Hyperglycemia and Hypoglycemia Are Associated with In-Hospital Mortality among Patients with Coronavirus Disease 2019 Supported with Extracorporeal Membrane Oxygenation.

Metabolic abnormalities, such as preexisting diabetes or hyperglycemia or hypoglycemia during hospitalization aggravated the severity of COVID-19. We evaluated whether diabetes history, hyperglycemia before and during extracorporeal membrane oxygenation (ECMO) support, and hypoglycemia were risk factors for mortality in patients with COVID-19. This study included data on 195 patients with COVID-19, who were aged ≥19 years and were treated with ECMO. The proportion of patients with diabetes history among nonsurvivors was higher than that among survivors. Univariate Cox regression analysis showed that in-hospital mortality after ECMO support was associated with diabetes history, renal replacement therapy (RRT), and body mass index (BMI) < 18.5 kg/m2. Glucose at admission >200 mg/dL and glucose levels before ventilator >200 mg/dL were not associated with in-hospital mortality. However, glucose levels before ECMO >200 mg/dL and minimal glucose levels during hospitalization <70 mg/dL were associated with in-hospital mortality. Multivariable Cox regression analysis showed that glucose >200 mg/dL before ECMO and minimal glucose <70 mg/dL during hospitalization remained risk factors for in-hospital mortality after adjustment for age, BMI, and RRT. In conclusion, glucose >200 mg/dL before ECMO and minimal glucose level <70 mg/dL during hospitalization were risk factors for in-hospital mortality among COVID-19 patients who underwent ECMO.

Employment, Economic, and Sociodemographic Factors Associated with Changes in Smoking and Drinking Behaviors during the COVID-19 Pandemic in South Korea.

The societal disruptions resulting from the coronavirus disease 2019 (COVID-19) pandemic may have caused changes in smoking and alcohol consumption. Using data from the Koreans' Happiness Survey, a nationally representative survey in South Korea, we (1) described population-level smoking and drinking behaviors; (2) assessed changes in smoking and drinking behaviors during the COVID-19 pandemic; and (3) identified employment, economic, and sociodemographic factors associated with these changes using multinomial logistic regression. The overall amount of smoking and drinking decreased during the pandemic, but the changes were heterogeneous across subgroups. Male gender, receipt of the basic living allowance, self-employment, unemployment, and chronic disease status were associated with increased smoking, while higher household income, temporary worker status, living with someone (versus alone), and having fewer offline friends were associated with decreased smoking. Male gender, self-employment, living alone, having more offline friends, and chronic disease status were associated with increased drinking, while younger age, male gender, low and high household income (i.e., a U-shaped relationship), long-term rent with a deposit, temporary worker status, and chronic disease status were associated with decreased drinking. Our findings provide evidence on changes in smoking and drinking during the COVID-19 pandemic in South Korea and differential changes across subgroups.

Socio-demographic, psychological, and experiential predictors of COVID-19 vaccine hesitancy in South Korea, October-December 2020.

Vaccine hesitancy is the primary barrier to controlling the COVID-19 pandemic in South Korea. We used logistic multivariate regression modeling to investigate (1) the prevalence and reasons for COVID-19 vaccine hesitancy, (2) sub-groups that had higher rates of vaccine hesitancy, and (3) vaccine hesitancy predictors. We used a national survey of representatively sampled households (n = 13,021 adults) from October to December 2020. A self-report questionnaire asked about vaccination intention and reasons for hesitancy and gathered data on socio-demographic, demographic, psychological, and experiential factors. Our study indicated that 39.8% of the participants answered that they hesitated or refused to be vaccinated. The most common reason for vaccine hesitancy was a lack of confidence in the COVID-19 vaccine (77.9%). Less or no fear of COVID-19 (OR = 2.08, 95% CI = 1.92-2.26; OR = 1.79, 95% CI = 1.54-2.08), unstable job status (OR = 1.42, 95% CI = 1.18-1.70), decreased family income (OR = 1.40, 95% CI = 1.21-1.61), and worsening health status (OR = 1.38, 95% CI = 1.13-1.68) were predictors of vaccine hesitancy. Younger age, no religious affiliation, political conservatism, and lower family income were also significantly associated with vaccine hesitancy. Effective health communication and policies need to consider the target subgroup population and predictors of vaccine hesitancy to attain herd immunity at an early stage.

Extracorporeal Membrane Oxygenation for Coronavirus Disease 2019: Expert Recommendations from The Korean Society for Thoracic and Cardiovascular Surgery.

Since the first reported case of coronavirus disease 2019 (COVID-19) in December 2019, the numbers of confirmed cases and deaths have continued to increase exponentially despite multi-factorial efforts. Although various attempts have been made to improve the level of evidence for extracorporeal membrane oxygenation (ECMO) treatment over the past 10 years, most experts still hesitate to take an active position on whether to apply ECMO in COVID-19 patients. Several ECMO management guidelines have been published recently, but they reflect some important differences from the Korean medical system and aspects of real-world medical practice in Korea. We aimed to find evidence on the efficacy of ECMO for COVID-19 patients by reviewing the published literature and to propose expert recommendations by analyzing the Korean COVID-19 ECMO registry data.