and during the pandemic significantly lessened (ßdiff, -0.027; 95% CI, -0.028 to -0.026). The 15-year (2005-2020) trend changes in the prevalence of obesity and overweight were similar (obesity prevalence from 2005-2008, 3.2%; 95% CI, 3.1-3.3 vs. obesity prevalence in 2020, 8.6%; 95% CI, 8.2-9.0; ßdiff, -0.309; 95% CI, -0.330 to -0.288). CONCLUSIONS: The 15-year trend of overall mean BMI and obesity and overweight prevalence demonstrated a significant increase; however, its slope decreased during the pandemic. These landmark results suggest the need for the development of precise strategies to prevent pediatric obesity and overweight during the COVID-19 pandemic.