Effect of socioeconomic disparities on the risk of COVID-19 in eight metropolitan cities, the Republic of Korea: a community-based study.

Objectives: Socioeconomic disparities have been reported as the main risk factors contributing to the spread of coronavirus disease 2019 (COVID-19) at the community level. We conducted an epidemiological study on the risk of COVID-19 incidence using area deprivation indices (DIs) depending on the characteristics of the susceptible population. Methods: The database of the confirmed COVID-19 cases in eight metropolitan cities, the Republic of Korea, from January 20, 2020 to December 31, 2021, was combined with the area DIs and standardized prevalence of diabetes and hypertension from the community health survey. The relative risk (RR) was estimated using a generalized linear model with Poisson distribution by age group. Results: The risk of COVID-19 incidence increased with the increasing age group, especially in patients aged ≥75 years. The RR per interquartile range increment of total social deprivation index (total SDI) was 1.54 (95% confidence interval [CI]: 1.34-1.70) in the COVID-19 incidence. Especially, the risk of COVID-19 incidence in the first wave was about three times higher in the region belonging to the lowest socioeconomic status than in the region with the highest socioeconomic status. The risk was 3.08 (95% CI: 2.42 to 3.78) based on the total SDI and 3.13 (95% CI: 2.53 to 3.83) based on the social deprivation index. Conclusion: This study provides scientific evidence that socioeconomic inequity is an important risk factor for the spread of COVID-19. This finding suggests that a mid-to-long-term strategy is needed for the susceptible population to reduce the burden of COVID-19 in the community.

Presenting characteristics and clinical outcome of patients with COVID-19 in South Korea: A nationwide retrospective observational study.

BACKGROUND: More than 13,000 cases were reported to be infected with COVID-19 by RT-PCR in South Korea. Most studies report clinical characteristics of hospitalized patients with COVID-19; the full spectrum of disease severity has thus not yet been well described. METHODS: Using retrospective observational methods, this study analyzed factors affecting early clinical symptoms, clinical progress, and severity of disease for COVID-19 positive patients released from quarantine to provide information on establishing optimized care for new patients. The medical data of 7803 laboratory-confirmed patients who had been discharged or died by April 30, 2020 were analyzed using multivariate logistic regression analysis. FINDINGS: On admission, 7383 (94•5%) patients were asymptomatic or showed mild illness, and 372 (4•8%) patients were severe illness. Also, 48 (0 0•6%) were hospitalized with critically ill when diagnosed. Most patients with asymptomatic or mild illness on admission remained mild until discharge, 253 (3•4%) progressed to severe illness, and 83 (1•1%) died in hospital. However, the case fatality were 29•8% and 62•5% in severe and critically ill patients, respectively. At admission, 73•0% of hospitalized patients had symptoms; most common were cough (42•5%), sputum (28•8%), and fever (20•1%). Only 35•2% of laboratory confirmed patients admitted to the temporary care facility complained of symptoms. Increasing odds of being critically ill was associated with older age (OR 28•93, 95% CI 13•34-62•75 for age >70y, vs. age <50 y; p<0•0001), being male (OR 2•15, 95% CI1•59-2•89; p<0•0001), fever (OR 2•52, 95% CI 1.84-3•45; p<0•0001), and shortness of breath (OR 7•40, 95% CI 5•37-10•19; p<0•0001). Comorbid illness significantly increased risk of critical illness or death. INTERPRETATION: Most cases were discharged as asymptomatic or recovered from mild illness, and only 9•7% developed severe disease requiring oxygen therapy or more. Case fatality rate was 2•9%, and markedly increased in those over age 50. Risk factors such as age, sex, fever, shortness of breath, and underlying disease can be useful in predicting future clinical severity. Additionally, the number of confirmed asymptomatic COVID-19 patients significantly contribute to continued spread. FUNDING: none.

Early Intervention Reduces the Spread of COVID-19 in Long-Term Care Facilities in the Republic of Korea.

This study describes the epidemiological characteristics of coronavirus disease 2019 (COVID-19) based on reported cases from long-term care facilities. As of April 20th, 2020, 3 long-term care facilities in a metropolitan area of South Korea had reported cases of COVID-19. These facilities' employees were presumed to be the sources of infection. There were 2 nursing hospitals that did not report any additional cases. One nursing home had a total of 25 cases, with an attack rate of 51.4% (95% CI 35.6-67.0), and a fatality rate of 38.9% (95% CI 20.3-61.4) among residents. The results from this study suggest that early detection and maintenance of infection control minimizes the risk of rapid transmission.