Current Healthcare Policy and Environmental Status of Digital Health Medical Devices in South Korea

Objectives: COVID 19 and increasing unmet needs of health technology had accelerated an adoption of digital health globally and the major categories are mobile-health, health information technology, telemedicine. Digital health interventions have various benefit on clinical efficacy, quality of care and reducing healthcare costs. The objective of the study is to identify new reimbursement policy trend of digital health medical devices in South Korea. Method(s): Official announcements published in national bodies and supplementary secondary research were used to capture policies, frameworks and currently approved products since 2019. Result(s): With policy development, several digital health devices and AI software have been introduced as non-reimbursement by utilizing new Health Technology Assessment (nHTA) pathway including grace period of nHTA and innovative medical devices integrated assessment pathway. AI based cardiac arrest risk management software (DeepCARS) and electroceutical device for major depressive disorders (MINDD STIM) have been approved as non-reimbursement use for about 3 years. Two digital therapeutics for insomnia and AI software for diagnosis of cerebral infarction were approved as the first innovative medical devices under new integrated assessment system, and they could be treated in the market. In addition, there is remote patient monitoring (RPM) reimbursement service fee. Continuous glucose monitoring devices have been reimbursed for type 1 diabetes patients by the National Health Insurance Service (NHIS) since January 2019. Homecare RPM service for peritoneal dialysis patients with cloud platform (Sharesource) has been reimbursed since December 2019, and long-term continuous ECG monitoring service fee for wearable ECG monitoring devices (ATpatch, MEMO) became reimbursement since January 2022. Conclusion(s): Although Korean government has been developed guidelines for digital health actively, only few products had been reimbursed. To introduce new technologies for improved patient centric treatment, novel value-based assessment and new pricing guideline of digital health medical devices are quite required.Copyright © 2023

Nigeria's new president ‘must walk the talk on health'

Speed read Nigeria's president-elect eyes 40 per cent health insurance coverage in two years Ambitious target needs funding, human resources Over 75,000 nurses and midwives left Nigeria in five years [LAGOS] Health experts in Nigeria say the country's president-elect who will be inaugurated on 29 May must prioritise health care and refrain from politicising it. While Nigeria committed to achieving universal health coverage (UHC) by 2030, its National Health Insurance Scheme (NHIS) established in 2005 makes health insurance coverage voluntary. [...]in May 2022, after two decades of sustained calls by health professionals, a new Act was passed which aimed to provide health insurance for all Nigerians, through a mandatory mechanism and in collaboration with state health insurance agencies.

Descriptive Study Investigating Impact of Transition to Universal Health Insurance Coverage on Utilization of Healthcare in Sudan, 2016 - 2021

Objectives: Since 2016, Sudan was transitioning from limited healthcare subsidization to universal health coverage (UHC). Increasing healthcare access was widely considered beneficial, but some worried that UHC would overwhelm clinical services. In 2020 and 2021 UHC faced the challenge of Covid-19. We undertook a review of national healthcare utilization and enrolment data in order to better understand the impact of UHC in Sudan. Method(s): We conducted a descriptive study using National Health Insurance Fund databases. We analyzed annual enrolment, participating facilities, prescription volume and utilization from 2016 to 2021. Enrolment was stratified by employment status (government, informal sector, private sector, pensioner, impoverished). Utilization was assessed by type of care: primary, specialty, chronic disease and other;we calculated the ratio of primary to specialty care visits. We used the Mann-Kendall test for evaluating trends. Result(s): Participating facilities increased from 2,083 in 2016 to 3,549 in 2019, with slight contraction to 3,495 during 2020-21. Annual enrolment increased significantly, from 16.4 million in 2016 to 36.5 million in 2021 (p value < 0.01). The impoverished sector had the largest increase in enrolment (217%);informal sector had the lowest enrolment growth rate (7%). Volume of primary healthcare visits and prescriptions increased every year, except 2020, the first year of Covid-19 in Sudan. Specialty healthcare visits decreased over the same period, from 2,461,424 to 1,249,585 (p < 0.01). The ratio of primary to specialty visits increased from 6.0 in 2016 to 15.7 in 2021 (p < 0.001). Conclusion(s): In Sudan, transition to UHC increased utilization of primary care services, but at a slower rate than enrolment growth. The ratio of primary to specialty visits increased and specialty visits declined, suggesting that more primary care may have prevented specialist-requiring disease states and sequelae. Fears of overwhelming the health system were unfounded indicating that other barriers to healthcare might exist.Copyright © 2023

Corrigendum: Saving more lives on time: Strategic policy implementation and financial inclusion for safe abortion in Indonesia during COVID-19 and beyond.

[This corrects the article DOI: 10.3389/fgwh.2022.901842.].

Trends in the Quality of Primary Care and Acute Care in Korea From 2008 to 2020: A Cross-sectional Study.

OBJECTIVES: Measuring the quality of care is paramount to inform policies for healthcare services. Nevertheless, little is known about the quality of primary care and acute care provided in Korea. This study investigated trends in the quality of primary care and acute care. METHODS: Case-fatality rates and avoidable hospitalization rates were used as performance indicators to assess the quality of primary care and acute care. Admission data for the period 2008 to 2020 were extracted from the National Health Insurance Claims Database. Case-fatality rates and avoidable hospitalization rates were standardized by age and sex to adjust for patients' characteristics over time, and significant changes in the rates were identified by joinpoint regression. RESULTS: The average annual percent change in age-/sex-standardized case-fatality rates for acute myocardial infarction was -2.3% (95% confidence interval, -4.6 to 0.0). For hemorrhagic and ischemic stroke, the age-/sex-standardized case-fatality rates were 21.8% and 5.9%, respectively in 2020; these rates decreased since 2008 (27.1 and 8.7%, respectively). The average annual percent change in age-/sex-standardized avoidable hospitalization rates ranged from -9.4% to -3.0%, with statistically significant changes between 2008 and 2020. In 2020, the avoidable hospitalization rates decreased considerably compared with the 2019 rate because of the coronavirus disease 2019 pandemic. CONCLUSIONS: The avoidable hospitalization rates and case-fatality rates decreased overall during the past decade, but they were relatively high compared with other countries. Strengthening primary care is an essential requirement to improve patient health outcomes in the rapidly aging Korean population.

New-Onset Thyroid Eye Disease After COVID-19 Infection in Patient with Graves' Disease Post-Radioactive Iodine Treatment

Introduction: Coronavirus disease 2019 (COVID-19) has been associated with dysregulation of the immune system and abnormal thyroid function. The aim of this novel case report is to inform physicians of the possibility that COVID-19 infection may precipitate thyroid eye disease (TED) in patients with Graves' Disease (GD) even after treatment with radioactive iodine (RAI). Case Description: In this report, we describe a patient with GD treated with RAI who developed TED after COVID-19 infection. The patient was initially diagnosed with GD in 2018. A thyroid uptake scan (I-123) was consistent with GD with moderately elevated uptake. She was initially managed with methimazole and atenolol and was eventually treated with RAI (16.32 millicurie I-131) in February 2021. She had post-ablative hypothyroidism managed with levothyroxine. The patient contracted COVID-19 in January 2022. In February 2022, the patient started experiencing eye irritation, dryness, protrusion of eyes, eyelid swelling, and visual disturbances. Thyroid stimulating hormone (TSH) receptor auto-antibodies (7.33 IU/L, normal < /=1.00 IU/L) and thyroid stimulating immunoglobulin (4.30 IU/L, normal < /=1.00 IU/L) were elevated. TSH was normal (2.180 mIU/L, normal 0.270 - 4.200 mIU/L) on levothyroxine 125 mcg daily. She was later diagnosed with TED. Discussion(s): GD is an autoimmune thyroid disorder related to the presence of TSH receptor-stimulating antibodies and is often associated with ocular symptoms. Activation of an autoimmune response during COVID-19 infection, may induce onset or relapse of GD. A study using the national health insurance service database in South Korea noted an increase in the incidence of subacute thyroiditis in 2020 in association with the COVID-19 pandemic. TED is usually seen in patients with GD. Radioactive iodine is widely used in the treatment of GD and has been associated with development or worsening of TED. There are published cases of TED occurring in patients with GD after receiving COVID-19 vaccine. It is thought that the inflammatory syndrome induced by the adjuvants could induce molecular mimicry, which could trigger TED. In most cases this adverse effect was transient, lasting a few months after treatment. There have been case reports of TED occurring after 3 to 21 days of COVID-19 vaccination in patients with controlled GD. Symptoms improved in 4-8 months. Development of TED in patients with GD who have been treated with RAI typically occurs soon after RAI therapy. For TED to occur in a GD patient 11 months after receiving RAI therapy is unusual. COVID-19 infection appears to have been the trigger for this patient's eye disease. This is highly unusual and has not been published to our knowledge.Copyright © 2023

Effects of the COVID-19 pandemic on cardiovascular disease financing in Indonesia (JKN claims data analysis 2019-2020).

The disease burden related to non-communicable diseases is a major public health problem in Indonesia. About one-third of all deaths in Indonesia are caused by cardiovascular disease. This study describes the cost of cardiovascular disease from claims data for Advanced Referral Health Facilities at BPJS Kesehatan before and during the COVID-19 pandemic. We analyzed claims data on the National Health Insurance system managed by BPJS. The data comes from referral health facilities throughout Indonesia in 2019 and 2020. Cardiovascular service claims data by sex and age group were analyzed descriptively and with different tests between years. There was a decrease in the number of patients accessing cardiovascular services at referral health facilities for all genders, age groups, and types of main diagnoses, by around 27.8%, from 933,017 (2019) to 673,801 (2020). There was a significant decrease in total claims for all types of cardiovascular disease during the COVID-19 pandemic compared to before, especially the reduction in aneurysms and aortic dissection (40.2%) and hypertensive heart disease (39.6%). The decline also occurred in all sexes and age groups, with an average percentage decline of 31.2%. Our findings show that the reduction in the cost of cardiovascular disease claims goes hand in hand with the decrease in the number of cardiovascular patient visits. To guarantee treatment for cardiovascular disease patients during the COVID-19 pandemic, BPJS can maximize the telemedicine services that have been built. The organizer of the National Health Insurance program in Indonesia has developed a JKN mobile application that has the potential for telemedicine services guaranteed by JKN. On the other hand, BPJS needs to limit promotive and preventive budgets related to CVD so that it does not become a potential catastrophic financing.

Non-reimbursable Financing of Health Projects in Romania

Health is our fundamental right as citizens and, therefore, it must occupy a priority place in government programs. Despite the progress of recent years, Romania is still in the last places at the EU level in terms of the financing of the health system and its results. As a result, health financing is a priority even in the current period. Non-reimbursable financing, whether it is European funds or funds from the national budget, or other non-reimbursable sources, is the key to investments for the development and modernization of the health system. Ensuring a high degree of absorption of European funds dedicated to the health field in the period 2021-2027 and using these funds as an additional source of funding for the Romanian health system, represents a solution for investment in this field. Funds from the European Union can be used both for improving health, for faster recovery from the Covid-19 crisis, and for reducing health inequalities. The paper also includes a study on the contribution of funding from non-refundable funds to the modernization of the Moinesti Municipal Emergency Hospital, Bac&acaron;u County, a hospital that is in the top 10 nationally in terms of medical services. The focus is on the projects implemented over the years at the unit level and their impact on the medical activity.

Policy measures, information technology, and people's collective behavior in Taiwan's COVID-19 response

COVID-19 has rampaged globally with devastating consequences on human lives and livelihoods. Taiwan, a democratic island-country with 23.5 million population, was predicted to have the second highest risk of imported cases at the outset and instead registered among the lowest COVID-19 prevalence and mortality rates during year one. This chapter describes Taiwan's emergency response policies, including the Communicable Disease Control Act (CDCA), pandemic measures in different segments of the population, the role of national health insurance and accessible healthcare, innovative integrations of information technology, and amendments to laws and regulations adapted to the evolving situation. Taiwan's CDCA was introduced in 1944. In addition to posting travel advisories, the Taiwan Centers for Disease Control (CDC) enhanced border control, as required by the CDCA. Taiwan CDC officers stationed at airports implemented health screening of passengers and provided healthcare advice. © 2023 John Wiley & Sons, Inc.

THE REGULATION BY THE NHIF IN THE CONTEXT OF COVID-19 IN OPINION OF GENERAL PRACTITIONERS.

The regulation over the expenditure of public funds for health is carried out by the only institution in the Republic of Bulgaria, which is responsible for the activities of the compulsory health insurance-the National Health Insurance Fund (NHIF). At present, research in the area of control related to the legal and effective expenditure of the statutory funds at the first level of medical care is not sufficiently covered. The aim is to clarify the degree of appropriateness in terms of control over the implementation of contracts for the provision of primary outpatient medical care (POMC) in the context of COVID-19, as well as to reveal gaps and bad practices in the control process, which will help to formulate recommendations for its optimization. The article presents the results of a survey conducted among 394 GPs across the country for the period from 23.06.2022 to 16.10.2022 using the online platform Google Forms. The results show that among two-thirds of the surveyed GPs (71.6%) there are suspicions of an unjustifiably high number of activities rejected for payment by the Fund. In one third of the surveyed GPs, another type of control by the NHIF was significantly more frequent in district centres (43.1%) compared to other localities (29.1%). Nearly half of the GPs (45.8%) were covered by inspections based on complaints from dissatisfied citizens. The main findings imply that appropriate action needs to be taken in the direction of optimizing control by the NHIF in order to raise the authority of the controlling institution perceived by POMC contractors.Copyright © 2022, Central Medical Library Medical University - Sofia. All rights reserved.

THE REGULATION BY THE NHIF IN THE CONTEXT OF COVID-19 IN OPINION OF GENERAL PRACTITIONERS.

The regulation over the expenditure of public funds for health is carried out by the only institution in the Republic of Bulgaria, which is responsible for the activities of the compulsory health insurance-the National Health Insurance Fund (NHIF). At present, research in the area of control related to the legal and effective expenditure of the statutory funds at the first level of medical care is not sufficiently covered. The aim is to clarify the degree of appropriateness in terms of control over the implementation of contracts for the provision of primary outpatient medical care (POMC) in the context of COVID-19, as well as to reveal gaps and bad practices in the control process, which will help to formulate recommendations for its optimization. The article presents the results of a survey conducted among 394 GPs across the country for the period from 23.06.2022 to 16.10.2022 using the online platform Google Forms. The results show that among two-thirds of the surveyed GPs (71.6%) there are suspicions of an unjustifiably high number of activities rejected for payment by the Fund. In one third of the surveyed GPs, another type of control by the NHIF was significantly more frequent in district centres (43.1%) compared to other localities (29.1%). Nearly half of the GPs (45.8%) were covered by inspections based on complaints from dissatisfied citizens. The main findings imply that appropriate action needs to be taken in the direction of optimizing control by the NHIF in order to raise the authority of the controlling institution perceived by POMC contractors.Copyright © 2022, Central Medical Library Medical University - Sofia. All rights reserved.

Aiming for a gender-transformative UHC agenda in Indonesia

At the 2019 High-Level Meeting on Universal Health Coverage (UHC), women's groups and their allies successfully lobbied for the recognition of gender equity and comprehensive sexual and reproductive health and rights (SRHR) as critical to UHC. Conservative opposition, however, remains, and realization of the then-approved political declaration will require their continued engagement to hold governments accountable and foster transformative reforms. This article, focusing on Indonesia's national health insurance or JKN, provides an illustration of possible interventions to advance a women's health and rights perspective in UHC in the context of existing barriers and opportunities for change. In particular, it presents women's groups' efforts, in part undertaken under the Australia-Indonesia Partnership for Gender Equality and Women's Empowerment or MAMPU before the COVID-19 pandemic, to promote women's participation in the national insurance scheme and improve its coverage of SRHR. Based on observational data, research findings and literature review, the article shows that these initiatives have contributed to the uptake of the scheme among disadvantaged women and brought significant gender biases to the attention of policy makers. However, much more will need to be done for the scheme to cover SRHR in a comprehensive and inclusive manner and recognize gender-responsiveness as a key element in improving women's health in Indonesia.

Major National Health Insurance policies in Taiwan and residents' satisfaction with them during the COVID-19 pandemic

Objectives: In this study, we explored major National Health Insurance (NHI) policies in Taiwan and residents' awareness about, support for, utilization rate of, and satisfaction with them during the COVID-19 pandemic to create a reference for health-care policymakers. Methods: We analyzed data collected through a survey conducted among the residents (age ≥18 years) of Taiwan using the 2021 NHI satisfaction questionnaire. The questionnaire comprised questions on NHI satisfaction, NHI MediCloud system, My Health Bank, referral system, premium payment deferral or installment, telemedicine, virtual NHI cards, and other topics. Results: A total of 3,266 and 2,226 valid samples were obtained through annual and thematic polls, respectively. The rate of satisfaction with NHI and medical institutions was >90%. Of the respondents, 86.3% were satisfied with the travel history, occupation, contact history, and cluster query reminder system;38.4% were aware that My Health Bank can be used to seek medical information;>86.4% were satisfied with their experience;88.8% were willing to participate in the referral system;33.5% did not seek medical care due to the pandemic;86.2% supported the policy related to deferred payment of premiums;and 70% supported telemedicine promotion and virtual NHI card policies. Conclusions: The COVID-19 pandemic appears to have had no negative effects on the general public's attitude toward major NHI policies, which showed an upward trend. In the future, technology may be used to facilitate epidemic prevention and provide immediate support to individuals during severe epidemics. © 2022, Taiwan Public Health Association. All rights reserved.

Major National Health Insurance policies in Taiwan and residents' satisfaction with them during the COVID-19 pandemic

Objectives: In this study, we explored major National Health Insurance (NHI) policies in Taiwan and residents' awareness about, support for, utilization rate of, and satisfaction with them during the COVID-19 pandemic to create a reference for health-care policymakers. Methods: We analyzed data collected through a survey conducted among the residents (age ≥18 years) of Taiwan using the 2021 NHI satisfaction questionnaire. The questionnaire comprised questions on NHI satisfaction, NHI MediCloud system, My Health Bank, referral system, premium payment deferral or installment, telemedicine, virtual NHI cards, and other topics. Results: A total of 3,266 and 2,226 valid samples were obtained through annual and thematic polls, respectively. The rate of satisfaction with NHI and medical institutions was >90%. Of the respondents, 86.3% were satisfied with the travel history, occupation, contact history, and cluster query reminder system;38.4% were aware that My Health Bank can be used to seek medical information;>86.4% were satisfied with their experience;88.8% were willing to participate in the referral system;33.5% did not seek medical care due to the pandemic;86.2% supported the policy related to deferred payment of premiums;and 70% supported telemedicine promotion and virtual NHI card policies. Conclusions: The COVID-19 pandemic appears to have had no negative effects on the general public's attitude toward major NHI policies, which showed an upward trend. In the future, technology may be used to facilitate epidemic prevention and provide immediate support to individuals during severe epidemics. © 2022, Taiwan Public Health Association. All rights reserved.

Taiwan's National Health Insurance at the Emergency Department following the COVID-19 outbreak.

Taiwan's National Health Insurance (NHI) is a widely acclaimed universal healthcare system. In the past few years, particularly following the COVID-19 outbreak, challenges related to maintaining the NHI system have surfaced. Since 2020, NHI has faced a series of challenges, including excessive patient visits to the hospital emergency department, a lack of an effective primary care and referral system, and a high turnover rate of healthcare workers. We review major problems related to Taiwan's NHI, emphasizing input from frontline healthcare workers. We provide recommendations for potential policies addressing the concerns around NHI, for example, strengthening the role of primary care services under the NHI administration, reducing the high turnover rate of healthcare workers, and increase the premium and copayments. We hope that this policy analysis may allow policymakers and scholars to understand both the merits and critical problems related to NHI from the clinical perspective.

Saving more lives on time: Strategic policy implementation and financial inclusion for safe abortion in Indonesia during COVID-19 and beyond.

Abortion is common in Indonesia, with 79% being unsafe. Unsafe abortion is one of the top five causes of maternal deaths globally. Meanwhile, in Indonesia, the maternal mortality rate (MMR) is still high, with up to 30% of it being related to unsafe abortion. In the COVID-19 pandemic, the number of unsafe abortions is expected to increase along with a 15-30% increase in unintended pregnancies. This will add to the number of maternal deaths on top of direct deaths caused by COVID-19. In Indonesia, access to safe abortion is still limited based on grounds. There are also gaps in implementation and in the financing mechanism of legal safe abortion, especially in the era of the national health insurance scheme (Jaminan Kesehatan Nasional/JKN). This brief aims to guide how to equitably implement and inclusively finance safe abortion in Indonesia-in and beyond the COVID-19 pandemic-to gain maximum socioeconomic benefit and leave no one behind.

A discourse and content analysis of representation in the mainstream media of the South African National Health Insurance policy from 2011 to 2019.

BACKGROUND: Media is a crucial factor in shaping public opinion and setting policy agendas. There is limited research on the role of media in health policy processes in low- and middle-income countries. This study profiles South Africa as a case example, currently in the process of implementing a major health policy reform, National Health Insurance (NHI). METHODS: A descriptive, mixed methods study was conducted in five sequential phases. Evidence was gathered through a scoping review of secondary literature; discourse analysis of global policy documents on universal health coverage and South African NHI policy documents; and a content and discourse analysis of South African print and online media texts focused on NHI. Representations within media were analysed and dominant discourses that might influence the policy process were identified. RESULTS: Discourses of 'health as a global public good' and 'neoliberalism' were identified in global and national policy documents. Similar neoliberal discourse was identified within SA media. Unique discourses were identified within SA media relating to biopolitics and corruption. Media representations revealed political and ideological contestation which was not as present in the global and national policy documents. Media representations did not mirror the lived reality of most of the South African population. The discourses identified influence the policy process and hinder public participation in these processes. They reinforce social hierarchy and power structures in South Africa, and might reinforce current inequalities in the health system, with negative repercussions for access to health care. CONCLUSIONS: There is a need to understand mainstream media as part of a people-centred health system, particularly in the context of universal health coverage reforms such as NHI. Harmful media representations should be counter-acted. This requires the formation of collaborative and sustainable networks of policy actors to develop strategies on how to leverage media within health policy to support policy processes, build public trust and social cohesion, and ultimately decrease inequalities and increase access to health care. Research should be undertaken to explore media in other diverse formats and languages, and in other contexts, particularly low- and middle-income countries, to further understand media's role in health policy processes.

A systems view of responding to the COVID-19 pandemic: A causal loop model for Taiwan's approach

Since the worldwide outbreak of the COVID-19 pandemic in December 2019, Taiwan has successfully stopped the spread of COVID-19. The policies and works of the epidemic control are a complex and dynamic process. This study applied the methodology of system dynamics to explore the structure of the COVID-19 epidemic control system in Taiwan and analysed its system behaviours. The results show that the system is composed of key subsystems, such as national health insurance and quarantine, combined with government policies. Joint efforts among the central and local governments and the general public have been made to strengthen the quarantine of border entrants, encourage the public to wear masks and employ technology for contact tracing and tracking down those being tested positive with COVID-19. Together with the efficient increase in the capacity of testing and medical treatments, these measures can effectively reach a balance between epidemic control and economic activities. © 2022 John Wiley & Sons, Ltd.

Increasing incidence of Pediatric Graves' Disease

Introduction: Graves' diseases is a rare autoimmune disease in children. Viral infections are considered as a trigger for autoimmune thyroid disorders. A temporal association between SARSCoV- 2 and a novel pediatric hyperinflammatory condition called Paediatric inflammatory multisystem syndrome has been reported in 2020, raising questions about the link between SARS-CoV-2 and autoimmune and autoinflammatory diseases. Over the last year (2021), we noticed an increase in the number of children presenting to our department with Graves' disease. Our primary aim is to document the incidence of Graves' disease in our department since 2005, comparing our data with national data regarding thiamazol delivery. Our secondary aim is to compare the characteristics of the patients diagnosed before and during the SARS-CoV-2 outbreak. Material(s) and Method(s): A retrospective study including all the pediatric patients diagnosed with Graves' disease seen in our department since 2005 was performed. Hyperthyroid newborns were excluded. Data collected were the date and the age at diagnosis, the thyroid hormone levels, TSI at diagnosis, data from the national health insurance regarding the number of delivered thyroid hormone synthesis inhibitor drugs, thiamazol, in children (<18 years)/year. Result(s): A total of 48 patients with Graves' disease were diagnosed since 2005 in our department. Fifteen patients (1/3) were diagnosed since the SARS-CoV-2 outbreak, with the highest incidence in 2021 (11 patients). At the national level, an increase of thiamazol delivery is observed in 2020 and 2021 compared to the preceding years. Similar results regarding the age of diagnosis, free T4 and T3 levels or the presence of auto-immune diseases in the personal or family history were observed between the patients diagnosed before and those diagnosed during the SARS-CoV-2 outbreak. Conclusion(s): We observed a temporal association between SARS-CoV-2 outbreak and an increase in pediatric Graves' disease. The age and severity of the disease seems not to be influenced by the SARS-CoV-2 outbreak. SARS-CoV-2 could thus constitute a trigger for pediatric Graves' disease. Further studies are needed to confirm our findings.