Performance of Indicators Used in the Regular Risk Assessment for Covid-19

Intro: Since November 2021, gradual changes in non-pharmaceutical interventions (NPI) had begun in consideration of the socio-economic cost and the high rate of COVID-19 vaccination. As an effort to monitor the COVID-19 situation and the effect of NPIs, regular risk assessment for COVID-19 has been conducted based on the input from the external advisory committee. This paper examines the correlation between the risk assessment results and other indicators, such as the incidence of COVID-19, public perception, community mobility, and the government policy from November 2021 to May 2022. Method(s): For weekly regular risk assessment of COVID-19, the data were collected from the National Infectious Disease Surveillance System website, which included incidence, mortality, and % of severe cases. Other indicators were from regular surveys on perceived risk among the public, community mobility from the Google website, and the government's response policy from The Oxford Stringency Index. The level of risk was classified into five levels from very low to very high. The level of COVID-19 risk and its correlation with the COVID-19 incidence, risk perception, community mobility, and government policy were examined. Finding(s): The result of the correlation analysis showed the highest positive correlation between the risk level and risk perception (r=0.86, CI 0.72-0.94). This indicates that the actual risk level and the risk perceived by the public are similar. Among the incidence-related indicators, the number of new severe cases of COVID-19 per week showed the highest correlation with the risk level (r=0.62, CI 0.33-0.80). Conclusion(s): The high correlation between the weekly severe cases and the overall COVID-19 risk level suggests that Korea's COVID-19 policy priority was mainly at protecting the high-risk populationCopyright © 2023

Inadvertent Treatment of a Vertical Banded Gastroplasty Stricture With a LAMS for Two Years

Introduction: Lumen-apposing metal stents (LAMS) are innovative endoscopic devices representing the next significant advancement in stent technology. LAMS have demonstrated success, most notably with improving drainage of pancreatic fluid collections. Other clinical indications for using LAMS include biliary drainage, gastroenterostomy, or the managment of luminal tract strictures. The stent has a larger lumen diameter than previously created stents as well as a unique "dumbbell" shape to limit migration. Studies have demonstrated advantages such as shorter procedure times and overall reduced repeat endoscopic procedures. As LAMS has gained notoriety, there have been increasing studies demonstrating potential complications of the device. Most common consequences of LAMS include bleeding, biliary stricture, and buried LAMS syndrome. As the anatomical design has decreased migration risk, prompt removal is recommended to prevent buried LAMS syndrome, where the stent is embedded in the wall of the gastric mucosa and can eventually not be visualized endoscopically. In this case, we will present a patient with an endoscopically placed LAMS, which was successfully removed with minimal complications after two years in place. Case Description/Methods: Our patient is a 68 year old female with a Vertical Banded Gastroplasty Stricture. She had required multiple repeat endoscopies for dilation therapy but the stricture was refractory to dilation, as a result, she underwent LAMS placement Due to the onset of the COVID pandemic, patient was lost to follow up. On a repeat EGD two years after placement, the stent remained in its original location. There were signs of mild gastric tissue overgrowth at the right lateral side of the LAMS. The stent was then removed easily with no signs of bleeding. After removal, the stricture remained dilated as the scope could be passed without difficulty. Over course of COVID she ate better than she had in years. (Figure) Discussion: LAMS have demonstrated significant success in a variety of endoscopic interventions. Their potential complications are well documented in various studies. This case is unique in regards to the length of time in which the LAMS remained in position. From a literature review, no study has demonstrated a LAMS in place as long as two years for stricture management. More remarkable is the lack of complications from the stent such as no bleeding with removal and no true buried LAMS syndrome as there was minimal tissue overgrowth. (Figure Presented).

Informing Decision-Makers on Preparedness and Response to Public Health Threats: Event-Based Surveillance and Rapid Risk Assessment of Infectious Diseases in the Republic of Korea

Intro: Event-based surveillance (EBS) and rapid risk assessment (RRA) are essential tools for the early warning system against outbreaks, especially in the initial stages of an incident of potential public health threat. Since the Middle East respiratory syndrome outbreak in 2015, Korea Disease Control and Prevention Agency (KDCA) established EBS and RRA systems. This paper described KDCA's implementation of EBS and RRA to support the decision-making process for acute public health events. Method(s): The process of EBS and RRA systems for potential public health threats occurring outside of Korea is described and potential barriers and challenges are discussed. Finding(s): EBS and RRA systems have been constantly utilized in Korea. One of the recent examples is the EBS and RRA activities for acute hepatitis of unknown etiology in children and the global monkeypox outbreak which provided the basis to establish timely surveillance and response systems. Discussion(s): EBS tends to rely heavily on access to timely information. The quality of information needs to be ensured through a verification process by trained personnel as the quality of information determines the credibility of EBS results. Efforts to strengthen the information coverage and enhance the quality of information are key elements of EBS and RRA. Standardized manuals and systematic implementation of the EBS and RRA enable a more accurate evaluation of the risk. The process of RRA also needs flexibility in the way the risk is estimated. Conclusion(s): Public health threats are more likely to be imported than before as exchanges among countries grow frequent due to the eased border control measures for COVID-19 in recent days. The EBS and RRA systems are essential tools for all countries to ensure a timely response. Efforts to improve access to timely information and to ensure the quality of information should be continuously made to improve EBS and RRA systems.Copyright © 2023

Monitored Anesthesia Care in Uterine Artery Embolization for Leiomyomas and Adenomyosis

Background: Patients undergoing an interventional radiology procedure report some degree of anxiety. Therefore, procedure-related anxiety needs to be managed. The aim of our study was to investigate patient satisfaction with monitored anesthesia care (MAC) for uterine artery embolization (UAE)-related procedural anxiety in symptomatic uterine fibroids or adenomyosis. Method(s): Between May 2021 and June 2022, 36 patients with symptomatic fibroids or adenomyosis underwent UAE with MAC. Follow-up evaluations consisted of clinical symptoms, degree of satisfaction with MAC in UAE, and complications. Result(s): MAC in UAE was successfully performed in all patients. UAE significantly reduced patients' complaints such as bleeding and pain: the scores for bleeding and pain were significantly reduced after 3 months of UAE compared with those before UAE, indicating the effectiveness of UAE. The mean score of satisfaction with MAC in UAE was 4.3 points, meaning that 94.4% of women were satisfied or very satisfied. No major complications were observed. Conclusion(s): MAC in UAE for symptomatic uterine fibroids or adenomyosis can be emotionally effective and safe for patients who are anxious about the procedure.Copyright © 2023 The Author(s).

Factors Influencing Post-traumatic Growth of Nurses at Nationally Designated Infectious Disease Hospital

Purpose: This study aimed to identify the factors that affect post-traumatic growth among frontline nurses during a COVID-19 pandemic. Methods: This study included 187 nurses working in nationally designated infectious disease hospitals as participants. Data were collected from January 11 to March 2, 2021 using structured questionnaires. Independent t-tests, one-way ANOVA, Pearson correlation coefficients, and hierarchical multiple regressions were performed to examine influencing factors of post-traumatic growth. Results: Posst-traumatic growth was positively correlated with traumatic event experience (r=.26, p<.001), post-traumatic stress (r=.32, p<.001), supervisor support (r=.39, p<.001), and colleague support (r=.36, p<.001). Factors affecting post-traumatic growth were emotional support of supervisors (β=.76, p<.001) and evaluative support of colleagues (β=.46, p<.018). Overall, approximately 40.0% of the variability in post-traumatic growth was explained by these two variables. Conclusion: To increase emotional support of supervisors and evaluative support of colleagues, the most influential factors for post-traumatic growth of frontline nurses who fought against COVID-19, a positive culture must be established. This includes horizontal communication, a safe working environment, and securing of appropriate nurse to patient ratio. © 2022 Korean Academy of Nursing Administration

Spontaneous Hematoma of Upper Extremities in a Patient with Antiphospholipid Antibody Syndrome: A Case Report

A 44-year-old woman with underlying systemic lupus erythematosus and antiphospholipid antibody syndrome presented with nausea and vomiting after her 2nd vaccination for coronavirus disease 2019 (COVID-19). Thirteen days after warfarin injection was administered along with steroid therapy, the patient suffered sudden right shoulder pain, paresthesia, and swelling, suggesting acute compartment syndrome. The warfarin regimen was bridged to low molecular weight heparin and fasciotomy was performed. Multiple hematoma evacuation after fasciotomy was done and the patient was referred for skin necrosis. Frequent debridement and negative pressure wound therapy were performed to heal the right upper extremity skin defect. Afterwards, the patient experienced hemorrhage in her left upper extremity and was treated conservatively with simple compression. This report suggests that patients undergoing anticoagulation therapy for antiphospholipid syndrome should be closely monitored for subcutaneous hemorrhage, and that prompt diagnosis and treatment may prevent adverse re-sults. If massive skin necrosis occurs, multiple surgical debridement procedures and application of negative pressure wound therapy may be an option. © 2022 Korean Wound Management Society.

Experiment assisting system with local augmented body (EASY-LAB) in dual presence environment

This paper introduces a system designed to support conducting experiments of subjects when the situation does not allow experimenter and subject to be in the same place such as the COVID19 pandemic where everyone relied on video conference applications which has its limitation. Due to the difficulty of directing with a video conferencing system using solely video and voice. The system we developed allows an experimenter to actively watch and interact with the subject. Even if you're operating from a distant area, it is still possible to conduct experiments. Another important aspect this study will focus on is the case of when there are several subjects required and the experimenter must be able to guide both subjects equally well. The system proposed uses a 6 DoF robotic arm with a camera and a laser pointer attached to it on the subject side. The experimenter uses a head-mounted display to control it and it moves corresponding to the head movement allowing for easy instruction and intervention to the subject side. Comparison with other similar research is also covered. The study will focus mainly on which viewing method is the easiest for the experimenter to use, and if teaching one subject at the time gives better results than teaching two subjects simultaneously. © 2022 International Measurement Confederation (IMEKO). All rights reserved.

Safety and clinical efficacy outcomes from the Long-term extension study of tolebrutinib in patients with relapsing multiple sclerosis: 2-year results

Introduction: Phase 2b trial (NCT03889639) findings in patients with relapsing multiple sclerosis showed central nervous systempenetrant Bruton's tyrosine kinase inhibitor tolebrutinib was well tolerated over 12 weeks and elicited dose-dependent reductions in new gadolinium-enhancing T1 and new/enlarging T2 lesions. Objective/Aim: To characterise tolebrutinib's safety and efficacy at Week 96 (2 years) in the phase 2b trial's long-term safety (LTS) extension (NCT03996291). Method(s): In LTS extension Part A, patients continued their core study tolebrutinib dose (5, 15, 30, or 60 mg/day) double-blind until the phase 3 study dose selection (60 mg/day). In Part B, patients received open-label tolebrutinib 60 mg/day. Safety was assessed via adverse event (AE) reporting. Efficacy outcomes included annualised relapse rate (ARR) and change from baseline Expanded Disability Status Scale (EDSS) score. Result(s): 124 of 125 patients completed Part A and transitioned to Part B;114 (90.5%) remained on study as of 7 March 2022. One patient receiving tolebrutinib 5 mg/day discontinued Part A because of progressive disease and 10 discontinued Part B because of AEs (n=3), perceived lack of efficacy (n=4), emigration (n=2), and patient decision (n=1). At Week 96, no new safety signals have been observed. The most common treatment-emergent AEs (TEAEs) were COVID-19 (20.8% [26/125]), headache (13.6% [17/125]), nasopharyngitis and upper respiratory tract infection (both 11.2% [14/125]), bacterial cystitis (7.2% [9/125]), and pharyngitis and arthralgia (both 5.6% [7/125]). No tolebrutinib dose effects for TEAEs or serious AEs were observed in Part A and no safety signals emerged for patients switching to tolebrutinib 60 mg/day in Part B. Of those who received tolebrutinib 60 mg/day for a minimum of 8 weeks, ARR was 0.17 (95% CI: 0.12, 0.25) and 80.6% remained relapse-free. Mean EDSS remained stable to Week 96. Conclusion(s): Through LTS Week 96, tolebrutinib 60 mg/day continues to show favourable safety, and is associated with a low ARR and stable disability status.

MRI, efficacy, and safety of tolebrutinib in patients with highly active disease (HAD): 2-year data from the phase 2b Long-term safety (LTS) Study

Intoduction: In the phase 2b trial (NCT03889639), brain-penetrant Bruton's tyrosine kinase inhibitor tolebrutinib was well tolerated with dose-dependent reductions in new/enlarging MRI lesions. Objective/Aim: Report MRI, efficacy, and safety outcomes at Week (W)96 (2 years) of the phase 2b trial long-term safety (LTS) extension (NCT03996291) in relapsing MS patients with highly active disease (HAD). Method(s): In the double-blind portion of LTS (Part A), patients continued their core study tolebrutinib dose (5, 15, 30, or 60 mg/day). In the open-label Part B, all participants received 60 mg/day. HAD was defined as one relapse in the year prior to screening and one of the following: >1 gadolinium (Gd)- enhancing lesion within the prior 6 months, or >=9 T2 lesions at baseline (BL) or >=2 relapses in the prior year. Outcomes included Gd-enhancing and new/enlarging T2 lesions, annualized relapse rate (ARR), and Expanded Disability Status Scale (EDSS) score. Result(s): 61 patients met the HAD criteria at BL;60 continued in LTS Part A and 59 transitioned to Part B. As of 7 March 2022, 55 (92%) patients remained on study. New Gd-enhancing lesion counts remained low in the 60/60-mg arm through W96 and were reduced in other arms by W48 through W96, except for 5/60 at W96 (mean+/-SD at W96: 2.00+/-3.83, 0.56+/-1.04, 0.47+/-1.13, 0.23+/-0.44 in 5/60-, 15/60-, 30/60-, 60/60-mg arms, respectively). New/enlarging T2 lesion counts remained low for 15/60, 30/60, and 60/60 mg. T2 lesion volume remained unchanged for 60/60 mg. The most common treatment-emergent adverse events (TEAE) were COVID-19 (20%), nasopharyngitis (16.7%), headache (13.3%), and upper respiratory tract infection (8.3%). There was no dose-relationship for TEAE/serious AE in Part A and no new safety findings for patients switching to 60 mg in Part B. Of the patients who received tolebrutinib 60 mg/day for a minimum of 8 weeks, ARR was 0.10 (95% CI: 0.02, 0.66) and 92.9% remained relapse-free at W96. Mean EDSS scores were stable through W96. Conclusion(s): Through LTS Week 96, in the HAD cohort, tolebrutinib 60 mg demonstrated favourable safety (similar to the overall population), tolerability, and low ARR. New Gd-enhancing lesion counts remained low for the 60/60-mg arm.

Topic and Trends of Public Perception and Sentiments of COVID-19 Pandemic in South Korea: A Text Mining Approach

Objectives: Public health risks and anxiety have been increasing since the outbreak of Coronavirus disease 19 (COVID-19). The public expresses questions related to the COVID-19 issue through the web base. The aim of this study was to analyze public perception and sentiments of COVID-19 Pandemic in South Korea. Methods: We collected the text data (questions: 252, 181) related to COVID-19 from Naver Knowledge-iN during January 1, 2020 to December 31, 2020. The search keywords included related to COVID-19 using Korean words for “SARS-Cov-2”, “COVID19”, “COVID-19”, “Wuhan pneumonia”, “Coronavirus”, “Corona”. A topic modeling analysis was used to investigate and search trends of public perception. The sentiment analysis was conducted to analyze of public emotions in the questions related to COVID-19. We performed the Pearson's correlation analysis between daily number of COVID-19 cases and daily proportion of negative sentiment in documents related to COVID-19 by COVID-19 outbreak period. Results: A total of 241, 776 documents used in this study. The most frequent words in the documents to appear cough, symptoms, tests, confirmed patients, mask and etc. Twenty topics (COVID-test, Economy, School, Hospital/Diagnose, Travel/Overseas, Health, Social issue, Symptom 1 (respiratory), Relationships, Symptom 2 (e.g., fever), Workplace, Mask/Social distancing, infection/Vaccine, Stimulus Package, Family, Delivery Service, Unclassified, Region, Study/Exam, Worry, Anxiety) were extracted using the topic modeling. There was a positive association between the daily counts of COVID-19 patients and proportion of negative sentiment. By COVID-19 period, Stage 4 had the highest correlation. Conclusion: This study identified the South Korean public's interest and emotions about COVID-19 during the prolonged pandemic crisis.

Telehealth utilization in gynecologic oncology clinical trials (295)

Objectives: In light of the COVID-19 pandemic, the Society of Gynecologic Oncology (SGO), National Cancer Institute, and Food and Drug Administration published clinical practice statements encouraging the use of telemedicine in clinical trials, which had previously been prohibited. Our study aimed to assess the feasibility and safety of telehealth utilization in clinical trials for gynecologic malignancies. Methods: A retrospective cohort study was performed. Patients who were enrolled in a gynecologic oncology clinical trial at the University of Pennsylvania Health System from March 16, 2020, to August 30, 2020, were included. Receipt of care during the telehealth period (March 16, 2020, to August 30, 2020) was compared to the pre-telehealth period (September 30, 2019, to March 15, 2020). Pairwise comparisons of clinical trial outcomes were performed between the two time periods, using paired t-test, Wilcoxon signed-rank test, simple linear regression, Chi-square, and ANOVA. Results: Thirty-one patients met the inclusion criteria. The mean age was 63.7 years (SD 10.3);84% were non-Hispanic White. The median distance from home zip code to study center was 25.2 miles (IQR: 16-46, range: 1.9-170). Most patients had high-grade serous ovarian carcinoma (84%) and had the disease at an advanced stage (Stage III 48%, Stage IV 38.7%). Trial drugs included 22.6% (n=7) intravenous only, 29% (n=9) oral only, and 48.4% (n=15) combination oral/intravenous therapies. The median duration of enrollment was similar between pre-telehealth (5.2 months, IQR: 3.2-5.6) and telehealth periods (5.6 months, IQR: 3.8-5.6), (p=0.682). During the TELEHEALTH period, significantly more virtual provider visits (p <0.001) and remote laboratory testing (p=0.015) occurred, with similar rates of remote imaging (p=0.551). Delayed provider visits (p = 0.965), laboratory testing (p = 0.989) and imaging (p = 0.999) occurred infrequently in both timeframes. The number of patient touchpoints (portal messages and phone calls) per month did not increase (p = 0.147). Patients who lived farther from the study center were more likely to use remote imaging (p = 0.013);however, the distance was not associated with the use of virtual provider visits (p = 0.309) or remote laboratory testing (p = 0.821). Number of dose reductions (p = 0.112) and toxicity-related treatment delays (p = 0.888) were similar. Increased need for extra imaging was noted in the telehealth period (p=0.007) and was not associated with disease progression (p=0.614). Extra provider visits, emergency department visits, and hospital admissions were infrequent and similar in both timeframes (Table 1). The total number of deviations was increased (p=0.010);however, when adjusted for minor deviations documenting telehealth use or deferment of research-related laboratory testing given the pandemic precautions, there was no difference between timeframes (p = 0.468). The total number of adverse events and severe adverse events did not increase in the telehealth period (p=0.494 and p=0.601, respectively). Conclusions: Utilizing telehealth in clinical trials for gynecologic oncology patients did not increase clinical workload or adverse patient outcomes. Documentation of telehealth use and pause of research-related laboratory collections resulted in a higher number of protocol deviations during the telehealth period. Telehealth should be incorporated into future clinical trials as it appears safe and feasible and may facilitate access for remote, rural, and under-served populations.

Analysis of the Deactivating Factors for Telework within Architectural Design Organization

The long-term pandemic caused by COVID-19 has changed many aspects of the work environment. Companies stalled to seriously consider telework and many have actually adopted it as an alternative way to work, hi fact 73.9% of overseas architect firms are using the telework while domestic architect firms shows no signs of introducing it yet. Various causes are suggested as to why the telework is not yet implemented in architectural practice even with the necessity of introduction, they are only unverified speculations and in order to understand the causes and solve the problems, a sophisticated analysis of the cause is required, hi addition, telework is not just a temporary option in pandemic situation but it needs to be established as another type of work in arcliitectiiral industiy in preparation for similar situation that may occur in the future. Therefore, this study aims to derive the impediments recognized by architect in introducing telework into domestic architect offices, and based on the results of the analysis from the derived factors, it was attempted to find a way to activate telework. Through the literature review, it is conformed that the research regarding the telework of architect office was insufficient and for this reason, telework consideration factors were derived from related studies targeting general companies. The questionnaire was prepared in consideration of the derived factors and the characteristics of the design work, and it was conducted at a time when the government's social distancing guidelines and telework recommendations were made. The study was conducted using the responses of 103 persons working in architect offices of the metropolitan area. As a result, it was confirmed that the cause of hindrace for teleworking perceived by the workers in the architect office was due to the specific characteristics of the design work, and it was confimed that the communication of visual information was the biggest hindrance factor ill the design work, hi addition, as a result of ANOVA on the questionnaire results, it was confirmed that there was a difference in the perceptions of architects about telework, and the main difference came from the work position and project experience. Afterwards. through factor analysis, specific directions were presented for three aspects: communication of design work when working from home, support within the organization, and establishment of IT infrastructure as a way to revitalize it. © 2022 Architectural Institute of Korea

THE EFFECT of IMMUNOSUPPRESSIVE AGENTS on ANTIBODY FORMATION after COVID-19 VACCINATION in RHEUMATOID ARTHRITIS PATIENTS

Background: There is still controversy about the efficacy of COVID-19 vaccination and its extent in lowering immunogenicity of Rheumatoid Arthritis (RA) patients. The guideline in whether immunosuppressive agents need to be discontinued before the vaccination is continuously updated because it is considered to lower immunogenicity. Furthermore, there is great discussion on the effectiveness of the COVID-19 booster vaccine and interest in antibody generation in different types of vaccine, as in South Korea there are many patients who were prescribed the mRNA booster vaccine after two doses of ChAdOx1-S nCoV-19 vaccine. Objectives: Thus, we investigated the differences of antibody production between patients who received only two doses of ChAdOx1-S nCoV-19 and those who received the mRNA booster vaccine. Also, antibody production under different types of immunosuppressive agents was analyzed. Methods: From October 14, 2021 to January 21, 2022 at a tertiary referral center, two patient groups diagnosed with RA were studied prospectively;one group that completed 1st and 2nd doses of ChAdOx1-S nCoV-19 vaccine, second group that completed mRNA booster vaccine as well as two doses of ChAdOx1-S nCoV-19 vaccine. SARS-CoV-2 antibody testing on the semiquantitative anti-SARS-CoV-2 S enzyme immunoassay was done, and differences in antibody titers were analyzed in patients who received different immunosup-pressive agents such as csDMARD, TNF inhibitor, JAK inhibitor, Tocilizumab, Abatacept and Corticosteroid. Statistical analysis with a multivariate logistic regression model was performed. Results: In a total of 261 patients, 153 patients had completed two doses of ChAdOx1-S nCoV-19, 108 patients had completed third mRNA booster vaccine. Anti-SARS-CoV-2 RBD antibody positive rate (titer>0.8U/mL) was 97%(149/153) and 99%(107/108) respectively, and only 5 patients showed negative result. In the aspect of high antibody titer(>250U/mL), which is the upper limit of the RBD antibody immunoassay, the result showed rate of 31% (47/153) in the non-booster group and 94%(102/108) in the booster group respectively. Among the different immunosuppressive agents and other clinical aspects, multivariate analysis revealed that corticosteroid use (OR 0.91;95% CI: 0.86-0.98), older age(OR 4.33;95% CI: 1.34-13.91), and male gender(OR 0.35;95% CI 0.16-0.75) were signifcantly associated with low rate of high antibody titer. Furthermore, out of 14 patients who underwent antibody test twice before and after the mRNA booster vaccine, other than four patients who already showed high titer of >250U/mL before the mRNA booster vaccine, 10 patients showed an increase in titer after the booster vaccine and 7 patients were acquired high titer of >250U/mL. Conclusion: Anti-SARS-CoV-2 RBD antibody positive rate was 97% or more regardless of the mRNA booster vaccination. However, patients who received the mRNA booster vaccine after two doses of ChAdOx1-S nCoV-19 vaccine showed high antibody titer (>250U/mL) three times more than those who did not receive the booster shot. Our fndings also showed that corticosteroid use, old age, and male gender is signifcantly associated with low rate of acquiring high antibody titer.

INCIDENCE of RHEUMATIC DISEASES during the COVID-19 PANDEMIC in KOREA: A NATIONWIDE CLAIMS STUDY

Background: In Korea, it has been reported that the incidence of some respiratory diseases and Kawasaki diseases has decreased compared to the previous year along with active non-pharmaceutical interventions in the early stages of the COVID-19 pandemic. Autoimmune infammatory rheumatic disease (AIIRD) is mainly affected musculoskeletal organs and connective tissues due to impaired immune regulation. Although gout and osteoarthritis are rheumatic diseases, they are not a disease of the immune system, and are not included in the AIIRD. Objectives: In this study, we investigated the change and difference in the incidence rate of various rheumatic diseases during the COVID-19 pandemic after 2020. Methods: The number of patients for each disease from January 2016 to December 2020 was obtained from the Korea Health Insurance Review and Assessment Service database. We compared the incidence of 9 rheumatic diseases [systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), ankylosing spondylitis (AS), Sjogren syndrome (SJS), Behcet's disease (BD), infammatory myositis (IIM), scleroderma, polymyalgia rheumatica (PMR), and gout] and hypertension before and after the COVID-19 outbreak. The incidence rates of patients before and after the COVID-19 outbreak were compared using the Poisson test. Results: From 2016 to 2019, the prevalence of rheumatic diseases showed gradually increased. In 2020, the incidence of SLE, AS, SJS, BD, and IIM were signif-cantly decreased compared to the previous 4 years. In contrast, the incidences of gout and hypertension during the COVID-19 pandemic period were signifcantly increased from the predicted values. Conclusion: In conclusion, we found that the incidence of many AIIRDs, including SLE, AS, SJS, BD, and IIM decreased despite the increased incidence of hypertension and gout during the COVID-19 pandemic.