Epidemiology and Health

COVID-19: Original Article

Viral shedding patterns of symptomatic SARS-CoV-2 infections by periods of variant predominance and vaccination status in Gyeonggi Province, Korea: Gawon Choi, Ah-Young Lim, Sojin Choi, Kunhee Park, Soon Young Lee, Jong-Hun Kim; Epidemiol Health. 2023;45:e2023008. Published online December 21, 2022; DOI: https://doi.org/10.4178/epih.e2023008

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
We compared the viral cycle threshold (Ct) values of infected patients to better understand viral kinetics by vaccination status during different periods of variant predominance in Gyeonggi Province, Korea.
METHODS
We obtained case-specific data from the coronavirus disease 2019 (COVID-19) surveillance system, Gyeonggi in-depth epidemiological report system, and Health Insurance Review & Assessment Service from January 2020 to January 2022. We defined periods of variant predominance and explored Ct values by analyzing viral sequencing test results. Using a generalized additive model, we performed a nonlinear regression analysis to determine viral kinetics over time.
RESULTS
Cases in the Delta variant’s period of predominance had higher viral shedding patterns than cases in other periods. The temporal change of viral shedding did not vary by vaccination status in the Omicron-predominant period, but viral shedding decreased in patients who had completed their third vaccination in the Delta-predominant period. During the Delta-predominant and Omicron-predominant periods, the time from symptom onset to peak viral shedding based on the E gene was approximately 2.4 days (95% confidence interval [CI], 2.2 to 2.5) and 2.1 days (95% CI, 2.0 to 2.1), respectively.
CONCLUSIONS
In one-time tests conducted to diagnose COVID-19 in a large population, although no adjustment for individual characteristics was conducted, it was confirmed that viral shedding differed by the predominant strain and vaccination history. These results show the value of utilizing hundreds of thousands of test data produced at COVID-19 screening test centers.; Summary

Korean summary
코로나19 선별진료소에서는 확진 검사를 위해 수십만 건에서 수백만 건까지의 일회성 검사를 시행해왔다. 검사를 받은 개인의 특성과 관련된 데이터 제한으로 인해 분석 시 이를 보정할 수는 없지만, 대규모 인구집단에서 얻어진 검사 결과는 SARS-CoV-2 배출 특성을 평가하는 데 활용될 수 있다. 이번 연구에서는 바이러스 변이의 종류와 백신 접종 이력에 따라 증상 발생 후 시간 경과에 따라 바이러스 배출량이 달라지는 것을 확인하였다. 이러한 대규모 선별 검사자료는 향후에도 유용하게 활용 가능하다.

Key Message
The screening center for COVID-19 has conducted hundreds of thousands to millions of one-time confirmation tests for diagnosis. Although individual characteristics cannot be adjusted for due to data limitations, the test results from a large population can still be utilized to evaluate SARS-CoV-2 shedding. We confirmed that viral shedding varied over time after symptom onset, depending on the type of virus variant and vaccination history.

COVID-19: Epidemiologic Investigation

Experience of a COVID-19 outbreak response in a general hospital in Gyeonggi Province, Korea: Chanhee Kim, Gawon Choi, Shin Young Park, Jieun Kim, Young Joon Park, Kyungnam Kim; Epidemiol Health. 2021;43:e2021083. Published online October 18, 2021; DOI: https://doi.org/10.4178/epih.e2021083

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2 Crossref

Abstract Summary PDF

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.

Summary

Korean summary
본 연구에서는 2020년 경기도 소재 한 종합병원에서 발생한 코로나19 유행 대응 사례 경험을 공유한다. 병원 외 지역사회 전파 사례를 포함하여 총 72명의 확진자가 이 유행에서 확인되었다. 종합병원은 지역 의료전달체계에서 중요한 역할을 하고 있기 때문에 코로나19로 인해 그 기능이 마비되지 않도록 예방하는 것이 가장 바람직하며, 이를 위해서는 평상 시에 적절한 대비 체계를 갖추어 두어야 한다.

Key Message
This study shares the experience of responding to the COVID-19 outbreak at a general hospital in Gyeonggi-do, 2020. A total of 72 confirmed cases were identified, including cases of community based transmission outside the hospital. Since general hospitals play an important role in the medical delivery system, it is most desirable to prevent the function from being paralyzed by COVID-19 situation, and for this, and appropriate preparedness should be established.

Citations

Citations to this article as recorded by

Vaccine effectiveness and the epidemiological characteristics of a COVID-19 outbreak in a tertiary hospital in Republic of Korea
Seonhee Ahn, Tae Jong Son, Yoonsuk Jang, Jihyun Choi, Young Joon Park, Jiseon Seong, Hyun Hee Kwon, Muk Ju Kim, Donghyok Kwon
Osong Public Health and Research Perspectives.2023; 14(3): 188. CrossRef
Effect of changes in the hearing aid subsidy on the prevalence of hearing loss in South Korea
Chul Young Yoon, Junhun Lee, Tae Hoon Kong, Young Joon Seo
Frontiers in Neurology.2023;[Epub] CrossRef

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