Epidemiology and Health

COVID-19: Original Article

Korea Seroprevalence Study of Monitoring of SARS-COV-2 Antibody Retention and Transmission (K-SEROSMART): findings from national representative sample: Jina Han, Hye Jin Baek, Eunbi Noh, Kyuhyun Yoon, Jung Ae Kim, Sukhyun Ryu, Kay O Lee, No Yai Park, Eunok Jung, Sangil Kim, Hyukmin Lee, Yoo-Sung Hwang, Jaehun Jung, Hun Jae Lee, Sung-il Cho, Sangcheol Oh, Migyeong Kim, Chang-Mo Oh, Byengchul Yu, Young-Seoub Hong, Keonyeop Kim, Sun Jae Jung, Mi Ah Han, Moo-Sik Lee, Jung-Jeung Lee, Young Hwangbo, Hyeon Woo Yim, Yu-Mi Kim, Joongyub Lee, Weon-Young Lee, Jae-Hyun Park, Sungsoo Oh, Heui Sug Jo, Hyeongsu Kim, Gilwon Kang, Hae-Sung Nam, Ju-Hyung Lee, Gyung-Jae Oh, Min-Ho Shin, Soyeon Ryu, Tae-Yoon Hwang, Soon-Woo Park, Sang Kyu Kim, Roma Seol, Ki-Soo Park, Su Young Kim, Jun-wook Kwon, Sung Soon Kim, Byoungguk Kim, June-Woo Lee, Eun Young Jang, Ah-Ra Kim, Jeonghyun Nam, The Korea Community Health Survey Group, Soon Young Lee, Dong-Hyun Kim; Epidemiol Health. 2023;45:e2023075. Published online August 17, 2023; DOI: https://doi.org/10.4178/epih.e2023075

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
We estimated the population prevalence of antibodies to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), including unreported infections, through a Korea Seroprevalence Study of Monitoring of SARS-CoV-2 Antibody Retention and Transmission (K-SEROSMART) in 258 communities throughout Korea.

METHODS

In August 2022, a survey was conducted among 10,000 household members aged 5 years and older, in households selected through two stage probability random sampling. During face-to-face household interviews, participants self-reported their health status, COVID-19 diagnosis and vaccination history, and general characteristics. Subsequently, participants visited a community health center or medical clinic for blood sampling. Blood samples were analyzed for the presence of antibodies to spike proteins (anti-S) and antibodies to nucleocapsid proteins (anti-N) SARS-CoV-2 proteins using an electrochemiluminescence immunoassay. To estimate the population prevalence, the PROC SURVEYMEANS statistical procedure was employed, with weighting to reflect demographic data from July 2022.

RESULTS

In total, 9,945 individuals from 5,041 households were surveyed across 258 communities, representing all basic local governments in Korea. The overall population-adjusted prevalence rates of anti-S and anti-N were 97.6% and 57.1%, respectively. Since the Korea Disease Control and Prevention Agency has reported a cumulative incidence of confirmed cases of 37.8% through July 31, 2022, the proportion of unreported infections among all COVID-19 infection was suggested to be 33.9%.

CONCLUSIONS

The K-SEROSMART represents the first nationwide, community-based seroepidemiologic survey of COVID-19, confirming that most individuals possess antibodies to SARS-CoV-2 and that a significant number of unreported cases existed. Furthermore, this study lays the foundation for a surveillance system to continuously monitor transmission at the community level and the response to COVID-19.

Summary

Korean summary
인구집단을 기반으로 하여 대표성 있는 표본을 추출하여 COVID-19 항체유병률 조사를 전국적으로 수행함으로 지역사회 단위에서 지속적으로 모니터링할 수 있는 COVID-19 감시체계 구축의 기반을 마련하였다. 2022년 8월 우리나라 국민의 대부분이 COVID-19에 대한 항체를 보유하고 있었고 인구 3명 중 1명은 미확진 감염자로 추정되었다.

Key Message
The K-SEROSMART represents the first nationwide, community-based seroepidemiologic survey of COVID-19. In August 2022, most of the Korean people had antibodies to COVID-19, and one in three people was estimated to have an unreported infection. This study lays the foundation for a surveillance system to continuously monitor transmission at the community level and the response to COVID-19.

Citations

Citations to this article as recorded by

Infection-mediated immune response in SARS-CoV-2 breakthrough infection and implications for next-generation COVID-19 vaccine development
Sho Miyamoto, Tadaki Suzuki
Vaccine.2024; 42(6): 1401. CrossRef

Original Articles

Risk of cancer, cardiovascular disease, thromboembolism, and mortality in patients with rheumatoid arthritis receiving Janus kinase inhibitors: a real-world retrospective observational study using Korean health insurance data: Hong Ki Min, Hyeongsu Kim, Ho Jin Jeong, Se Hee Kim, Hae-Rim Kim, Sang-Heon Lee, KunSei Lee, Soon-Ae Shin, Jong Heon Park; Epidemiol Health. 2023;45:e2023045. Published online April 15, 2023; DOI: https://doi.org/10.4178/epih.e2023045

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
This study investigated whether Janus kinase inhibitors (JAKis) raise the risk of cardiovascular disease (CVD), venous thromboembolism (VTE), and cancer in patients with rheumatoid arthritis (RA).

METHODS

We conducted a real-world retrospective observational study using data obtained from the Korean National Health Insurance Service database. Two data sets were analyzed: tumor necrosis factor inhibitor (TNFi)/JAKi-naive RA patients (set 1) and all RA patients who used TNFis or JAKis (set 2). The incidence rate ratios (IRRs) and hazard ratios (HRs) for acute myocardial infarction (AMI), stroke, cardiovascular (CV)-related mortality, major adverse cardiovascular events (MACE), VTE, arterial thromboembolism (ATE), cancer, and all-cause mortality were compared between the JAKi and TNFi groups.

RESULTS

Set 1 included 1,596 RA patients (JAKi group: 645; TNFi group: 951), and set 2 included 11,765 RA patients (JAKi group: 2,498; TNFi group: 9,267). No adverse events (AEs) showed significantly higher IRRs in the JAKi groups than in the TNFi groups of sets 1 and 2. The HRs for MACE in the JAKi groups of sets 1 and 2 were 0.59 (95% confidence [CI], 0.35 to 0.99) and 0.80 (95% CI, 0.67 to 0.97), respectively. The JAKi group of set 2 showed a significantly higher risk of all-cause mortality (HR, 1.71; 95% CI, 1.32 to 2.20), but the other AEs did not demonstrate increased risks in the JAKi groups.

CONCLUSIONS

In this study, JAKis did not increase the risk of AMI, stroke, CV-related mortality, MACE, VTE, ATE, or cancer in Korean RA patients relative to TNFis.

Summary

Korean summary
1. 한국인 류마티스관절염 환자를 대상으로 한 실제임상자료 결과, JAK 억제제가 종양괴사인자 억제제에 비해 심혈관질환, 혈전증, 암 등의 심각한 부작용을 증가시키지는 않았다. 2. 본 연구를 토대로 한국인 대상자에서 JAK 억제제가 심혈관질환 등의 심각한 부작용을 증가시키는지에 대한 재평가가 필요하다.

Key Message
1. The real word-data based results showed that risks of MACE, thromboembolism, and cancers were not increased in Korean RA patients with JAK inhibitor when compared to Korean RA patients with TNF inhibitors. 2. Therefore, the risk of serious adverse events of JAK inhibitors in Korean population should be reconsidered and reassessed before adding black box warning of JAK inhibitors.

Citations

Citations to this article as recorded by

Multicenter evaluation of tofacitinib retention and safety in rheumatoid arthritis – why cardiovascular risk factors do not equate to overt risk
Anna Felis-Giemza, Mateusz Moskal, Krzysztof Proc, Zbigniew Guzera, Marcin Stajszczyk, Karolina Palej, Kornelia Chmurzyńska, Piotr Wiland, Krzysztof Batko, Bogdan Batko
Rheumatology.2024; 61(6): 414. CrossRef
Safety and Effectiveness of Baricitinib in Chinese Patients with Moderate-to-Severe Rheumatoid Arthritis: 24-Week Results from a Post-Marketing Safety Study
Chan-yuan Wu, Qian Wang, Jian Shi, Xiu-ying Zhang, Rong Du, Jie-ruo Gu, Qi-huan Liu, Jiao Yu, Jia-wei Xu, Yan-jie Zhang, Hao Zhu, Meng-tao Li, Xiao-feng Zeng
Rheumatology and Therapy.2023; 10(6): 1609. CrossRef
Comparative cardiovascular safety with janus kinase inhibitors and biological disease-modifying antirheumatic drugs as used in clinical practice: an observational cohort study from Sweden in patients with rheumatoid arthritis
Hannah Bower, Thomas Frisell, Daniela di Giuseppe, Benedicte Delcoigne, Johan Askling
RMD Open.2023; 9(4): e003630. CrossRef
Are JAKis more effective among elderly patients with RA, smokers and those with higher cardiovascular risk? A comparative effectiveness study of b/tsDMARDs in Sweden
Hannah Bower, Thomas Frisell, Daniela di Giuseppe, Benedicte Delcoigne, Ulf Lindström, Carl Turesson, Katerina Chatzidionysiou, Elisabet Lindqvist, Ann Knight, Helena Forsblad-d'Elia, Johan Askling
RMD Open.2023; 9(4): e003648. CrossRef

The association between metabolic syndrome and heart failure in middle-aged male and female: Korean population-based study of 2 million individuals: Tae-Eun Kim, Hyeongsu Kim, JiDong Sung, Duk-Kyung Kim, Myoung-Soon Lee, Seong Woo Han, Hyun-Joong Kim, Sung Hea Kim, Kyu-Hyung Ryu; Epidemiol Health. 2022;44:e2022078. Published online September 21, 2022; DOI: https://doi.org/10.4178/epih.e2022078

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Abstract PDF

Abstract

OBJECTIVES
Although an association is known to exist between metabolic syndrome (MetS) and heart failure (HF) risk, large longitudinal studies are limited. We investigated metabolic status as a risk factor for HF in middle-aged male and female and considered sex differences in various risk factors for HF using nationwide real-world data.

METHODS

Data obtained from the Korean National Health Insurance Service from 2009 to 2016 were analyzed. A total of 2,151,597 middle-aged subjects (between 50 and 59 years old) were enrolled. Subjects were divided into 3 groups (normal, pre‐ MetS, and MetS). Cox proportional hazard models were used to estimate the association between MetS and incident HF after adjusting for clinical risk factors.

RESULTS

At baseline, MetS existed in 23.77% of male and 10.58% of female. Pre-MetS and MetS increased the risk of HF: the hazard ratios of pre-MetS for incident HF were 1.508 (95% confidence interval [CI], 1.287 to 1.767) in male and 1.395 (95% CI, 1.158 to 1.681) in female, and those of MetS were 1.711 (95% CI, 1.433 to 2.044) in male and 2.144 (95% CI, 1.674 to 2.747) in female. Current smoking, a low hemoglobin level, underweight (body mass index < 18.5 kg/m2), a high creatinine level, and acute myocardial infarction were also predictors of HF in both sexes.

CONCLUSIONS

Pre-MetS and MetS were identified as risk factors for HF in middle-aged male and female. The effect of MetS on the occurrence of HF was stronger in female than in male. Pre-MetS was also a predictor of HF, but was associated with a lower risk than MetS.

Summary

Citations

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Integrating machine learning and nontargeted plasma lipidomics to explore lipid characteristics of premetabolic syndrome and metabolic syndrome
Xinfeng Huang, Qing He, Haiping Hu, Huanhuan Shi, Xiaoyang Zhang, Youqiong Xu
Frontiers in Endocrinology.2024;[Epub] CrossRef
17-year follow-up of association between telomere length and all-cause mortality, cardiovascular mortality in individuals with metabolic syndrome: results from the NHANES database prospective cohort study
Lijiao Xiong, Guangyan Yang, Tianting Guo, Zhaohao Zeng, Tingfeng Liao, Yanchun Li, Ying Li, Fujuan Chen, Shu Yang, Lin Kang, Zhen Liang
Diabetology & Metabolic Syndrome.2023;[Epub] CrossRef
Modifications of long-term heart rate variability produced in an experimental model of diet-induced metabolic syndrome
W. M. Lozano, J. E. Ortiz-Guzmán, O. Arias-Mutis, A. Bizy, P. Genovés, L. Such-Miquel, A. Alberola, F. J. Chorro, M. Zarzoso, C. J. Calvo
Interface Focus.2023;[Epub] CrossRef

Sero-prevalence of Hepatitis B Virus Surface Antigen and Antibody in High School Students in Chungju-city.: Hyeongsu Kim, Kun Sei Lee, Soung Hoon Chang, Suekyung Park, Cheongsik Kim, Chang Hee Lee, Hyuk Jung Kweon, Soon Sup Chung; Korean J Epidemiol. 2002;24(2):107-112.

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Abstract PDF: Abstract
OBJECTIVES
Since Korea has been known to be one of the endemic area for hepatitis B virus(HBV) infection, vaccination for HBV has been recommended for all neonates in Korea. After starting vaccination in 1983, the change of sero-positivity of HBsAg and HBsAb is expected. This study was carried out to investigate the seropositive rate of hepatitis B virus surface antigen and antibody in high school freshmen students in Chungju-city.
METHODS
AND MATERIALS: From 1998 to 2001, a total of 11,735 who were born in 1982 to 1986, were enrolled in this study. HBsAg and anti-HBs were tested by reversed passive hemagglutination and passive hemagglutination, respectively. PESULTS: The study population was 11,735 students who were composed of 5,813 males (49.6%) and 5,914 females (50.4%). The HBsAg sero-positivity of male and female students was 3.25% (n=381) and 2.59% (n=153) respectively. The anti-HBs sero-positivity of male and female students was 62.2% (n=3,154) and 64.1% (n=2,969) respectively. There are significant difference observed in comparison of HBsAg and anti-HBs seropositivity according to sex (p<0.05). From 1982 to 1986 on birth year, anti-HBs sero-positivity has been increased significantly from 63.3% to 73.3%. But the change of HBsAg sero-positivity has not been changed significantly.
CONCLUSIONS
As compared with previous studies of HBsAg and anti-HBs, the sero-positive rate of HBsAg has not been changed but that of HBsAb has been increased significantly. This result revealed that the effect of HBV vaccination program was successful.; Summary

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