Changes in Otorhinolaryngologic Disease Incidences before and during the COVID-19 Pandemic in Korea.

This study aimed to investigate the change in the incidence and variance of otorhinolaryngologic diseases during the coronavirus disease 19 (COVID-19) pandemic. The entire Korean population (~50 million) was evaluated for the monthly incidence of 11 common otorhinolaryngologic diseases of upper respiratory infection (URI), influenza, acute tonsillitis, peritonsillar abscess, retropharyngeal and parapharyngeal abscess, acute laryngitis and bronchitis, stomatitis and related lesions, acute sinusitis, rhinitis, otitis media, and dizziness from January 2018 through March 2021 using the International Classification of Disease (ICD)-10 codes with the data of the Korea National Health Insurance Service. The differences in the mean incidence of 11 common otorhinolaryngologic diseases before and during COVID-19 were compared using the Mann-Whitney U test. The differences in the variance of incidence before and during COVID-19 were compared using Levene's test. The incidence of all 11 otorhinolaryngologic diseases was lower during COVID-19 than before COVID-19 (all p < 0.05). The variations in disease incidence by season were lower during COVID-19 than before COVID-19 for infectious diseases, including URI, influenza, acute tonsillitis, peritonsillar abscess, retropharyngeal and parapharyngeal abscess, acute laryngitis and bronchitis, acute sinusitis, and otitis media (all p < 0.05), while it was not in noninfectious diseases, including stomatitis, rhinitis, and dizziness. As expected, the incidences of all otorhinolalryngolgic diseases were decreased. Additionally, we found that seasonal variations in infectious diseases disappeared during the COVID-19 pandemic, while noninfectious diseases did not.

Depression, Stress, and Suicide in Korean Adults before and during the COVID-19 Pandemic Using Data from the Korea National Health and Nutritional Examination Survey.

This study investigated changes in the prevalence of depression, stress, and suicidal attempts during the COVID-19 pandemic. The ≥19-year-old population in the Korea National Health and Nutrition Examination Survey in 2019 and 2020 was included. The histories of depression, stress, and suicidal attempts were compared between the 2019 and 2020 cohorts using multiple logistic regression analysis with complex sampling. The prevalence of depression was not significantly different between the 2019 and 2020 groups (4.1% vs. 4.5%, p = 0.326). The prevalence of stress and suicide attempts was also not significantly different between groups (all p > 0.05). The rates of depression, stress, and suicide attempts were not associated with the 2020 group compared to the 2019 group (all p > 0.05). The 19- to 39-year-old group in the 2020 group indicated a higher rate of depression (diagnosed by physicians) than the 19- to 39-year-old group in the 2019 group (adjusted odds ratio = 1.58, 95% confidence intervals = 1.00-2.50, p = 0.049). The risks of depression, stress, and suicidal attempts were not related to the COVID-19 pandemic in Korean adults. A young adult population demonstrated an increased risk of depression associated with the COVID-19 pandemic.

Physical Activity and Sedentary Time in Korean Adults before and during the COVID-19 Pandemic Using Data from the Korea National Health and Nutritional Examination Survey.

Several recent studies suggested reduced physical activity (PA) related to the COVID-19 pandemic without consensus. This study investigated the changes in PA and sedentary time during the COVID-19 pandemic compared to before the COVID-19 era. The Korea National Health and Nutrition Examination Survey 2019 and 2020 were used. The ≥19-year-old population was examined in 2019 and 2020 for time spent engaging in high- and moderate-intensity PA and sedentary time. Based on the recommended level of PA by the World Health Organization, ≥75 min/wk of high PA and ≥150 min/of moderate PA were classified. A sedentary time of ≥120 min/d was selected. Multiple logistic regression analysis with complex sampling was conducted for ≥75 min/wk of high PA, ≥150 min/wk of moderate PA, and ≥120 min/d of sedentary time in the 2020 group compared to the 2019 group. The ≥75 min/wk high PA was not lower in the 2020 group than in the 2019 group (adjusted odds ratio (aOR) = 0.96, 95% confidence intervals (95% CIs) = 0.79-1.18, P = 0.696). The ≥150 min/wk of moderate PA was also not lower in the 2020 group (aOR = 1.12, 95% CI = 0.94-1.32, p = 0.201). However, the ≥150 min/wk of moderate PA in the female group was higher in the 2020 group than in the 2019 group (aOR = 1.29, 95% CI = 1.01-1.65, p = 0.042). Sedentary time ≥ 120 min/d was lower in the 2020 group (aOR = 0.35, 95% CI = 0.17-0.72, p = 0.005). This association was consistent in the 19-39-year-old and female group. In conclusion, during the COVID-19 pandemic, high and moderate PA were not decreased in Korean adults, while sedentary time was reduced.

Changes in the Incidence of Cardiovascular Diseases during the COVID-19 Pandemic in Korea.

There is scarcity in the evidence addressing the indirect impact of the COVID-19 pandemic on the epidemiology of CVDs. In this study we aimed to examine possible changes in the incidence of CVDs in Korea during the COVID-19 pandemic. ICD-10 codes of six common CVDs (cerebral hemorrhage, cerebral infarction, myocardial infarction, ischemic heart disease, cardiac failure, and arrhythmia) were collected from clinical visits between January 2018 and March 2021 using the National Health Insurance service database, which stores data on all citizens of Korea (~50 million people). The number and distribution of monthly visits for CVDs were compared before and during the COVID-19 pandemic, and the differences were analyzed using the Mann-Whitney U test and Levene's test. Our data showed similar incidences of cerebral hemorrhage and ischemic heart disease, a lower incidence of cerebral infarction, and higher incidences of myocardial infarction, cardiac failure, and arrhythmia during COVID-19. Despite statistical differences, the changes in incidences were not considered meaningful. The monthly incidences also remained similar throughout the year, without seasonal variations, both before and during the COVID-19 outbreak. This study found no significant changes in the incidences or monthly variation in CVDs due to the COVID-19 pandemic in Korea.

Changes in the Incidence Rates of Gastrointestinal Diseases Due to the COVID-19 Pandemic in South Korea: A Long-Term Perspective.

We investigated whether the coronavirus disease 2019 (COVID-19) pandemic, in conjunction with public health measures, influenced the incidence of gastrointestinal diseases according to age and sex during the pandemic. Changes in the monthly incidence rates (January 2018 to June 2021) of common gastrointestinal diseases were assessed using data from the Korean National Health Insurance Service by comparing the data of two periods: before COVID-19 (January 2018-February 2020) and during COVID-19 (March 2020-June 2021). The Mann-Whitney U test and Levene's test were used to compare the differences in the incidences before and during the pandemic. In the pandemic period, compared to in the pre-COVID-19 period, the incidence rates of ulcerative colitis, Crohn's disease, cholelithiasis, and esophageal reflux significantly increased, whereas those of infective enteritis and irritable bowel syndrome decreased, regardless of age or sex. There were no significant changes in the incidence rates of pancreatitis, acute appendicitis, liver cirrhosis, and hemorrhoids. No seasonal variations in gastrointestinal disease occurrence were observed. In conclusion, the COVID-19 pandemic may have had unprecedented and long-term impacts on the epidemiology of gastrointestinal disease. These changes may indicate a substantial future burden on healthcare resources during the recovery phase of the pandemic and thereafter.

Changes in the Mean of Medical Visits Due to Psychiatric Disease in Korean Children and Adolescents before and during the COVID-19 Pandemic.

The COVID-19 pandemic has been suggested to have adverse impacts on psychiatric disorders. This study aimed to investigate the changes in medical visits due to a wide range of psychiatric disorders in children during the COVID-19 pandemic. The medical visits of all Korean children and adolescents (0-19 years old) due to the 12 following psychiatric disorders were investigated: autism; attention-deficit/hyperactivity disorder (ADHD); depressive disorder; bipolar disorder; primary insomnia; schizophrenia; panic disorder; hypochondriasis; posttraumatic stress disorder (PTSD); anxiety disorder; anorexia nervosa; and adephagia. The mean medical visits before and during the COVID-19 pandemic were compared. The mean number of clinical visits due to autism, ADHD, depressive disorder, bipolar disorder, panic disorder, hypochondriasis, PTSD, anxiety disorder, and anorexia nervosa was higher during the COVID-19 pandemic than before the COVID-19 pandemic (all p < 0.05). The higher mean number of medical visits due to psychiatric disorders was maintained in age and sex subgroups. The female and adolescent groups demonstrated a higher mean number of medical visits due to psychiatric disorders during the COVID-19 pandemic. The medical visits due to many psychiatric disorders were higher during the COVID-19 pandemic than before COVID-19 in children and adolescents in Korea. Women and adolescents were more susceptible to psychiatric disorders during the COVID-19 pandemic.

Changes in the Mean of and Variance in Psychological Disease Incidences before and during the COVID-19 Pandemic in the Korean Adult Population.

The coronavirus disease 2019 (COVID-19) pandemic has been suggested to increase the risk of depression and anxiety disorders. This study expanded upon previous findings by estimating the changes in medical visits for various psychological disorders during the COVID-19 pandemic compared to before COVID-19. The entire Korean population ≥ 20 years old (~42.3 million) was included. The first COVID-19 case in Korea was reported on 20 January 2020. Thus, the period from January 2018 through to February 2020 was classified as "before COVID-19", and the period from March 2020 through to May 2021 was classified as "during COVID-19". Monthly medical visits due to the following 13 psychological disorders were evaluated: depressive disorder, bipolar disorder, primary insomnia, schizophrenia, panic disorder, hypochondriasis, posttraumatic stress disorder (PTSD), anxiety disorder, anorexia nervosa, addephagia, alcoholism, nicotine dependency, and gambling addiction were evaluated. The differences in the number of medical visits and the variance of diseases before and during the COVID-19 pandemic were analyzed using the Mann-Whitney U test and Levene's test. Subgroup analyses were conducted according to age and sex. The frequencies of medical visits for depressive disorder, bipolar disorder, primary insomnia, panic disorder, hypochondriasis, PTSD, anxiety disorder, anorexia nervosa, addephagia, and gambling addiction were higher during COVID-19 than before COVID-19 (all p < 0.001). However, the frequencies of medical visits for schizophrenia, alcoholism, and nicotine dependency were lower during the COVID-19 pandemic than before the COVID-19 pandemic (all p < 0.001). The psychological disorders with a higher frequency of medical visits during COVID-19 were consistent in all age and sex subgroups. In the old age group, the number of medical visits due to schizophrenia was also higher during COVID-19 than before COVID-19 (p < 0.001). Many psychological disorders, including depressive disorder, bipolar disorder, primary insomnia, panic disorder, hypochondriasis, PTSD, anxiety disorder, anorexia nervosa, addephagia, and gambling addiction, had a higher number of related medical visits, while disorders such as schizophrenia, alcoholism, and nicotine dependency had a lower number of related medical visits during COVID-19 among Korean adults.

Physical Activity Is Associated with a Lower Risk of Osteoporotic Fractures in Osteoporosis: A Longitudinal Study.

The purpose of our study was to examine the occurrence of osteoporotic fractures (fxs) according to the level of physical activity (PA) among osteoporosis using the Korean National Health Insurance Service (NHIS) customized database. From NHIS data from 2009 to 2017, osteoporosis was selected as requested. PA was classified into 'high PA' (n = 58,620), 'moderate PA' (n = 58,620), and 'low PA' (n = 58,620) and were matched in a 1:1:1 ratio by gender, age, income within the household unit, and region of residence. A stratified Cox proportional hazard model was used to calculate hazard ratios (HRs) for each type of fx comparing PA groups. The 'low PA' group was the reference group. For vertebral fx, the adjusted HR (95% confidence intervals (CIs)) was 0.27 (0.26-0.28) for the 'high PA' group and 0.43 (0.42-0.44) for the 'moderate PA' group. For hip fx, the adjusted HR (95% CIs) was 0.37 (0.34-0.40) for the 'high PA' group and 0.51 (0.47-0.55) for the 'moderate PA' group. For distal radius fx, the adjusted HR (95% CIs) was 0.32 (0.30-0.33) for the 'high PA' group and 0.46 (0.45-0.48) for the 'moderate PA' group. The results of this study suggest that a higher intensity of PA is associated with a lower risk of osteoporotic fxs, including vertebral fx, hip fx, and distal radius fx.

Physical Activity, Sunshine Duration, and Osteoporotic Fractures: A Nested Case-Control Study.

This study examined the associations between the occurrence of osteoporotic fractures in detailed sites and combined physical activity (PA) and sunshine duration (SD). Data from the Korean National Health Insurance Service-National Health Screening Cohort for 7-year periods and from the Korea Meteorological Administration were used. Osteoporotic fractures (n = 12,103), including vertebral fractures, hip fractures, and distal radius fractures, and matched controls (n = 24,206) were selected in 1:2 ratios by age, sex, income, and region of residence. PA was classified as moderate- to high-intensity PA (High PA) and low-intensity PA (Low PA). SD was classified as Short SD (<6.1 h) and Long SD (≥6.1 h). Conditional logistic regression was used to calculate the odds ratios (ORs) with 95%-confidence intervals (CIs) of the combined PA and SD groups for the occurrence of each osteoporotic fracture. Compared to 'Low PA + Short SD', the adjusted ORs (95% CIs) for vertebral fracture in 'High PA + Short SD' and 'High PA + Long SD' were 0.83 (0.76-0.91) and 0.84 (0.77-0.92), respectively. Hip/distal radius fractures were not associated with the combined PA and SD group. We suggest that a higher intensity of PA is inversely associated with the risk of vertebral fracture.

Infection control in operating rooms for COVID-19 patients

Background Surgeries performed for patients with coronavirus disease 2019 (COVID-19) place the medical staff at very high risk of infection. We suggest recommendations for appropriate operation preparation, anesthetic management, and infection control for COVID-19 patients in operating rooms. Current Concepts Surgeries must be performed in an airborne infection isolation room, such as a negative-pressure operating room. It is recommended that scheduled surgeries for COVID-19 patients be postponed to an acceptable extent, with the exception of emergency cases. Moreover, the number of medical staff participating in the surgery should be minimized. Medical staffs should practice proper hand hygiene and wear an appropriate level of personal protective equipment depending on the infection risk. While performing surgery and inducing anesthesia in COVID-19 patients, endotracheal intubation should be performed by trained anesthesiologists with a video laryngoscope, preferably using high-efficiency viral filters, which can prevent contamination in the anesthesia machine. Use of disposable equipment or COVID-19 patient-specific devices is recommended to prevent the spread of infection, but instruments that require sharing among multiple patients must be thoroughly cleaned and disinfected before their use for the next patient. Discussion and Conclusion: Medical staff performing surgeries for COVID-19 patients are at very high risk of infection. Therefore, the use of appropriate personal protective equipment, high-efficiency viral filters in breathing circuits during anesthesia, and disinfection of contaminated equipment after the operation are mandatory.