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1.
Frontiers in Psychiatry ; 13, 2022.
Article in English | Web of Science | ID: covidwho-2022918

ABSTRACT

BackgroundDelirium is a neuropsychiatric condition strongly associated with poor clinical outcomes such as high mortality and long hospitalization. In the patients with Coronavirus disease 2019 (COVID-19), delirium is common and it is considered as one of the risk factors for mortality. For those admitted to negative-pressure isolation units, a reliable, validated and contact-free delirium screening tool is required. Materials and methodsWe prospectively recruited eligible patients from multiple medical centers in South Korea. Delirium was evaluated using the Confusion Assessment Method (CAM) and 4'A's Test (4AT). The attentional component of the 4AT was modified such that respondents are required to count days, rather than months, backward in Korean. Blinded medical staff evaluated all patients and determined whether their symptoms met the delirium criteria of the Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5). An independent population of COVID-19 patients was used to validate the 4AT as a remote delirium screening tool. We calculated the area under the receiver operating characteristic curve (AUC). ResultsOut of 286 general inpatients, 28 (9.8%) inpatients had delirium. In this population, the patients with delirium were significantly older (p = 0.018) than the patients without delirium, and higher proportion of males were included in the delirium group (p < 0.001). The AUC of the 4AT was 0.992 [95% confidence interval (CI) 0.983-1.000] and the optimal cutoff was at 3. Of the independent COVID-19 patients, 13 of 108 (12.0%) had delirium. Demographically, the COVID-19 patients who had delirium only differed in employment status (p = 0.047) from the COVID-19 patients who did not have delirium. The AUC for remote screening using the 4AT was 0.996 (0.989-1.000). The optimal cutoff of this population was also at 3. ConclusionThe modified K-4AT had acceptable reliability and validity when used to screen inpatients for delirium. More importantly, the 4AT efficiently screened for delirium during remote evaluations of COVID-19 patients, and the optimal cutoff was 3. The protocol presented herein can be used for remote screening of delirium using the 4AT.

2.
Innovation in Aging ; 5:438-439, 2021.
Article in English | Web of Science | ID: covidwho-2011747
3.
Computational and Structural Biotechnology Journal ; 20:3533-3544, 2022.
Article in English | Web of Science | ID: covidwho-1977168

ABSTRACT

Both novel and conventional vaccination strategies have been implemented worldwide since the onset of coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Despite various medical advances in the treatment and prevention of the spread of this contagious disease, it remains a major public health threat with a high mortality rate. As several lethal SARS-CoV-2 variants continue to emerge, the development of several vaccines and medicines, each with certain advantages and disadvantages, is underway. Additionally, many modalities are at various stages of research and development or clinical trials. Here, we summarize emerging SARS-CoV-2 variants, including delta, omicron, and "stealth omicron," as well as available oral drugs for COVID-19. We also discuss possible antigen candidates other than the receptor-binding domain protein for the development of a universal COVID-19 vaccine. The present review will serve as a helpful resource for future vaccine and drug development to combat COVID-19.(c) 2022 The Author(s). Published by Elsevier B.V. on behalf of Research Network of Computational and Structural Biotechnology. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

4.
Gastroenterology ; 162(7):S-1280, 2022.
Article in English | EMBASE | ID: covidwho-1967446

ABSTRACT

Background & Aims: Prior studies have indicated the presence of hepatic inflammation (as signified by elevated liver function test (LFT) values), as conferring an escalated risk toward adverse outcomes in patients admitted with COVID-19. In line with this hypothesis, we study the various thresholds of LFTs and its associated prognostic risks toward COVID- 19 related hospital deaths Method: This was a single-center retrospective study involving patients admitted with COVID-19. Univariate Cox regression analysis identified the LFT variables significantly associated with our primary endpoint, in-hospital death. Subsequently, 500 iterations of thresholds were generated for each biomarker to estimate the prognostic relationship between biomarker and endpoint. Multivariate Cox regression and event-analyses were performed for each threshold to identify the minimal cutoffs at which the prognostic relationship was significant. Event curves were drawn for each significant relationship. Results: A total of 858 patients with COVID-19 were included with a median follow-up time of 5 days from admission. From the total, 90 patients passed away during admission (10.5%). The deceased cases were more likely to be older (66.2 vs 55.3y p<0.001);however, there was no difference in gender (male: 66 vs 56.2% p=0.11). Between the cases and controls (no-death), deceased cases had higher incidence of nonalcoholic fatty liver disease (7.78 vs 2.99% p=0.042), COPD (18.9 vs 7.80% p=0.001), lung cancer (4.44 vs 0.65% p= 0.009), ICU admissions (81.1 vs 26% p<0.001), and intubation events (84.4 vs 19.5% p<0.001), however there was no difference in alcohol use (21.1 vs 30.6% p=0.083) and alcoholic liver disease (5.56 vs 2.08% p=0.097). Upon univariate Cox analysis, the following LFT parameters were associated with in-hospital death: Bilirubin (p<0.001), AST (p<0.001), ALT (p<0.001). However, alkaline phosphatase (p=0.449) was not associated with the primary endpoint. The iterations of event regression analyses using 500 sequences of LFT thresholds showed the following cutoffs to be significantly associated with in-hospital death (minimally significant values): ALT (281.71 IU/L), AST (120.94 IU/L), bilirubin (2.615 mg/ dL). On the multivariate analysis, while controlling for demographics and cardiopulmonary/ medical comorbidities, the following adjusted hazard ratios were derived for each cutoff: ALT (aHR: 6.43 95%CI 1.85-22.40), AST (aHR: 3.35 95%CI 1.84-6.11), and bilirubin (aHR: 2.77 95%CI 1.15-6.65). Conclusion: The delineated cutoffs for AST, ALT, and bilirubin levels can serve as clinical benchmarks to help determine when a COVID-19 infection poses significant risk. Given this finding, the cutoffs can be used as part of a risk assessment for patients to support early preventative therapies and medical management. (Table Presented)

5.
Gastroenterology ; 162(7):S-1279-S-1280, 2022.
Article in English | EMBASE | ID: covidwho-1967445

ABSTRACT

Background and Aims: While the relationship between elevated liver enzymes and COVID- 19 related adverse events is well-established, a liver-dependent prognostic model that predicts the risk of death is helpful to accurately stratify admitted patients. In this study, we use a bootstrapping-enhanced method of regression modeling to predict COVID-19 related deaths in admitted patients. Method: This was a single-center, retrospective study. Univariate and multivariate Cox regression analyses were performed using 30-day mortality as the primary endpoint to establish associated hepatic risk factors. Regression-based prediction models were constructed using a series of modeling iterations with an escalating number of categorical terms. Model performance was evaluated using receiver operating characteristic (ROC) curves. Model accuracy was internally validated using bootstrapping-enhanced iterations. Results: 858 patients admitted to hospital with COVID-19 were included. 78 were deceased by 30 days (9.09%). Cox regression (greater than 20 variables) showed the following core variables to be significant: INR (aHR 1.26 95%CI 1.06-1.49), AST (aHR 1.00 95%CI 1.00- 1.00), age (aHR 1.05 95%CI 1.02-1.08), WBC (aHR 1.07 95%CI 1.03-1.11), lung cancer (aHR 3.38 95%CI 1.15-9.90), COPD (aHR 2.26 95%CI 1.21-4.22). Using these core variables and additional categorical terms, the following model iterations were constructed with their respective AUC;model 1 (core only): 0.82 95%CI 0.776-0.82, model 2 (core + demographics): 0.828 95%CI 0.785-0.828, model 3 (prior terms + additional biomarkers): 0.842 95%CI 0.799-0.842, model 4 (prior terms + comorbidities): 0.851 95%CI 0.809-0.851, model 5 (prior terms + life-sustaining therapies): 0.933 95%CI 0.91-0.933, model 6 (prior terms + COVID-19 medications): 0.934 95%CI 0.91-0.934. Model 1 demonstrated the following parameters at 0.91 TPR: 0.54 specificity, 0.17 PPV, 0.98 NPV. Bootstrapped iterations showed the following AUC for the respective models: model 1: 0.82 95%CI 0.765-0.882, model 2 0.828 95%CI 0.764-0.885, model 3 0.842 95%CI 0.779-0.883, model 4: 0.851 95%CI 0.808-0.914, model 5: 0.933 95%CI 0.901-0.957, model 6: 0.934 95%CI 0.901- 0.961. Conclusion: Model 1 displays high prediction performance (AUC >0.8) in both regression-based and bootstrapping-enhanced modeling iterations. Therefore, this model can be adopted for clinical use as a calculator to evaluate the risk of 30-day mortality in patients admitted with COVID-19. (Table Presented)

7.
Applied Chemistry for Engineering ; 33(1):83-89, 2022.
Article in Korean | Scopus | ID: covidwho-1761287

ABSTRACT

Since the pandemic of COVID-19, active investigation to develop immunity to infectious disease by delivering nucleic acids has been proceeded. Particularly, many studies have been conducted on non-viral vector as several vital side-effects which were found on nucleic acid delivery system using viral vectors. In this study, we have developed plasmid DNA (pDNA) load-ed-hyaluronic acid derivative (HA) coated-polyethyleneimine (PEI) based polyplex for enhanced nucleic acid delivery efficiency. We have optimized the ratio of pDNA: PEI: HA by measuring size and protein transcription efficiency. The final product, polyplex-HA, was characterized through measuring size, zeta-potential and TEM image. Intracellular uptake and protein transcription efficiency were compared to commercially available transfection reagent, lipofectamine, through fluo-rescence image and flow cytometry. In conclusion, polyplex-HA presents a novel gene delivery system for efficient and stable protein transcription since it is available for delivering various genetic materials and has less immunoreactivity. © 2022, Korean Society of Industrial Engineering Chemistry. All rights reserved.

8.
Global Business and Finance Review ; 26(3):111-123, 2021.
Article in English | Scopus | ID: covidwho-1614394

ABSTRACT

Purpose: To weather the Covid-19 crisis and remain sustainable, restaurants need the trust of their customers. This study tested the impact of value similarity and preventive measures on customer trust and examined the impact of customer trust on customer cooperation. This study investigated the moderating effect of risk perception between study constructs. Design/methodology/approach: A web-based survey was administered to U.S. restaurant customers. For the main study, among the 240 surveys obtained, 218 usable responses remained after screening. Multiple regression and hierarchical regression analyses were conducted to test the research hypotheses. Findings: The results indicated that value similarity and preventive measures were significant predictors in under-standing customer trust in restaurants during Covid-19. It also demonstrated that restaurants’ preventive measures were a stronger determinant than value similarity in predicting customer trust, which significantly influenced customer cooperation behavior. Hierarchical regression analysis revealed that risk perception moderated the relationship between preventive measures and customer trust. The effect of preventive measures on customer trust was greater for customers with a high level of risk perception than with those with a lower one. Research limitations/implications: The measurements of two antecedents of trust― value similarity and preventive measures― require further testing to confirm their validity and reliability in future research due to incomplete examination in prior hospitality studies. Originality/value: This study contributes to the existing knowledge by elucidating the strong impacts of both fac-tors, value similarity and preventive measures, which were found to be contributory factors of customer trust during the crisis. The findings have meaningful implications for restaurant managers who take actions against the Covid-19 crisis to achieve sustainable business growth. © 2021 People and Global Business Association.

9.
Aerosol and Air Quality Research ; 21(9):14, 2021.
Article in English | Web of Science | ID: covidwho-1497589

ABSTRACT

In March 2020, the average concentration of PM2.5 in Seoul decreased by 44% compared to that in March 2019 (from 45 mu g m(-3) to 25 mu g m(-3)). In this study, the synoptic and local meteorological conditions during the period with reduced PM2.5 concentrations were analyzed. The synoptic meteorological conditions during March 2020 show a common characteristic of strong zonal flow and winds. Therefore, air circulation was active and meteorological conditions were unfavorable to long-range transboundary transport. Local meteorological conditions such as wind and turbulent motion at the surface were sensitive to PM2.5 concentrations. Our analyses indicate that the greatly reduced PM2.5 concentrations were mainly influenced by synoptic rather than local conditions. Decreased demand for heating of buildings due to warmer temperatures in March 2020, the economic slowdown following the outbreak of COVID-19, and the implementation of guidelines aimed at controlling particulate matter (PM) were other important causes of reduced PM2.5 emissions. A decrease in long-range transboundary transport contributed to the reduced PM2.5 concentrations.

10.
International Journal of Infectious Diseases ; 17:17, 2021.
Article in English | MEDLINE | ID: covidwho-1210241

ABSTRACT

BACKGROUND: Complete contact tracing of COVID-19 patients in Korea allows a unique opportunity to investigate cluster characteristics. This study aimed to investigate all the reported COVID-19 clusters in Seoul Metropolitan area from January 23 to September 24, 2020. METHODS: Publicly available COVID-19 data was collected from the Seoul Metropolitan city and Gyeonggi Province. Community clusters with >= 5 cases were characterized by size and duration and then categorized using K-means clustering, and the correlation between the types of clusters and the level of social distancing was investigated. RESULTS: A total of 134 clusters including 4,033 cases were identified. The clusters were categorized into small (Type I, II), medium (type III), and large (type IV) clusters. With the same number of daily confirmed cases, cases were composed of different types of clusters by different periods of time. Raising social distancing was related with shifting types of clusters from large to small sized clusters. CONCLUSIONS: Classification of clusters may provide opportunities to better portray the pattern of COVID-19 outbreaks and implement more effective strategies. Social distancing administered by the government may be effective in suppressing large clusters but may not be effective in controlling small and sporadic clusters.

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