Epidemiology and Health

COVID-19: Original Article

Parental concerns about COVID-19 vaccine safety and hesitancy in Korea: implications for vaccine communication: Hye-Kyung Cho, Hyunju Lee, Young June Choe, Shinkyeong Kim, Sujin Seo, Jiwon Moon, Eun Hwa Choi, Geun-Yong Kwon, Jee Yeon Shin, Sang-Yoon Choi, Mi Jin Jeong, Myoungsoon You; Epidemiol Health. 2023;45:e2023004. Published online December 13, 2022; DOI: https://doi.org/10.4178/epih.e2023004

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Abstract Summary PDF: Abstract
OBJECTIVES
Vaccination is one of the most important strategies to contain the spread of coronavirus disease 2019 (COVID-19). Vaccination in children is dependent on their parents, making it important to understand parents’ awareness and attitudes toward vaccines in order to devise strategies to raise vaccination rates in children.
METHODS
A web-based nationwide survey was conducted among Korean parents of 7-year-old to 18-year-old children in August 2021 to estimate parents’ intention to vaccinate their children against COVID-19 and identify key factors affecting parental acceptance and hesitancy through regression analysis.
RESULTS
Approximately 56.4% (575/1,019) were willing to vaccinate their children against COVID-19. Contributing factors to COVID-19 vaccine hesitancy were being a mother (adjusted odds ratio [aOR], 0.36; 95% confidence interval [CI], 0.25 to 0.52), a lower education level (aOR, 0.83; 95% CI, 0.70 to 0.97), hesitancy to other childhood vaccines (aOR, 0.78; 95% CI, 0.64 to 0.96), and refusal to vaccinate themselves (aOR, 0.08; 95% CI, 0.02 to 0.20). Having older children (aOR, 1.20; 95% CI, 1.13 to 1.28), trusting the child’s doctor (aOR, 1.19; 95% CI, 1.07 to 1.32), positive perceptions of the COVID-19 vaccine’s effectiveness (aOR, 2.60; 95% CI, 1.90 to 3.57) and perceiving the COVID-19 vaccine as low-risk (aOR, 1.68; 95% CI, 1.27 to 2.24) were associated with COVID-19 vaccine acceptance. Concerns about adverse reactions were the most common cause of hesitancy.
CONCLUSIONS
Providing parents with accurate and reliable information on vaccine effectiveness and safety is important to increase COVID-19 vaccine uptake in children. Differential or targeted approaches to parents according to gender, age, and their children’s age are necessary for effective communication about vaccination in children.; Summary

Korean summary
부모에게 백신 효과와 안전성에 대한 정확하고 믿을만한 정보를 제공하는 것이 소아 코로나19 백신 접종률을 높이는데 중요하다. 자녀의 백신 접종에 대한 의사소통을 효율적으로 하기 위해서는 부모의 성별과 연령, 자녀의 연령을 고려한 차별적인 접근 방법이 필요하다.

Key Message
To improve COVID-19 vaccine uptake in children, it's crucial to provide parents with reliable and precise information about vaccine safety and effectiveness. Targeted communication strategies that consider factors such as the age of the parents and their children, as well as gender, may be necessary to effectively convey this information.

Original Article

Changes in the prevalence of metabolic syndrome in Korean adults after the COVID-19 outbreak: Ji-Young Kwon, Sang-Wook Song; Epidemiol Health. 2022;44:e2022101. Published online November 5, 2022; DOI: https://doi.org/10.4178/epih.e2022101

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Abstract PDF: Abstract
OBJECTIVES
This study sought to reveal changes in the prevalence of metabolic syndrome (MetS) after the start of the coronavirus disease 2019 (COVID-19) pandemic and to identify the groups showing the greatest changes.
METHODS
We compared the prevalence of MetS between 2017–2019 (i.e., the 3-year period before the COVID-19 pandemic) and soon after the initial outbreak of COVID-19 in 2020 among 24,564 adults ≥ 19 years of age using data from the Korea National Health and Nutrition Examination Survey.
RESULTS
The prevalence of MetS increased steadily between 2017 and 2020 (29.4 to 35.3%, p for trend < 0.001), with annual percent changes of 2.0%p, 2.2%p, and 1.7%p, respectively. Compared to 3 years before the COVID-19 pandemic, the prevalence of MetS significantly increased during the COVID-19 pandemic in males (6.2%p; 95% confidence interval [CI], 3.5 to 8.9) compared to females (1.5%p; 95% CI, -1.2 to 4.1). The age groups with the greatest increases in MetS prevalence after the COVID-19 pandemic were those in their 40s (4.6%p; 95% CI, 0.9 to 8.4) and 50s (5.8%p; 95% CI, 2.2 to 9.4). By educational background, the increase in MetS prevalence was greatest among those with a college degree or higher (5.1%p). The prevalence of MetS in high-income (5.3%p) and low-income (4.6%p) groups significantly increased.
CONCLUSIONS
The increasing trend in the overall prevalence of MetS continued during the COVID-19 pandemic. In particular, the prevalence of MetS among adult males in their 40s and 50s increased significantly after the COVID-19 outbreak in Korea.; Summary

Korean summary

Key Message

COVID-19: Brief Communication

Dynamics of hospitalizations and in-hospital deaths from COVID-19 in northeast Brazil: a retrospective analysis based on the circulation of SARS-CoV-2 variants and vaccination coverage: Paulo Ricardo Martins-Filho, Adriano Antunes de Souza Araújo, Lucindo José Quintans-Júnior, Bárbara dos Santos Soares, Waneska de Souza Barboza, Taise Ferreira Cavalcante, Victor Santana Santos; Epidemiol Health. 2022;44:e2022036. Published online April 5, 2022; DOI: https://doi.org/10.4178/epih.e2022036

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Abstract PDF

Abstract

This study investigated the dynamics of hospitalizations and in-hospital deaths from coronavirus disease 2019 (COVID-19) throughout the pandemic in northeast Brazil, the Brazilian region with the worst socioeconomic indicators. In total, 141,445 cases, 8,213 hospital admissions, and 1,644 in-hospital deaths from COVID-19 were registered from March 14, 2020 to February 5, 2022. The overall rates of hospitalization and in-hospital deaths were 5.8% and 20.0%, respectively. The hospitalization and death rates significantly decreased over time, which may have been related to progress in vaccination. During the spread of the Gamma variant (January to June 2021), most hospitalized individuals were young adults, and approximately 40% of deaths occurred in this age group. During the predominance of Delta (July to December 2021), over 75% of deaths occurred among the elderly and unvaccinated or partially vaccinated individuals. This rate decreased to 42.3% during the transmission of the Omicron variant (January to February 2022), during which 34.6% of deaths were recorded among fully vaccinated individuals (2 doses) and 23.1% among those who received full vaccination and a booster. The Omicron-driven third wave was associated with a rise in the proportion of deaths among vaccinated individuals, especially among those who had not received a booster dose.

Summary

Korean summary

Key Message
The Omicron-driven third wave in Brazil was associated with a rise in the proportion of deaths among vaccinated individuals, especially among those who had not received a booster dose

Citations

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Case-fatality rates and risk of death from COVID-19 and influenza A/H3N2 in Brazil: A nationwide ecological study
Paulo Ricardo Martins-Filho, Jerocílio Maciel de Oliveira Júnior, Cliomar Alves dos Santos
Enfermedades Infecciosas y Microbiología Clínica.2023; 41(3): 199. CrossRef
SARS-CoV-2 infection and mortality in pediatric patients with hematological malignancies and solid tumors
João Eduardo Andrade Tavares de Aguiar, Marcos Antônio Lima Carvalho, Simone Santana Viana, Paulo Ricardo Martins-Filho, Rosana Cipolotti
Pediatric Hematology and Oncology.2023; 40(4): 429. CrossRef
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Pediatric Infectious Disease Journal.2023; 42(2): 136. CrossRef
Case-fatality rates and risk of death from COVID-19 and influenza A/H3N2 in Brazil: A nationwide ecological study
Paulo Ricardo Martins-Filho, Jerocílio Maciel de Oliveira Júnior, Cliomar Alves dos Santos
Enfermedades infecciosas y microbiologia clinica (English ed.).2023; 41(3): 199. CrossRef
Impact of inactivated vaccines on decrease of viral RNA levels in individuals with the SARS-CoV-2 Omicron (BA.2) variant: A retrospective cohort study in Shanghai, China
Peng Yang, Bianli Dang, Wen Kang, Xiaofeng Li, Tianping Wang, Ruijuan Li, Meijuan Peng, Yushen Liu, Linxu Wang, Yan Cheng, Suhuai Yu, Min Wei, Han Gao, Wenzhen Kang, Lei Shang
Frontiers in Public Health.2023;[Epub] CrossRef
Comparison of the disease severity with infection of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) Delta and Omicron variants: A meta‐analysis
Ying Qiu, Zhenghao Li, Fan Lin, Yilin Yang, Lanxuan Yang, Ting Li
MedComm – Future Medicine.2023;[Epub] CrossRef

COVID-19: Original Article

Model-based cost-effectiveness analysis of oral antivirals against SARS-CoV-2 in Korea: Youngji Jo, Sun Bean Kim, Munkhzul Radnaabaatar, Kyungmin Huh, Jin-Hong Yoo, Kyong Ran Peck, Hojun Park, Jaehun Jung; Epidemiol Health. 2022;44:e2022034. Published online March 12, 2022; DOI: https://doi.org/10.4178/epih.e2022034

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Many countries have authorized the emergency use of oral antiviral agents for patients with mild-to-moderate cases of coronavirus disease 2019 (COVID-19). We assessed the cost-effectiveness of these agents for reducing the number of severe COVID-19 cases and the burden on Korea’s medical system.

METHODS

Using an existing model, we estimated the number of people who would require hospital/intensive care unit (ICU) admission in Korea in 2022. The treatment scenarios included (1) all adult patients, (2) elderly patients only, and (3) adult patients with underlying diseases only, compared to standard care. Based on the current health system capacity, we calculated the incremental costs per severe case averted and hospital admission for each scenario.

RESULTS

We estimated that 236,510 COVID-19 patients would require hospital/ICU admission in 2022 with standard care only. Nirmatrelvir/ritonavir (87% efficacy) was predicted to reduce this number by 80%, 24%, and 17% when targeting all adults, adults with underlying diseases, and elderly patients (25, 8, and 4%, respectively, for molnupiravir, with 30% efficacy). Nirmatrelvir/ritonavir use is likely to be cost-effective, with predicted costs of US$8,878, US$8,964, and US$1,454, per severe patient averted for the target groups listed above, respectively, while molnupiravir is likely to be less cost-effective, with costs of US$28,492, US$29,575, and US$7,915, respectively.

CONCLUSIONS

In Korea, oral treatment using nirmatrelvir/ritonavir for symptomatic COVID-19 patients targeting elderly patients would be highly cost-effective and would substantially reduce the demand for hospital admission to below the capacity of the health system if targeted to all adult patients instead of standard care.

Summary

Korean summary
본 연구는 감염병 수리모형을 바탕으로 두가지 항바이러스제의 (nirmatrelvir/ritonavir와 molnupiravir) 비용 효익을 평가하였다. 본 모델에 따르면, 2022년 한국에서, 현재 의료시스템의 수용한계를 넘는 코로나 19 대유행이 발생할 때, nirmatrelvir/ritonavir 를 코로나 감염 및 증상 있는 고령층 환자들을 대상으로 투여할 경우 높은 비용 효익이 기대되고 (중증환자 1명 감소효과에$1,454 비용소요), 성인 환자 대상으로 투여할 경우, (molnupiravir이나 nirmatrelvir/ritonavir를 투여하지 않는) 일반 치료에 비해서 전체 입원 수요를 80% 줄일 것으로 기대된다.

Key Message
Given an expected high epidemic resurgence in 2022 that could exceed South Korea’s current health system capacity, oral treatment using nirmatrelvir/ritonavir for symptomatic COVID-19 patients may be a highly cost-effective solution if targeted to elderly patients ($1,454 per severe case averted) and substantially reduce the demand for hospital admission (80%, 188,478 patients) below the capacity of the health system if targeted to all adult patients compared to standard care.

Citations

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Impact of the Use of Oral Antiviral Agents on the Risk of Hospitalization in Community Coronavirus Disease 2019 Patients (COVID-19)
Terry Cheuk-Fung Yip, Grace Chung-Yan Lui, Mandy Sze-Man Lai, Vincent Wai-Sun Wong, Yee-Kit Tse, Bosco Hon-Ming Ma, Elsie Hui, Maria K W Leung, Henry Lik-Yuen Chan, David Shu-Cheong Hui, Grace Lai-Hung Wong
Clinical Infectious Diseases.2023; 76(3): e26. CrossRef
Nirmatrelvir plus ritonavir in COVID-19: a profile of its use
Hannah A. Blair
Drugs & Therapy Perspectives.2023; 39(2): 41. CrossRef
Multi-Faceted Analysis of COVID-19 Epidemic in Korea Considering Omicron Variant: Mathematical Modeling-Based Study
Youngsuk Ko, Victoria May Mendoza, Renier Mendoza, Yubin Seo, Jacob Lee, Jonggul Lee, Donghyok Kwon, Eunok Jung
Journal of Korean Medical Science.2022;[Epub] CrossRef
Adjusting non-pharmaceutical interventions based on hospital bed capacity using a multi-operator differential evolution
Victoria May P. Mendoza, Renier Mendoza, Jongmin Lee, Eunok Jung
AIMS Mathematics.2022; 7(11): 19922. CrossRef
The Possible Impact of Nationwide Vaccination on Outcomes of the COVID-19 Epidemic in North Korea: A Modelling Study
Sung-mok Jung, Jaehun Jung
Journal of Korean Medical Science.2022;[Epub] CrossRef
Medications for early treatment of COVID ‐19 in Australia
Adam Polkinghorne, James M Branley
Medical Journal of Australia.2022;[Epub] CrossRef
Comparative effectiveness of sotrovimab and molnupiravir for prevention of severe covid-19 outcomes in patients in the community: observational cohort study with the OpenSAFELY platform
Bang Zheng, Amelia C A Green, John Tazare, Helen J Curtis, Louis Fisher, Linda Nab, Anna Schultze, Viyaasan Mahalingasivam, Edward P K Parker, William J Hulme, Sebastian C J Bacon, Nicholas J DeVito, Christopher Bates, David Evans, Peter Inglesby, Henry D
BMJ.2022; : e071932. CrossRef
Treatment Options for Patients With Mild-to-Moderate Coronavirus Disease 2019 in Korea
Jaehyun Jeon, BumSik Chin
Journal of Korean Medical Science.2022;[Epub] CrossRef

COVID-19: Original Article

Seroprevalence of SARS-CoV-2 antibodies in the community based on participants in the 2020 Korea National Health and Nutrition Examination Survey: Ah-Ra Kim, Dohsik Minn, Su Hwan Kim, Hyeon Nam Do, Byoungguk Kim, Young Sill Choi, Dong-Hyun Kim, Eun-Jee Oh, Kyungwon Oh, Donghyok Kwon, Jun-Wook Kwon, Sung Soon Kim, June-Woo Lee; Epidemiol Health. 2022;44:e2022028. Published online February 21, 2022; DOI: https://doi.org/10.4178/epih.e2022028

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Abstract Summary PDF

Abstract

OBJECTIVES
The Korea National Health and Nutrition Examination Survey (KNHANES) is a nationwide cross-sectional surveillance system that assesses the health and nutritional status of the Korean population. To evaluate the occurrence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the community, we investigated the prevalence of anti-SARS-CoV-2 antibodies in the sera of KNHANES participants.

METHODS

Subjects were recruited between April 24 and December 12, 2020. In total, 5,284 subjects aged 10-90 years from 17 regions participated. SARS-CoV-2 antibodies were screened using the Elecsys Anti-SARS-CoV-2 assay. Positive samples were verified using 4 different SARS-CoV-2 antibody assays and the plaque reduction neutralizing test. The final seropositivity criteria were a positive screening test and at least 1 positive result from the 5 additional tests.

RESULTS

Almost half (49.2%; 2,600/5,284) of participants were from metropolitan areas, 48.9% were middle-aged (40-69 years), and 20.5% were in their 20s or younger. The seropositivity rate was 0.09% (5/5,284). Three of the 5 antibody-positive subjects had a history of infection, of whom 2 were infected abroad and 1 was infected in a local cluster outbreak.

CONCLUSIONS

The low SARS-CoV-2 antibody seroprevalence in Korea indicates that there have been few coronavirus disease 2019 (COVID-19) cases due to successful COVID-19 management measures (e.g., diagnostic tests for overseas arrivals, national social distancing, and strict quarantine measures). Moreover, asymptomatic infections were uncommon due to active polymerase chain reaction testing. However, hidden infections may exist in the community, requiring the continuation of quarantine and vaccination measures.

Summary

Korean summary
코로나19에 대한 방역대책 및 예방접종 정책 수립을 위한 과학적 근거를 확보하기 위하여 2020년도 국민건강영양조사(이하 국건영) 참여자 5,284명에 대해 코로나19 항체보유율을 조사함. 그 결과 2020년도 국건영 참여자의 항체양성률은 0.09%(5/5,284)였으며, 이중 확진 이력이 있는 사람은 3명이었음. 따라서 지역사회 미진단 감염자는 2명으로 확인됨. 국내 항체보유율은 해외 사례에 비해 낮으며, 이는 적극적인 방역관리에 따른 것으로 사료되며, 지역사회에 미진단 감염자가 존재함이 확인되어 이들에 대한 철저한 관리가 요구됨.

Key Message
The low SARS-CoV-2 antibody seroprevalence in Korea indicates that there have been few COVID-19 cases due to successful management measures, however, hidden infections may exist in the community, requiring the continuation of quarantine and vaccination measures.

Citations

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Accelerated Cognitive Function Decline in Community-Dwelling Older Adults during COVID-19 Pandemic: The Korean Frailty and Aging Cohort Study (KFACS)
Jaehoon Jung, Sunyoung Kim, Byungsung Kim, Miji Kim, Jisoo Yang, Dongmin Chung, Changwon Won
International Journal of Environmental Research and Public Health.2022; 19(17): 10666. CrossRef

COVID-19: Systematic Review

Quality of biosafety guidelines for dental clinical practice throughout the world in the early COVID-19 pandemic: a systematic review: Renata Cristina Soares, Juliana Schaia Rocha, Saulo Vinicius da Rosa, Jéssica Rodrigues da Silva Noll Gonçalves, Priscilla Lesly Perlas Condori, Ana Elisa Ribeiro, Samuel Jorge Moysés, Márcia Helena Baldani; Epidemiol Health. 2021;43:e2021089. Published online October 22, 2021; DOI: https://doi.org/10.4178/epih.e2021089

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Abstract PDF Supplementary Material: Abstract
OBJECTIVES
To conduct a systematic review of coronavirus disease 2019 (COVID-19)-related biosafety guidelines for dental clinical practice in the early stage of the pandemic, focusing on quality assessment.
METHODS
Electronic (via PubMed, Scopus, Web of Science, Latin American and Caribbean Health Sciences Literature database, Brazilian Library in Dentistry, and Cochrane Library) and gray literature searches were performed for documents published up to May 12, 2020. Guidelines updated until April 17, 2021 were identified. Documents were included as guidelines if they (1) consisted of a set of statements, directions, or principles presenting current or future rules or policy; (2) were developed by government agencies, institutions, organizations, or expert panels; and (3) were related to the general conduct of healthcare activities rather a particular condition. Two researchers, using the Appraisal of Guidelines for Research & Evaluation II, independently extracted the recommendations and evaluated the quality of the guidelines.
RESULTS
Twenty-seven documents from 19 countries were included in the review. These documents presented 122 recommendations related to (1) professional biosafety; (2) patients’/companions’ safety; (3) the organization and biosafety of the physical dental facility environment; and (4) the work process in dental care. Overall, the scientific quality of the guidelines was considered low. Some recommendations presented in these guidelines would require further research to establish their effectiveness.
CONCLUSIONS
We found a wide variety of biosafety guidelines for dental practice regarding COVID-19 in the early months of the pandemic, but their quality was low. Biosafety recommendations should be frequently updated.; Summary

Korean summary

Key Message
Despite the wide variety of biosafety guidelines for dental practice regarding COVID-19 in the early months of the pandemic, their quality was low. These findings demonstrate the need for more guidelines for dental practice with more high-quality evidence, focusing on clarification of the strictness of development, financing, conflicts of interest, and applicability. Guidelines with high scientific quality are essential for the formation of a robust scientific consensus facilitating the ability to offer safer and more reliable procedures in the pandemic context.

COVID-19: Original Article

The role of vitamin D deficiency on COVID-19: a systematic review and meta-analysis of observational studies: Mehmet Onur Kaya, Esra Pamukçu, Burkay Yakar; Epidemiol Health. 2021;43:e2021074. Published online September 23, 2021; DOI: https://doi.org/10.4178/epih.e2021074

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29 Citations

Abstract PDF Supplementary Material

Abstract

OBJECTIVES
Although vaccination has started, coronavirus disease 2019 (COVID-19) poses a continuing threat to public health. Therefore, in addition to vaccination, the use of supplements to support the immune system may be important. The purpose of this study was to synthesize evidence on the possible effect of low serum vitamin D levels (25[OH]D<20 ng/mL or 50 nmol/L) on COVID-19 infection and outcomes.

METHODS

We searched Google Scholar, PubMed, Scopus, Web of Science, and ScienceDirect without any language restrictions for articles published between January 1 and December 15, 2020. We performed 3 meta-analyses (called vitamin D and COVID-19 infection meta-analysis [D-CIMA], vitamin D and COVID-19 severity meta-analysis [D-CSMA], and vitamin D and COV ID-19 mortality meta-analysis [D-CMMA] for COVID-19 infection, severity, and mortality, respectively) to combine odds ratio values according to laboratory measurement units for vitamin D and the measured serum 25(OH)D level.

RESULTS

Twenty-one eligible studies were found to be relevant to the relationship between vitamin D and COVID-19 infection/outcomes (n=205,869). The D-CIMA meta-analysis showed that individuals with low serum vitamin D levels were 1.64 times (95% confidence interval [CI], 1.32 to 2.04; p<0.001) more likely to contract COVID-19. The D-CSMA meta-analysis showed that people with serum 25(OH)D levels below 20 ng/mL or 50 nmol/L were 2.42 times (95% CI, 1.13 to 5.18; p=0.022) more likely to have severe COVID-19. The D-CMMA meta-analysis showed that low vitamin D levels had no effect on COVID-19 mortality (OR, 1.64; 95% CI, 0.53 to 5.06, p=0.390).

CONCLUSIONS

According to our results, vitamin D deficiency may increase the risk of COVID-19 infection and the likelihood of severe disease. Therefore, we recommend vitamin D supplementation to prevent COVID-19 and its negative outcomes.

Summary

Korean summary

Key Message
Although vaccination has started, it seems that Covid-19 will continue to threaten public health for a long time. In addition to the vaccine, the use of supplements to support the immune system may also be important. The purpose of this study is to indicate the possible effect of low serum vitamin D (25(OH)D<20 ng/mL or 50nmol/L) on the Covid-19 infection and outcomes. According to our remarkable results, vitamin D deficiency increases the risk of Covid-19 infection and the potential for the severity of the disease. Therefore, vitamin D supplements should be added to prevention and treatment protocols for Covid-19 disease.

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Svetlana G. Makarova, Evgeny E. Emelyashenkov, Dmitry S. Yasakov, Irina Yu. Pronina, Oksana A. Ereshko, Irina G. Gordeeva, Albina A. Galimova, Tamara R. Chumbadze, Ayina M. Lebedeva
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COVID-19 Severity and Mortality in Two Pandemic Waves in Poland and Predictors of Poor Outcomes of SARS-CoV-2 Infection in Hospitalized Young Adults
Laura Ziuzia-Januszewska, Marcin Januszewski, Joanna Sosnowska-Nowak, Mariusz Janiszewski, Paweł Dobrzyński, Alicja A. Jakimiuk, Artur J. Jakimiuk
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Sadegh Mazaheri-Tehrani, Mohammad Hossein Mirzapour, Maryam Yazdi, Mohammad Fakhrolmobasheri, Amir Parsa Abhari
Clinical Nutrition ESPEN.2022; 51: 120. CrossRef
Administration of vitamin D and its metabolites in critically ill adult patients: an updated systematic review with meta-analysis of randomized controlled trials
Johannes Menger, Zheng-Yii Lee, Quirin Notz, Julia Wallqvist, M. Shahnaz Hasan, Gunnar Elke, Martin Dworschak, Patrick Meybohm, Daren K. Heyland, Christian Stoppe
Critical Care.2022;[Epub] CrossRef
Prevention of covid-19 and other acute respiratory infections with cod liver oil supplementation, a low dose vitamin D supplement: quadruple blinded, randomised placebo controlled trial
Sonja H Brunvoll, Anders B Nygaard, Merete Ellingjord-Dale, Petter Holland, Mette Stausland Istre, Karl Trygve Kalleberg, Camilla L Søraas, Kirsten B Holven, Stine M Ulven, Anette Hjartåker, Trond Haider, Fridtjof Lund-Johansen, John Arne Dahl, Haakon E M
BMJ.2022; : e071245. CrossRef
Adipokines, and not vitamin D, associate with antibody immune responses following dual BNT162b2 vaccination within individuals younger than 60 years
Mariana Pavel-Tanasa, Daniela Constantinescu, Corina Maria Cianga, Ecaterina Anisie, Ana Irina Mereuta, Cristina Gabriela Tuchilus, Petru Cianga
Frontiers in Immunology.2022;[Epub] CrossRef
Vitamin D intoxication induced severe hypercalcemia from self-medication for COVID-19 infection: a public health problem?
Stefano PINI, Giuseppe SCAPARROTTA, Valentina DI VICO, Antonio FRAGASSO, Lucia F. STEFANELLI, Federico NALESSO, Lorenzo A. CALÒ
Minerva Endocrinology.2022;[Epub] CrossRef
Novel CYP11A1-Derived Vitamin D and Lumisterol Biometabolites for the Management of COVID-19
Shariq Qayyum, Radomir M. Slominski, Chander Raman, Andrzej T. Slominski
Nutrients.2022; 14(22): 4779. CrossRef
COVID-19 Prevention: Vitamin D Is Still a Valid Remedy
Rachel Nicoll, Michael Y. Henein
Journal of Clinical Medicine.2022; 11(22): 6818. CrossRef
Integrated bioinformatics and in silico approaches reveal the biological targets and molecular mechanisms of 1,25-dihydroxyvitamin D against COVID-19 and diabetes mellitus
Fanqiang Zeng, Yongli Xu, Chaoling Tang, Zhigang Yan, Chaohe Wei
Frontiers in Nutrition.2022;[Epub] CrossRef
Vitamin D in the prevention or treatment of COVID-19
Adrian R. Martineau
Proceedings of the Nutrition Society.2022; : 1. CrossRef
Can vitamin D status influence seroconversion to SARS-COV2 vaccines?
Endrit Shahini, Francesco Pesce, Antonella Argentiero, Antonio Giovanni Solimando
Frontiers in Immunology.2022;[Epub] CrossRef
Cholecalciferol as part of complex therapy for acute COVID-19
K.A. Golovatyuk, T.L. Karonova, A.A. Mikhailova, D.I. Lagutina, A.T. Chernikova, E.Yu. Vasilieva, E.V. Shlyakhto
Profilakticheskaya meditsina.2022; 25(12): 106. CrossRef
Vitamin D Metabolism Gene Polymorphisms and Their Associated Disorders: A Literature Review
Mohamed Abouzid, Franciszek Główka, Leonid Kagan, Marta Karaźniewicz-Łada
Current Drug Metabolism.2022; 23(8): 630. CrossRef
The role of serum vitamin 25(OH)D concentration in the Covid-19 pandemic in children
Chrysoula Kosmeri, Foteini Balomenou, Dimitrios Rallis, Maria Baltogianni, Vasileios Giapros
British Journal of Nutrition.2022; : 1. CrossRef
Nutraceuticals in prevention and management of COVID-19
Ivana Đuričić, Milica Zrnić-Ćirić, Bojana Vidović, Vanja Todorović, Nevena Dabetić, Nevena Ivanović
Hrana i ishrana.2021; 62(2): 7. CrossRef

COVID-19: Epidemiologic Investigation

COVID-19 outbreak in a military unit in Korea: Chanhee Kim, Young-Man Kim, Namwoo Heo, Eunjung Park, Sojin Choi, Sehyuk Jang, Nayoung Kim, Donghyok Kwon, Young-Joon Park, Byeongseop Choi, Beomman Ha, Kyounghwa Jung, Changbo Park, Sejin Park, Heeyoung Lee; Epidemiol Health. 2021;43:e2021065. Published online September 8, 2021; DOI: https://doi.org/10.4178/epih.e2021065

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Abstract Summary PDF

Abstract

OBJECTIVES
This study presents the response of a military unit to an outbreak of coronavirus disease 2019 (COVID-19) in Gyeonggi Province. As soon as 2 soldiers were identified as index cases, the infectious disease investigators of the Gyeonggi Provincial Government, Korea Disease Control and Prevention Agency, and the Armed Forces Epidemiologic Investigation Center discussed the investigation and response plan for an imminent massive outbreak.

METHODS

The joint immediate response team (IRT) conducted interviews with confirmed COVID-19 patients, reviewed their medical records, performed contact tracing using global positioning system data, and undertook a field investigation. For risk assessment, the joint IRT visited all 8 sites of the military units and the army chaplain’s church to evaluate the transmission risk at each site. The evaluation items included the size of the site, the use of air conditioning, whether windows were opened, and whether masks were worn. Pooled testing was used for the low-risk population to quickly detect the spread of COVID-19 in the military base.

RESULTS

One day before the symptom onset of the index case, the lecturer and >50% of the attendees were infected with COVID-19 while attending a lecture that lasted 2 hours and 30 minutes. Attendees were not wearing masks and were in a poorly ventilated room.

CONCLUSIONS

Since COVID-19 can be spread before symptom onset, contact tracing must be performed to investigate potential exposures prior to symptom onset and to manage any exposed persons.

Summary

Korean summary
본 연구는 경기도 군부대에서 발생한 코로나19 대응 경험을 공유하는 국내 최초의 연구 결과이다. 본 연구를 통해 정리된 역학조사 과정은 군부대, 기숙사, 교정시설 등 집단 시설의 방역 대책 수립에 도움이 될 것으로 기대한다. 또한, 이번 사례는 집단 감염 발생 시 여러 유관 기관의 협조 체계가 신속한 대응과 추가 전파 예방에 중요하다는 점을 시사한다.

Key Message
This study is the first research in South Korea to share the experience of responding to COVID-19 at the military unit in Gyeonggi-do. The epidemiological investigation process organized through this study is expected to help establish response measures for group facilities such as military units, dormitories, and correctional facilities. In addition, this case suggests that the cooperative system of various related organizations in the event of a mass infection is important for rapid response and prevention of further transmission.

Citations

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Trends in Confirmed COVID-19 Cases in the Korean Military Before and After the Emergence of the Omicron Variant
Dong Hoon Shin, Haebong Jang, Sangho Lee, Byung Seop Choi, Donghoon Kim, Hong Sang Oh
Journal of Korean Medical Science.2022;[Epub] CrossRef
Characteristics of COVID-19 outbreaks and risk factors for transmission at an army training center in South Korea from June to August 2021
U Jin Cho, Seongjin Wang, Seonju Yi, Yeon Hwa Choi, Eun-Young Kim, Jin A Kim, Sanghwan Bae, Jungyeon Yu, Jangkyu Choi, Young-Joon Park
Osong Public Health and Research Perspectives.2022; 13(4): 263. CrossRef

COVID-19: Perspective

Herd immunity: challenges and the way forward in Korea: Jiyoung Oh, Sohyun Kim, Boyeong Ryu, Minjoung Shin, Bryan Inho Kim; Epidemiol Health. 2021;43:e2021054. Published online August 18, 2021; DOI: https://doi.org/10.4178/epih.e2021054

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Abstract Summary PDF

Abstract

Vaccination is considered to be the most effective measure for preventing the spread of coronavirus disease 2019 (COVID-19). Many countries, including of Korea, are focusing on achieving herd immunity with the goal of reaching a vaccination rate of 70-80%. However, achieving herd immunity does not mean eradicating COVID-19, and the following challenges can occur in the process of achieving herd immunity. First, as the vaccination rate is likely to slow down over time, it is necessary to promote the benefits of vaccination through risk communication strategies and provide incentives for those who have been vaccinated. Second, a booster dose may be required depending on future studies on vaccine-induced immunity. Third, since variants capable of evading immunity and with higher transmissibility can emerge, rapid contract tracing and regular community genomic surveillance could help mitigate the impact of new variants. When the impact of COVID-19 is controlled to the level of seasonal influenza, the current public health measures that have been strictly imposed on society since the beginning of the pandemic will no longer be needed. The overall response strategy to COVID-19 will need to change accordingly, based on evaluations of the level of population immunity. These changes will include more efficient and targeted contact tracing and eased quarantine measures for vaccinated close contacts and travelers. Mask wearing and a minimum of social distancing will still be required in the journey towards the end of the pandemic. The COVID-19 pandemic will end, but the virus will not disappear.

Summary

Korean summary
한국을 포함한 많은 국가에서 예방접종률 70~80% 달성을 목표로 집단면역을 달성하는데 집중하고 있으나, 집단면역 달성은 코로나19 퇴치를 의미하지 않으며, 집단면역을 달성해 나가는 과정에서 여러 어려움이 발생할 수 있다. 코로나19의 전반적인 영향력이 계절성 인플루엔자와 같은 관리가능한 수준으로 낮아진다면 현재의 코로나19 대응조치들은 인구집단의 면역 수준을 고려하여 점차 완화될 것이지만 마스크 착용과 최소한의 사회적 거리두기는 당분간 지속될 것이며, 코로나19 대유행이 끝나더라도 바이러스는 사라지지 않을 것이다.

Key Message
Achieving herd immunity does not mean eradicating COVID-19, and some challenges can occur in the process of achieving herd immunity. When the impact of COVID-19 is controlled to the level of seasonal influenza, the current public health measures that have been strictly imposed on society since the beginning of the pandemic will no longer be needed. The overall response strategy to COVID-19 will need to change accordingly, based on evaluations of the level of population immunity. However, mask wearing and a minimum of social distancing will still be required in the journey towards the end of the pandemic. The COVID-19 pandemic will end, but the virus will not disappear.

Citations

Citations to this article as recorded by

Towards a sustainable integrated management approach to uncertainty surrounding COVID‐19
Tiep Nguyen, Leonie Hallo, Nicholas Chileshe, Nghia Hoai Nguyen
Systems Research and Behavioral Science.2023;[Epub] CrossRef
What Happens to the Immune System after Vaccination or Recovery from COVID-19?
Bruna T. Tiyo, Gabriela J. H. Schmitz, Marina M. Ortega, Laís T. da Silva, Alexandre de Almeida, Telma M. Oshiro, Alberto J. da S. Duarte
Life.2021; 11(11): 1152. CrossRef

COVID-19: Brief Communication

Hydrogen peroxide as an auxiliary treatment for COVID-19 in Brazil: a randomized double-blind clinical trial: Marielle Bazzo Di Domênico, Kauê Collares, Renan Brandenburg dos Santos, Ulysses Lenz, Vinícius Picoli Antunes, Vinicius Webber Godinho, Henrique Cesca, Thales Henrique Jincziwski Ponciano, Pedro Henrique Corazza; Epidemiol Health. 2021;43:e2021051. Published online August 3, 2021; DOI: https://doi.org/10.4178/epih.e2021051

9,169 View
258 Download
2 Citations

Abstract PDF

Abstract

OBJECTIVES
This study evaluated the effectiveness of hydrogen peroxide (H₂O₂) as mouthwash and nasal spray on symptom relief in coronavirus disease 2019 (COVID-19) patients.

METHODS

Patients positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), who were treated in a hospital or at home, and patients’ family members (not positive for SARS-CoV-2), were randomized into 2 groups: experimental (1% H₂O₂ for gargling, 0.5% H₂O₂ for nasal wash), and control. Patients gargled the solution 3 times a day, and applied the nasal spray twice a day, for a 7-day period. Family members received the same treatment as the treated COVID-19 patient. The researchers contacted patients every 2 days over an 8-day period. An average post-treatment interval of 8 days passed before testing family members.

RESULTS

The most frequent symptoms on day 0 were cough, loss of taste, and hyposmia; there were no significant differences between groups, independent of the period. The symptom of dyspnea presented a significant difference between days 2 and 4 (p<0.05). Among family members, 86.0% had no antibodies, 2.3% had antibodies, and 11.6% had active infections (4 in the experimental group and 6 in the control group). The most frequent adverse effects in the H₂O₂ group were a burning throat and nose.

CONCLUSIONS

H₂O₂ was not effective for the relief of COVID-19 symptoms and was associated with reports of transient adverse effects.

Summary

Korean summary

Key Message
The hydrogen peroxide (H2O2) at low concentrations disrupts the lipid membranes of some viruses through the action of oxygen free radicals. Nevertheless, the data obtained in the present study demonstrated that the use of the H2O2 as mouthwash and nasal spray was not effective on symptom relief in patients with COVID-19. Moreover, it was associated with transient adverse effects such as burning sensations in the nose and throat. Thus, the authors of this study advise against the use of H2O2 as a mouthwash and nasal spray to relieve COVID-19 symptoms and transmission.

Citations

Citations to this article as recorded by

Efficacy of Mouth Rinses and Nasal Spray in the Inactivation of SARS-CoV-2: A Systematic Review and Meta-Analysis of In Vitro and In Vivo Studies
Majdy Idrees, Bridget McGowan, Amr Fawzy, Abdulwahab Ali Abuderman, Ramesh Balasubramaniam, Omar Kujan
International Journal of Environmental Research and Public Health.2022; 19(19): 12148. CrossRef
Enhanced Nasal Deposition and Anti-Coronavirus Effect of Favipiravir-Loaded Mucoadhesive Chitosan–Alginate Nanoparticles
Khent Primo Alcantara, Nonthaneth Nalinratana, Nopporn Chutiwitoonchai, Agnes L. Castillo, Wijit Banlunara, Opa Vajragupta, Pornchai Rojsitthisak, Pranee Rojsitthisak
Pharmaceutics.2022; 14(12): 2680. CrossRef

COVID-19: Systematic Review

Clinical outcomes of COVID-19 amongst HIV patients: a systematic literature review: Thomas Massarvva; Epidemiol Health. 2021;43:e2021036. Published online May 17, 2021; DOI: https://doi.org/10.4178/epih.e2021036

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Abstract PDF Supplementary Material

Abstract

OBJECTIVES
The global pandemic coronavirus disease 2019 (COVID-19) emerged in the city of Wuhan, China around December 2019. Since then, the virus has caused severe morbidity and mortality worldwide and has put pressure on the global medical system. Still, there are limited data regarding the clinical impact of COVID-19 on people living with human immunodeficiency virus (HIV). The primary aim of this study was, therefore, to systematically review up-to-date studies reporting the clinical outcomes of COVID-19 amongst HIV patients.

METHODS

A thorough literature search was carried out using MEDLINE, Embase, Scopus, and the Cochrane Library Databases in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines.

RESULTS

A total of 22 studies were identified. Amongst 730 HIV/COVID-19-coinfected patients, 79.4% were males, the median age was 51.5 years, and the number of reported patients receiving antiretroviral drugs was 708 (97.2%). Most coinfected patients had mild to moderate symptoms, including cough (37.7%), fever (37.5%), and dyspnoea (24.7%). Among pre-existing comorbidities, hypertension (26.3%) was the most prevalent in HIV/COVID-19 coinfected patients, and 87% of coinfected patients recovered.

CONCLUSIONS

Based on the existing data in this systematic literature review, HIV patients with pre-existing comorbidities, obesity, and older age should be considered as a high-risk group for COVID-19. Furthermore, coinfected patients appear to have marginally comparable clinical outcomes with the general population. The study’s findings highlight the need for further investigation to elucidate the impact of COVID-19 infection on HIV patients.

Summary

Korean summary

Key Message
In this systematic literature review, various aspects of COVID-19 outcomes amongst HIV patients are identified and quantified, including the proportion of different symptoms, severity, pre-existing comorbidities, recovery, death, and the most commonly prescribed antiretroviral drugs in HIV patients with COVID-19 coinfection.

Citations

Citations to this article as recorded by

Double Trouble Co-Infections: Understanding the Correlation Between COVID-19 and HIV Viruses
Sassi Ashraf Ali Abbasi, Tarika Noor, Maneeth Mylavarapu, Monika Sahotra, Hunmble A Bashir, Rakshita Ramesh Bhat, Urmi Jindal, Uzma Amin, Anushree V, Humza F Siddiqui
Cureus.2023;[Epub] CrossRef

COVID-19: Original Article

Effectiveness of hydrogen peroxide as auxiliary treatment for hospitalized COVID-19 patients in Brazil: preliminary results of a randomized double-blind clinical trial: Marielle Bazzo Di Domênico, Henrique Cesca, Thales Henrique Jincziwski Ponciano, Renan Brandenburg dos Santos, Ulysses Lenz, Vinícius Picoli Antunes, Vinicius Webber Godinho, Kauê Collares, Pedro Henrique Corazza; Epidemiol Health. 2021;43:e2021032. Published online May 1, 2021; DOI: https://doi.org/10.4178/epih.e2021032

11,272 View
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2 Citations

Abstract PDF

Abstract

OBJECTIVES
To evaluate the effectiveness of hydrogen peroxide (H2O2) in the form of mouthwash and nasal spray as an auxiliary treatment for coronavirus disease 2019 (COVID-19).

METHODS

Forty hospitalized patients who tested positive for severe acute respiratory syndrome coronavirus 2 using a reverse-transcription polymerase chain reaction test were evaluated. They were randomly divided into an experimental group (n= 20; gargling with 1.0% H2O2 and nasal wash with 0.5% H2O2) or a control group (n= 20). The solutions were used for 7 days and the patients were monitored every 2 days, for a total of 8 days. At check-ups, patients were asked about their symptoms and possible adverse effects of the solutions. The presence and severity (mild, moderate, or severe) of symptoms were recorded. Data were compared using the Student test and the Fisher exact test (α= 0.05).

RESULTS

There was no significant difference between the 2 groups in the length of hospital stay (p= 0.65). The most frequent symptom on day 0 was coughing (72.0% in the experimental group and 76.5% in the control group), which abated over time. There was no significant difference between the groups in the evaluated symptoms. Most (75.0%) of the patients in the experimental group presented a reduction in dyspnea between days 0 and 2. Few patients reported adverse effects from the use of the solutions.

CONCLUSIONS

H2O2 as a mouthwash and nasal spray is safe to use. There is insufficient evidence to demonstrate that H2O2 is effective as an auxiliary treatment for hospitalized COVID-19 patients.

Summary

Korean summary

Key Message
Despite some improvement trends in the symptom 'difficulty breathing', the effectiveness of the mouthwash and nasal spray of H2O2 for COVID-19 hospitalized patients was not proven yet.

Citations

Citations to this article as recorded by

The effectiveness of mouthwash against SARS-CoV-2 infection: A review of scientific and clinical evidence
Ming-Hsu Chen, Po-Chun Chang
Journal of the Formosan Medical Association.2022; 121(5): 879. CrossRef
Hydrogen peroxide as an auxiliary treatment for COVID-19 in Brazil: a randomized double-blind clinical trial
Marielle Bazzo Di Domênico, Kauê Collares, Renan Brandenburg dos Santos, Ulysses Lenz, Vinícius Picoli Antunes, Vinicius Webber Godinho, Henrique Cesca, Thales Henrique Jincziwski Ponciano, Pedro Henrique Corazza
Epidemiology and Health.2021; 43: e2021051. CrossRef

COVID-19: Brief Communication

Follow-up investigation of asymptomatic COVID-19 cases at diagnosis in Busan, Korea: Miyoung Lee, Youngduck Eun, Kyounghee Park, Jeonghun Heo, Hyunjin Son; Epidemiol Health. 2020;42:e2020046. Published online June 23, 2020; DOI: https://doi.org/10.4178/epih.e2020046

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
The objective of the study was to conduct a follow-up investigation of 10 asymptomatic patients at diagnosis among the 98 confirmed coronavirus disease 2019 (COVID-19) cases reported in Busan between February 21, 2020 and March 13, 2020 to determine whether asymptomatic infection and transmission during asymptomatic period are possible.

METHODS

The study analyzed 10 asymptomatic, confirmed COVID-19 cases to determine whether asymptomatic infection is possible. We conducted in-depth interviews with patients and guardians; interviews with primary physicians; review of medical records and drug utilization review (DUR) reports; and base station-based location tracking.

RESULTS

Among the 98, confirmed COVID-19 cases reported in Busan, the study analyzed 10 (10.2%) asymptomatic patients at diagnosis. The results confirmed that two (2.0%) patients reported to be asymptomatic during the initial epidemiological investigation, but turned symptomatic before diagnosis as per the in-depth interview results. Four cases (4.0%) of early detection led to confirmed diagnosis during the incubation period and presentation of symptoms after diagnosis. In addition, the remaining four patients (4.0%), having no subjective symptoms nor specific findings on chest radiography and computed tomography, remained asymptomatic until the isolation order was lifted. With regard to whether transmission during the asymptomatic period is possible, it was found that one out of 23 household contacts of the confirmed patients was identified as an additional confirmed case after coming in close contact with an index patient during the presymptomatic period.

CONCLUSIONS

Among the 98 confirmed cases, asymptomatic infection was confirmed in four cases (4.0%). In addition, there was one additional confirmed case in which the patient was a family member who came in close contact with an index patient during the incubation period, thereby confirming that transmission during the asymptomatic period is possible. The possibility of transmission during the asymptomatic period has been confirmed; therefore, it is necessary to review the measures for expanding contact tracing that is currently being applied starting one day prior to the onset of symptoms.

Summary

Korean summary
본 연구는 부산광역시에서 무증상으로 COVID-19에 진단된 10명의 환자를 추적조사하여 무증상 감염이 가능한가, 무증상기에 전파가 가능한가에 대해 확인하였다. 조사결과 4명(4.0%)의 무증상 감염환자를 확인하였고, 환자의 무증상기에 밀접 접촉한 가족 중 1명의 추가 환자를 확인하여 무증상기 전파가 가능하다는 것을 확인하였다.

Key Message

Citations

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Characterization of COVID-19 cases in the early phase (March to July 2020) of the pandemic in Kenya
Philip Ngere, Joyce Onsongo, Daniel Langat, Elizabeth Nzioka, Faith Mudachi, Samuel Kadivane, Bernard Chege, Elvis Kirui, Ian Were, Stephen Mutiso, Amos Kibisu, Josephine Ihahi, Gladys Mutethya, Trufosa Mochache, Peter Lokamar, Waqo Boru, Lyndah Makayotto
Journal of Global Health.2022;[Epub] CrossRef
Asymptomatic Cases, the Hidden Challenge in Predicting COVID-19 Caseload Increases
Brett Snider, Bhumi Patel, Edward McBean
Infectious Disease Reports.2021; 13(2): 340. CrossRef
Efficacy and safety of traditional Chinese medicine combined with routine western medicine for the asymptomatic novel coronavirus disease (COVID–19)
Jiahao Wang, Xue Zhu, Yuying Sun, Xingcai Zhang, Wei Zhang
Medicine.2020; 99(35): e21927. CrossRef

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