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1.
BMC Pharmacol Toxicol ; 23(1): 9, 2022 01 17.
Article in English | MEDLINE | ID: covidwho-1636310

ABSTRACT

BACKGROUND: This study aimed to evaluate incidence risk and adverse clinical outcomes in COVID-19 disease among short-term users of acid-suppressants in South Korea. METHODS: This retrospective cohort study, conducted using a nationwide claims database for South Korea, used data from patients with COVID-19 tested between January 1 and May 15, 2020. Patients aged over 18 years and prescribed proton pump inhibitors (PPI) or histamine-2 receptor antagonist (H2RA) for more than 7 days were identified. Primary outcome was COVID-19 while secondary outcomes were all-cause mortality, hospitalization with respiratory disease, or intensive respiratory intervention. Large-scale propensity scores were used to match patients, while the Cox proportional hazard model was utilized to evaluate any association between exposure and outcome(s). The risk estimates were calibrated by using 123 negative control outcomes. RESULTS: We identified 26,166 PPI users and 62,117 H2RA users. After propensity score matching, compared to H2RA use, PPI use was not significantly associated with lower risk of COVID-19 (calibrated hazard ratio [HR], 0.81 [95% confidence interval (CI), 0.30-2.19]); moreover, PPI use was not associated with adverse clinical outcomes in COVID-19, namely, hospitalization with respiratory disease (calibrated HR, 0.88 [95% CI, 0.72-1.08]), intensive respiratory interventions (calibrated HR, 0.92 [95% CI, 0.46-1.82]), except for all-cause mortality (calibrated HR, 0.54 [95% CI, 0.31-0.95]). CONCLUSIONS: In this study, we found that the PPI user was not associated with risk of COVID-19 compared to H2RA users. There was no significant relationship between severe clinical outcomes of COVID-19 and exposure to PPI compared with H2RA, except for all-cause mortality.


Subject(s)
COVID-19/epidemiology , Histamine H2 Antagonists/therapeutic use , Proton Pump Inhibitors/therapeutic use , SARS-CoV-2 , Adolescent , Adult , Aged , Aged, 80 and over , COVID-19/complications , COVID-19/therapy , Female , Hospitalization/statistics & numerical data , Humans , Incidence , Male , Middle Aged , Republic of Korea/epidemiology , Retrospective Studies , Risk Factors , Treatment Outcome , Young Adult
2.
Medicine (Baltimore) ; 101(2): e28567, 2022 Jan 14.
Article in English | MEDLINE | ID: covidwho-1625627

ABSTRACT

ABSTRACT: Gyeonggi-do (Gyeonggi province) has the second highest number of coronavirus disease (COVID-19) cases in the Republic of Korea after Seoul, with approximately 25% of the COVID-19 patients as of January 2021. Our center is a level I trauma center located in south Gyeonggi-do, and we aimed to evaluate whether the characteristics of trauma patients changed after the COVID-19 pandemic.We retrospectively reviewed the trauma patients registered with the Korea Trauma Database of the Center from February 2019 to January 2021. The patients were dichotomized into pre-coronavirus disease (pre-COVID) and coronavirus disease (COVID) groups, and their trauma volumes, injury characteristics, intentionality, and outcomes were compared.A total of 2628 and 2636 patients were included in the pre-COVID and COVID groups, respectively. During the COVID-19 period, motorcycle accidents, bicycle accidents, and penetrating injury cases increased, and pedestrian traffic accidents, slips, and injury by machines decreased. The average daily number of patients in the COVID group was lower in March (5.6 ±â€Š2.6/day vs 7.2 ±â€Š2.4/day, P = .014) and higher in September (9.9 ±â€Š3.2/day vs 7.7 ±â€Š2.0/day, P = .003) compared to the pre-COVID group. The COVID group also had a higher ratio of direct admissions (67.5% vs 57.2%, P < .001), proportion of suicidal patients (4.1% vs 2.7%, P = .005), and injury severity scores (14 [9-22] vs 12 [4-22], P < .001) than the pre-COVID group. The overall mortality (4.7% vs 4.9%, P = .670) and intensive care unit length of stay (2 [0-3] days vs 2 [0-4] days, P = .153) was not different between the 2 groups.Although the total number of patients did not change, the COVID-19 pandemic affected the number of monthly admissions and the injury mechanisms changed. More severely injured patients were admitted directly to the trauma center.


Subject(s)
COVID-19 , Patient Admission/statistics & numerical data , Trauma Centers/statistics & numerical data , Wounds and Injuries/epidemiology , Adult , COVID-19/epidemiology , Female , Humans , Male , Middle Aged , Pandemics/prevention & control , Republic of Korea/epidemiology , Retrospective Studies , SARS-CoV-2 , Wounds and Injuries/diagnosis , Wounds and Injuries/therapy
3.
Int J Environ Res Public Health ; 19(1)2022 01 03.
Article in English | MEDLINE | ID: covidwho-1613757

ABSTRACT

OBJECTIVES: The aim of this study was to examine the status of community care services regarding traditional Korean medicine (TKM) for older adults and raise awareness on current opinions and services of TKM institutions. METHODS: The National Development Institute of Korean Medicine conducted a survey of 16 local governments by sending official letters through an electronic document system from October 2020 to November 2020. The survey items included basic demographic information and information about TKM service. RESULTS: Eleven (68.8%) of the 16 local governments provided TKM home care services. A total of 136 TKM clinics provided home care services for 598 older adults with musculoskeletal disorders. The number of TKM services provided in five or more local governments were cupping 11 (100.0%), acupuncture 11 (100.0%), education and consulting 10 (90.9%), and moxibustion 9 (81.8%). Moreover, pain (recorded on visual analogue scale) and quality of life significantly improved following TKM services (p < 0.001). CONCLUSIONS: Covered under medical policy, TKM homecare services could function as a viable alternative for continued medical care disrupted during the coronavirus disease 19 pandemic. In addition, standardisation and legalisation of these services could ensure and improve their efficiency.


Subject(s)
COVID-19 , Home Care Services , Aged , Humans , Medicine, Korean Traditional , Pandemics , Quality of Life , Republic of Korea/epidemiology , SARS-CoV-2
4.
Epidemiol Infect ; 150: e19, 2022 01 07.
Article in English | MEDLINE | ID: covidwho-1612147

ABSTRACT

This study investigated the characteristics of transmission routes of COVID-19 cluster infections (⩾10 linked cases within a short period) in Gangwon Province between 22 February 2020 and 31 May 2021. Transmission routes were divided into five major categories and 35 sub-categories according to the relationship between the infector and the infectee and the location of transmission. A total of 61 clusters occurred during the study period, including 1741 confirmed cases (55.7% of all confirmed cases (n = 3125)). The the five major routes of transmission were as follows: 'using (staying in) the same facility (50.7%), 'cohabiting family members' (23.3%), 'social gatherings with acquaintances' (10.8%), 'other transmission routes' (7.0%), and 'social gatherings with non-cohabiting family members/relatives' (5.5%). For transmission caused by using (staying in) the same facility, the highest number of confirmed cases was associated with churches, followed by medical institutions (inpatient), sports facilities, military bases, offices, nightlife businesses, schools, restaurants, day-care centres and kindergarten, and service businesses. Our analysis highlights specific locations with frequent transmission of infections, and transmission routes that should be targeted in situations where adherence to disease control rules is difficult.


Subject(s)
COVID-19/transmission , Adolescent , Adult , Aged , Aged, 80 and over , COVID-19/epidemiology , COVID-19/mortality , Child , Child, Preschool , Cluster Analysis , Family , Female , Humans , Infant , Male , Middle Aged , Occupations/statistics & numerical data , Republic of Korea/epidemiology , Risk Factors , Young Adult
5.
Int J Environ Res Public Health ; 19(1)2021 Dec 21.
Article in English | MEDLINE | ID: covidwho-1576994

ABSTRACT

The debate continues as to which governance structure is most appropriate for collaborative disaster response, particularly between centralization and decentralization. This article aims to contribute to this debate by analyzing the structural characteristics of a multisectoral network that emerged and evolved under strong state control during the 2015 outbreak of Middle East respiratory syndrome-coronavirus (MERS) in South Korea. This study particularly focuses on the evolution of intra- and inter-sectoral collaboration ties in the network. The data for the study were collected through a content analysis of government documents and news articles. Using social network analysis, the authors found that the network evolved into a centralized structure around a small number of governmental organizations at the central level, organizing the ties between participating organizations rather hierarchically. The network displayed a preponderance of internal ties both among health and non-health organizations and among public and nonpublic health organizations, but under different influences of structural characteristics. This tendency was intensified during the peak period. Based on these findings, the authors conclude that the centralization of disaster management may not or only marginally be conducive to cross-sector collaboration during public health disasters, calling for a careful design of governance structures for disaster response.


Subject(s)
Coronavirus Infections , Disasters , Middle East Respiratory Syndrome Coronavirus , Coronavirus Infections/epidemiology , Disease Outbreaks , Humans , Republic of Korea/epidemiology
6.
J Korean Med Sci ; 37(1): e12, 2022 Jan 03.
Article in English | MEDLINE | ID: covidwho-1608780

ABSTRACT

BACKGROUND: Despite the extraordinary speed of mass vaccination efforts, an outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) delta variant in a vaccinee with coronavirus disease 2019 (COVID-19) mRNA vaccine was identified in an adult day service center (ADSC) of Jeju, South Korea. The primary objective of this study was to investigate the epidemiologic features in infection-vulnerable facilities with a high vaccination rate of BNT162b2 mRNA COVID-19 vaccine. The second was to estimate the secondary transmission prevention effect of the vaccine in the household members by vaccination status. METHODS: We included all ADSC participants, staff and their household members. All COVID-19 infected cases were confirmed by reverse transcriptase polymerase chain reaction. We calculated attack rate in ADSC and the secondary attack rate (SAR) in household members by vaccination status. RESULTS: Among a total of 42 participants and 16 staff, of which 96.6% were fully vaccinated with BNT162b2 mRNA COVID-19 vaccine, 12 symptomatic cases and 13 asymptomatic confirmed cases of COVID-19 were found. The attack rate was 43.1%, with 13 isolates identified as SARS-CoV-2 virus, delta variant. The SAR in unvaccinated and partially vaccinated household members were 27.8% (5/18) and 25.0% (5/20), respectively, while the SAR in fully vaccinated household members was 12.5% (1/8). CONCLUSION: We describe a SARS-CoV-2 delta variant outbreak in ADSC with high vaccine coverage rate, characterized by high infection rate, high transmissibility, and low clinical severity. The outbreak proceeded to unvaccinated or partially vaccinated household members, emphasizing the need for immunizing close contacts of high-risk groups.


Subject(s)
COVID-19/epidemiology , SARS-CoV-2 , Adult , Aged , Aged, 80 and over , COVID-19/prevention & control , COVID-19/transmission , COVID-19 Vaccines , Female , Humans , Incidence , Male , Middle Aged , Republic of Korea/epidemiology , Vaccination
7.
J Korean Med Sci ; 37(1): e13, 2022 Jan 03.
Article in English | MEDLINE | ID: covidwho-1606050

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID-19) is generally asymptomatic or mild in otherwise healthy children, however, severe cases may occur. In this study, we report the clinical characteristics of children classified as critical COVID-19 in Korea to provide further insights into risk factors and management in children. METHODS: This study was a retrospective case series of children < 18 years of age classified as critical COVID-19. Cases were identified by the Korea Disease Control and Prevention Agency surveillance system and medical records were reviewed. Critical COVID-19 was defined as cases with severe illness requiring noninvasive (high flow nasal cannula, continuous positive airway pressure, or bilevel positive airway pressure) or invasive mechanical ventilation, extracorporeal membrane oxygenation (ECMO) or continuous renal replacement therapy (CRRT), between January 20, 2020 and October 7, 2021. RESULTS: Among 39,146 cases diagnosed with COVID-19 in subjects < 18 years of age, eight cases (0.02%) were identified as critical COVID-19. The median age was 13 years (range 10 month-17 years) and male-to-female ratio was 1:1. Three children had underlying diseases; one child has asthma and major depressive disorder, one child had Lennox-Gastaut syndrome and one child had mental retardation and was newly diagnosed with type 2 diabetes mellitus with the diagnosis of COVID-19. Among the eight children, seven were obese (body mass index range [BMI] median 29.3, range 25.9-38.2, weight-for-length > 97% for infant) and one was overweight (BMI 21.3). All patients had fever, six patients had dyspnea or cough and other accompanied symptoms included sore throat, headache, lethargy and myalgia. Radiologic findings showed pneumonia within 1-8 days after symptom onset. Pneumonia progressed in these children for 2-6 days and was improved within 5-32 days after diagnosis. Among the eight critical cases, remdesivir was administered in six cases. Steroids were provided for all cases. Inotropics were administered in one case. Six cases were treated with noninvasive mechanical ventilator and three required mechanical ventilator. One case required ECMO due to acute respiratory distress syndrome. All cases were admitted to the intensive care unit and admission period ranged from 9-39 days. Among all critical COVID-19 cases < 18 years of age, there were no fatal cases. CONCLUSION: To develop appropriate policies for children in the COVID-19 pandemic, it is important to monitor and assess the clinical burden in this population.


Subject(s)
COVID-19/epidemiology , SARS-CoV-2 , Adolescent , COVID-19/complications , COVID-19/therapy , Child , Child, Preschool , Critical Care , Female , Humans , Infant , Male , Republic of Korea/epidemiology , Retrospective Studies , Severity of Illness Index
8.
Stud Health Technol Inform ; 284: 41-43, 2021 Dec 15.
Article in English | MEDLINE | ID: covidwho-1604166

ABSTRACT

After the COVID-19 pandemic occurred in South Korea in 2020, medical institutions have dealt with the epidemiological crisis. The institutions' strategies in response to the crisis were classified into four stages depending on the change of epidemic circumstances. Efficiently responding to the pandemic, close cooperation between the government and medical institutions is essential.


Subject(s)
COVID-19 , Government , Humans , Pandemics/prevention & control , Republic of Korea/epidemiology , SARS-CoV-2
9.
Medicine (Baltimore) ; 100(51): e28461, 2021 Dec 23.
Article in English | MEDLINE | ID: covidwho-1594863

ABSTRACT

ABSTRACT: The coronavirus disease-2019 (COVID-19) pandemic has not only changed the lives of people around the world but also affected all areas of the healthcare system, including sleep medicine. However, no studies in Korea have investigated the status of domestic sleep centers and their challenges during the pandemic.An online survey was performed from December 2020 to January 2021. Hospitals that belonged to sleep-related academic societies and were considered well managed were included in this survey. The questionnaire focused on changes in sleep center operations, infection control policies, and patient treatment since the start of the COVID-19 pandemic. Telemedicine and future directions for sleep medicine services were also investigated.Of the 20 sleep centers that responded, 80% were at university hospitals with more than 500 inpatient beds. During the third wave of the COVID-19 pandemic in Korea (November-December 2020), the routine operating schedule of the sleep study room was reduced in 30% of the sleep centers compared to November-December 2019 (before COVID-19). The number of type 1 polysomnographies performed decreased in 85% of the sleep centers. In contrast, in-lab positive airway pressure (PAP) titrations decreased in 40%, remained unchanged in 35%, and increased in 25%. With respect to prescriptions, 30% of the sleep centers increased the number of prescriptions for auto-titrating continuous PAP. However, 60% of the sleep centers reported no change in the rate of fixed continuous PAP and auto-titrating continuous PAP prescriptions. All sleep centers that participated in this survey agreed that the need for documented infection control regulations will continue after the COVID-19 pandemic. Since the beginning of the pandemic, 30% of the centers have tried telemedicine. However, respondents expressed concern about telemedicine, citing a number of practical issues.Compared to countries where the COVID-19 pandemic was severe, Korea had less impact of COVID-19 on the sleep center operations and sleep apnea treatment. Infection and quality control in the sleep study room are important and inevitable issues, and regulation within each institution is necessary. Further research and discussion are needed regarding telemedicine and home sleep apnea test in Korea.


Subject(s)
Ambulatory Care Facilities/statistics & numerical data , COVID-19 , Sleep Apnea Syndromes , Telemedicine , Humans , Pandemics , Republic of Korea/epidemiology , Sleep , Sleep Apnea Syndromes/epidemiology , Surveys and Questionnaires
10.
Sci Rep ; 11(1): 24470, 2021 12 28.
Article in English | MEDLINE | ID: covidwho-1594859

ABSTRACT

A novel severe acute respiratory syndrome coronavirus 2 emerged in December 2019, and it took only a few months for WHO to declare COVID-19 as a pandemic in March 2020. It is very challenging to discover complex spatial-temporal transmission mechanisms. However, it is crucial to capture essential features of regional-temporal patterns of COVID-19 to implement prompt and effective prevention or mitigation interventions. In this work, we develop a novel framework of compatible window-wise dynamic mode decomposition (CwDMD) for nonlinear infectious disease dynamics. The compatible window is a selected representative subdomain of time series data, in which compatibility between spatial and temporal resolutions is established so that DMD can provide meaningful data analysis. A total of four compatible windows have been selected from COVID-19 time-series data from January 20, 2020, to May 10, 2021, in South Korea. The spatiotemporal patterns of these four windows are then analyzed. Several hot and cold spots were identified, their spatial-temporal relationships, and some hidden regional patterns were discovered. Our analysis reveals that the first wave was contained in the Daegu and Gyeongbuk areas, but it spread rapidly to the whole of South Korea after the second wave. Later on, the spatial distribution is seen to become more homogeneous after the third wave. Our analysis also identifies that some patterns are not related to regional relevance. These findings have then been analyzed and associated with the inter-regional and local characteristics of South Korea. Thus, the present study is expected to provide public health officials helpful insights for future regional-temporal specific mitigation plans.


Subject(s)
COVID-19/epidemiology , Algorithms , COVID-19/mortality , COVID-19/virology , Humans , Republic of Korea/epidemiology , SARS-CoV-2/isolation & purification , Spatio-Temporal Analysis , Time Factors
11.
J Korean Med Sci ; 36(50): e346, 2021 Dec 27.
Article in English | MEDLINE | ID: covidwho-1595229

ABSTRACT

In November 2021, 14 international travel-related severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) B.1.1.529 (omicron) variant of concern (VOC) patients were detected in South Korea. Epidemiologic investigation revealed community transmission of the omicron VOC. A total of 80 SARS-CoV-2 omicron VOC-positive patients were identified until December 10, 2021 and 66 of them reported no relation to the international travel. There may be more transmissions with this VOC in Korea than reported.


Subject(s)
COVID-19/transmission , SARS-CoV-2 , Travel-Related Illness , Adult , Aged , Aged, 80 and over , COVID-19/epidemiology , Female , Humans , Male , Middle Aged , Republic of Korea/epidemiology , Young Adult
12.
Am J Health Behav ; 45(6): 1031-1040, 2021 11 15.
Article in English | MEDLINE | ID: covidwho-1593896

ABSTRACT

OBJECTIVES: In this study, we investigated the changes in smoking behavior during the COVID-19 outbreak in Korea in 2020. We also examined the influence of general characteristics and mental health problems due to COVID-19 on changes in smoking behavior. METHODS: We collected data from August to October 2020 from adults aged 19 years and older from the Korea Community Health Survey (N=229,269). RESULTS: Among current smokers (N=39,534), 11.0% reported an increase in smoking, and 12.8% reported a decrease in smoking. Overall, 33.3% reported perceived stress and 3.7% reported depression. Participants reported COVID-related anxiety about infecting family (83.0%), economic damage (76.3%), blame or harm from others (66.5%), infection (60.6%), and death (31.3%). Lower education level, living alone, and poor subjective health status were associated with increased smoking. Being a woman and being of older age were associated with decreased smoking. Stress, depression, and anxiety about economic damage due to COVID-19 were more likely to result in increased smoking. Anxiety related to death due to COVID-19 was more likely to result in decreased smoking. CONCLUSION: These findings provide insight into the changes in smoking behavior caused by COVID-19.


Subject(s)
COVID-19 , Smoking , Adult , Aged , Anxiety/epidemiology , Depression/epidemiology , Female , Humans , Male , Middle Aged , Republic of Korea/epidemiology , Smoking/epidemiology , Young Adult
13.
J Korean Med Sci ; 36(49): e341, 2021 Dec 20.
Article in English | MEDLINE | ID: covidwho-1581390

ABSTRACT

BACKGROUND: Data on severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) delta variant virulence are insufficient. We retrospectively compared the clinical features of adult coronavirus disease 2019 (COVID-19) patients without risk factors for severe COVID-19 who entered residential treatment centers (RTCs) before and after the delta variant outbreak. METHODS: We collected medical information from two RTCs in South Korea. On the basis of nationwide delta variant surveillance, we divided the patients into two groups: 1) the delta-minor group (diagnosed from December 2020-June 2021, detection rate < 10%) and 2) the delta-dominant group (diagnosed during August 2021, detection rate > 90%). After propensity-score matching, the incidences of pneumonia, hospital transfer and need for supplemental oxygen were compared between the groups. In addition, risk factors for hospital transfer were analysed. RESULTS: A total of 1,915 patients were included. The incidence of pneumonia (14.6% vs. 9.2%, P = 0.009), all-cause hospital transfer (10.4% vs. 6.3%, P = 0.020) and COVID-19-related hospital transfer (7.5% vs. 4.8%, P = 0.081) were higher in the delta-dominant group than those in the delta-minor group. In the multivariate analysis, the delta-dominant group was an independent risk factor for all-cause (adjusted odds ratio [aOR], 1.91; 95% confidence interval [CI], 1.16-3.13; P = 0.011) and COVID-19-related hospital transfer (aOR, 1.86; 95% CI, 1.04-3.32; P = 0.036). CONCLUSION: Hospitalization rates were increased in the adult COVID-19 patients during the delta variant nationwide outbreak. Our results showed that the delta variant may be more virulent than previous lineages.


Subject(s)
COVID-19/diagnosis , COVID-19/epidemiology , Hospitalization , SARS-CoV-2 , Adult , Disease Outbreaks , Female , Humans , Incidence , Male , Middle Aged , Odds Ratio , Republic of Korea/epidemiology , Retrospective Studies , Risk Factors , Time Factors
14.
Int J Environ Res Public Health ; 19(1)2021 12 23.
Article in English | MEDLINE | ID: covidwho-1580842

ABSTRACT

The purpose of this study is to examine changes in physical activity in Korean society, after the outbreak of COVID-19. Method This study was conducted using the Korean Community Health Survey conducted in 2019 and 2020. Subjects that have been diagnosed with hypertension and diabetes were excluded; a total of 355,914 cases were involved for analysis. In terms of the analysis method, General Linear Model (GLM) was conducted to examine the changes in physical activities in 2019 and 2020 depending on the presence of a spouse, educational status, and economic activities. In addition, the GLM was adopted to divide the subjects by gender and age, and analyze their physical activity changes in 2019 and 2020 with spouse presence, educational status, and economic activities as adjusted variables. Result In terms of Koreans, those without a spouse, high educational attainment, and economically inactive were less engaged in physical activities. Differences were found in subjects regarding moderate-intensity physical activities after social distancing following the spread of COVID-19. Senior females without a spouse, both males and females with low educational attainment, economically inactive adult females, and economically active senior males showed a greater drop in physical activities. For walking hours, both adult males and females without a spouse, adult females with all educational attainment level excluding elementary and middle school graduates, and economically inactive adult males and females also showed a downward trend. Conclusion The study recommends that people develop a strategy to increase their post-outbreak physical activity, taking into account the sociodemographic.


Subject(s)
COVID-19 , Adult , Disease Outbreaks , Exercise , Female , Humans , Male , Republic of Korea/epidemiology , SARS-CoV-2
15.
J Med Internet Res ; 23(2): e24165, 2021 02 25.
Article in English | MEDLINE | ID: covidwho-1574848

ABSTRACT

BACKGROUND: Sending emergency messages via mobile phone text messaging can be a promising communication tool to rapidly disseminate information and promote preventive behavior among the public during epidemic outbreaks. The battle to overcome COVID-19 is not yet over; thus, it is essential that the public practices preventive measures to prevent the spread of COVID-19. OBJECTIVE: This study aimed to investigate the effectiveness of reading and obtaining information via emergency alert SMS text messages and their effects on the individual's practice of preventive behaviors during the early stages of the COVID-19 outbreak in South Korea. METHODS: A cross-sectional web-based survey comprising 990 participants was conducted over 3 days (March 25-27, 2020). A multivariable logistic regression analysis revealed the sociodemographic factors that might influence the behavior of reading emergency alert text messages. A hierarchical linear regression model estimated the associations between reading emergency alert text messages for each precautionary behavior practiced against COVID-19. Additionally, the indirect effects of reading the text messages on each precautionary behavior via psychological factors (ie, perceived risk and response efficacy) were calculated. All data were weighted according to the 2019 Korea census data. RESULTS: Overall, 49.2% (487/990) of the participants reported that they always read emergency alert text messages and visited the linked website to obtain more information. Factors such as female sex (odds ratio [OR] 1.68, 95% CI 1.28-2.21) and older age (30-39 years: OR 2.02, 95% CI 1.25-3.28; 40-49 years: OR 2.84, 95% CI 1.80-4.47; 50-59 years: OR 3.19, 95% CI 2.01-5.06; 60 years and above: OR 3.12, 95% CI 2.00-4.86 versus 18-29 years) were identified to be associated with a higher frequency of reading the text messages. Participants who always read the text messages practiced wearing facial masks (ß=.074, P=.01) more frequently than those who did not. In terms of social distancing, participants who reported they always read the text messages avoided crowded places (ß=.078, P=.01) and canceled or postponed social gatherings (ß=.103, P<.001) more frequently than those who did not read the text messages. Furthermore, reading text messages directly and indirectly affected practicing precautionary behaviors, as the mediation effect of response efficacy between reading text messages and practicing preventive behaviors was significant. CONCLUSIONS: Our findings suggest that emergency alert text messages sent to individuals' mobile phones are timely and effective strategies for encouraging preventive behavior in public. Sending emergency alert text messages to provide the public with accurate and reliable information could be positively considered by the health authorities, which might reduce the negative impact of infodemics.


Subject(s)
COVID-19/prevention & control , Cell Phone , Internet , Text Messaging , Adolescent , Adult , COVID-19/transmission , Communication , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Republic of Korea/epidemiology , SARS-CoV-2/isolation & purification , Young Adult
16.
J Med Internet Res ; 23(2): e26257, 2021 02 22.
Article in English | MEDLINE | ID: covidwho-1574035

ABSTRACT

BACKGROUND: As the COVID-19 pandemic continues, an initial risk-adapted allocation is crucial for managing medical resources and providing intensive care. OBJECTIVE: In this study, we aimed to identify factors that predict the overall survival rate for COVID-19 cases and develop a COVID-19 prognosis score (COPS) system based on these factors. In addition, disease severity and the length of hospital stay for patients with COVID-19 were analyzed. METHODS: We retrospectively analyzed a nationwide cohort of laboratory-confirmed COVID-19 cases between January and April 2020 in Korea. The cohort was split randomly into a development cohort and a validation cohort with a 2:1 ratio. In the development cohort (n=3729), we tried to identify factors associated with overall survival and develop a scoring system to predict the overall survival rate by using parameters identified by the Cox proportional hazard regression model with bootstrapping methods. In the validation cohort (n=1865), we evaluated the prediction accuracy using the area under the receiver operating characteristic curve. The score of each variable in the COPS system was rounded off following the log-scaled conversion of the adjusted hazard ratio. RESULTS: Among the 5594 patients included in this analysis, 234 (4.2%) died after receiving a COVID-19 diagnosis. In the development cohort, six parameters were significantly related to poor overall survival: older age, dementia, chronic renal failure, dyspnea, mental disturbance, and absolute lymphocyte count <1000/mm3. The following risk groups were formed: low-risk (score 0-2), intermediate-risk (score 3), high-risk (score 4), and very high-risk (score 5-7) groups. The COPS system yielded an area under the curve value of 0.918 for predicting the 14-day survival rate and 0.896 for predicting the 28-day survival rate in the validation cohort. Using the COPS system, 28-day survival rates were discriminatively estimated at 99.8%, 95.4%, 82.3%, and 55.1% in the low-risk, intermediate-risk, high-risk, and very high-risk groups, respectively, of the total cohort (P<.001). The length of hospital stay and disease severity were directly associated with overall survival (P<.001), and the hospital stay duration was significantly longer among survivors (mean 26.1, SD 10.7 days) than among nonsurvivors (mean 15.6, SD 13.3 days). CONCLUSIONS: The newly developed predictive COPS system may assist in making risk-adapted decisions for the allocation of medical resources, including intensive care, during the COVID-19 pandemic.


Subject(s)
COVID-19/diagnosis , COVID-19/mortality , Age Factors , Aged , Critical Care/statistics & numerical data , Dementia/epidemiology , Female , Humans , Kidney Failure, Chronic/epidemiology , Length of Stay/statistics & numerical data , Male , Middle Aged , Pandemics , Prognosis , Proportional Hazards Models , ROC Curve , Republic of Korea/epidemiology , Retrospective Studies , Risk Factors , Severity of Illness Index , Survival Rate
18.
Epidemiol Health ; 43: e2021083, 2021.
Article in English | MEDLINE | ID: covidwho-1572772

ABSTRACT

OBJECTIVES: Coronavirus disease 2019 (COVID-19) outbreaks in general hospitals are particularly risky because they not only overburden the regional healthcare delivery system, but also increase the possibility of community transmission. This study shares an experience of a COVID-19 outbreak response in a general hospital in Gyeonggi Province, Korea. METHODS: Since the first COVID-19 confirmed case was recognized in Hospital A on March 29, 2020, the Immediate Response Team of Gyeonggi Province and Korea Disease Control and Prevention Agency devised a plan to conduct an epidemiological investigation and minimize the paralysis of hospital functions. Apart from the epidemiological investigation, a risk assessment of the hospital and management of contacts, including patients and workers, were also undertaken. RESULTS: In total, 72 confirmed cases were identified, including 26 hospitalized patients, 16 healthcare personnel, 7 visitors, and 22 cases identified externally. The majority of the confirmed cases were exposed in Ward B or were contacts of people exposed in Ward A (58.3% of 72 cases). Among healthcare personnel, caregivers were found to be the most vulnerable to COVID-19 in this outbreak. CONCLUSIONS: Preparation for all possible situations in medical facilities is important because it is difficult to find alternative resources. The findings of this study provide information on controlling the further transmission of COVID-19 and furnish evidence of the importance of ordinary management skills to be prepared for COVID-19.


Subject(s)
COVID-19 , Disease Outbreaks , Hospitals, General , Humans , Republic of Korea/epidemiology , SARS-CoV-2
19.
Int J Environ Res Public Health ; 18(24)2021 12 07.
Article in English | MEDLINE | ID: covidwho-1554892

ABSTRACT

The COVID-19 pandemic has been spreading worldwide with more than 246 million confirmed cases and 5 million deaths across more than 200 countries as of October 2021. There have been multiple disease clusters, and transmission in South Korea continues. We aim to analyze COVID-19 clusters in Seoul from 4 March to 4 December 2020. A branching process model is employed to investigate the strength and heterogeneity of cluster-induced transmissions. We estimate the cluster-specific effective reproduction number Reff and the dispersion parameter κ using a maximum likelihood method. We also compute Rm as the mean secondary daily cases during the infection period with a cluster size m. As a result, a total of 61 clusters with 3088 cases are elucidated. The clusters are categorized into six groups, including religious groups, convalescent homes, and hospitals. The values of Reff and κ of all clusters are estimated to be 2.26 (95% CI: 2.02-2.53) and 0.20 (95% CI: 0.14-0.28), respectively. This indicates strong evidence for the occurrence of superspreading events in Seoul. The religious groups cluster has the largest value of Reff among all clusters, followed by workplaces, schools, and convalescent home clusters. Our results allow us to infer the presence or absence of superspreading events and to understand the cluster-specific characteristics of COVID-19 outbreaks. Therefore, more effective suppression strategies can be implemented to halt the ongoing or future cluster transmissions caused by small and sporadic clusters as well as large superspreading events.


Subject(s)
COVID-19 , Disease Outbreaks , Humans , Pandemics , Republic of Korea/epidemiology , SARS-CoV-2
20.
Front Public Health ; 9: 767671, 2021.
Article in English | MEDLINE | ID: covidwho-1533723

ABSTRACT

The telemedicine system, which has been gradually introduced, has changed dramatically with the outbreak of COVID-19. Now, with the development of related laws and technologies, the introduction of telemedicine will be further accelerated, and like the advent of smartphones, this will become an unstoppable trend of the times. However, just as there are various crimes and corruption problems in the current health system, the introduction of telemedicine may bring other problems. Therefore, it is important to anticipate the types of corruption or crimes that will occur with the introduction of telemedicine. And based on these expectations, we will have an opportunity to properly prepare for the various problems associated with telemedicine.


Subject(s)
COVID-19 , Telemedicine , Crime , Humans , Republic of Korea/epidemiology , SARS-CoV-2
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