Coronavirus Disease 2019 In South Korea Research Articles

Role of Stigma in Moderating the Effects of Loneliness on Mental Health Problems Among Patients With COVID-19 in South Korea.

This study examined the factors affecting depression, anxiety, and suicidal ideation among patients with coronavirus disease-2019 (COVID-19) during the early phase of COVID-19 in South Korea and investigated the role of stigma in moderating the effects of loneliness on mental health problems among these patients. Conducted as part of the COVID-19 Mental Health Panel Survey over 12 weeks in 2021, this survey enrolled participants aged 15-79 years, applying standardized weights for ratio correction, and collected 640 completed questionnaires. Demographic characteristics were analyzed using descriptive statistics. Suicidal ideation, anxiety, and depression post-COVID-19 were examined using t-tests and logistic regression. The PROCESS macro explored stigma's moderating effects on loneliness and mental health outcomes. Results showed that 7.9% and 10.0% of the enrolled participants were at risk for anxiety and depression, respectively, with 3% contemplating suicide post-COVID-19. Stigma positively impacted depression and anxiety, acting as a significant moderator for loneliness, and mental health, with a stronger effect for higher stigma perception. Unemployment and college education elevated mental health risks in COVID-19 cases. Low health satisfaction and poor sleep were linked to suicidal ideation, while fatigue and COVID-19 stigma increased depression and anxiety risks. Loneliness was significantly associated with suicidal ideation, depression, and anxiety. Unemployment, college education, low health satisfaction, and poor sleep were linked to suicidal ideation. Fatigue and COVID-19 stigma raised depression/anxiety risks. Loneliness correlated with suicidal thoughts, depression, and anxiety. Stigma moderated the link between loneliness and mental health issues.

Factors influencing stigma among college students with COVID-19 in South Korea: a descriptive study.

This study is descriptive research aiming to identify factors influencing the stigma experienced by college students with coronavirus disease 2019 (COVID-19), focusing on COVID-19 pandemic stress, depression, and fear of negative evaluation as the main variables. An online survey was administered to 175 college students who had been diagnosed with COVID-19 from January to May 2022 and were enrolled in universities in Seoul, Cheongju, and Daegu, South Korea. The survey collected data on pandemic stress, depression, fear of negative evaluation, and stigma. The data were analyzed using the t-test, ANOVA, the Scheffé test, Pearson's correlation coefficients, and stepwise multiple regression in SPSS/WIN 26.0. We analyzed differences in stigma scores based on general characteristics of the college students and found significant differences in stigma scores by age, major satisfaction, interpersonal satisfaction, date of COVID-19 confirmation, treatment modality, and recent subjective health condition. Factors influencing stigmatization were identified as COVID-19 pandemic stress, depression, date of COVID-19 confirmation, treatment modality, recent subjective health condition, and major satisfaction, with an overall explanatory power of 37.6%. This study is significant as it identifies emotional changes across various aspects of pandemic stress, depression, fear of negative evaluation, and stigma among college students who have been diagnosed with COVID-19. The findings of this study suggest the development of programs to reduce psychological distress and enhance mental health management skills among these students.

Association between social networks and symptoms of post-traumatic stress during the pandemic: Cohort study in South Korea

BackgroundThis study estimated the association between pre-pandemic social network properties and symptoms of posttraumatic stress during the coronavirus disease 2019 (COVID-19) pandemic in South Korea. MethodsWe conducted four online mental health surveys during COVID-19 (from March 14, 2020, to December 11, 2021) among individuals enrolled in a community-based cohort study (previously recruited from 2013 to 2018). Among 4060 people interviewed at the pre-pandemic baseline, 2652 individuals (men = 951, women = 1701) who responded to at least one of the four surveys conducted were included. At baseline, each individual's social network, including size and average closeness, was measured in an egocentric way. Post Traumatic Stress Disorder Checklist for DSM-5 (PCL-5) was measured at each survey point. A generalized linear model and a generalized linear mixed model were used after stratified by sex. ResultsAmong men, network size was negatively associated with total PCL-5 score (b = −0.42, SE = 0.16, p = 0.002). The magnitude of the association increased over time and was maximal by the 4th survey (b = −0.65, SE = 0.31, p = 0.037). Among women, average closeness was negatively associated with the total PCL-5 score (b = −1.16, SE = 0.37, p = 0.002). In analyses disaggregated by symptom clusters, social networks were associated explicitly with symptoms of intrusion and mood but not with avoidance and arousal symptoms. ConclusionIn this cohort of adults followed for more than a year during the outbreak of COVID-19 in South Korea, social networks established before the onset of the COVID-19 pandemic had a protective association against developing symptoms of PTSD during the first two years of the pandemic.

Characteristics of victim blaming related to COVID-19 in South Korea

This study aimed to determine the characteristics of the victim-blaming tendency of patients with coronavirus disease-2019 (COVID-19) and the worry of being blamed because of COVID-19 infection. This study utilized two methodologies based on the theory of defensive attribution and information processing. First, a media analysis was conducted to determine the characteristics of the two representative COVID-19 victim blaming cases (the Itaewon Club case and the Omicron-infected pastor case). The results show that from the viewpoint of defensive attribution theory, the victim blaming of patients infected with COVID-19 is related to social identity and moral violations committed by the patients. The Korean public emphasized their social identity and believed that the patients were different from them from an ego-defensive viewpoint. Second, we conducted three longitudinal online panel surveys (N1 = 1569; N2 = 1037; N3 = 833). The samples were selected by stratified random sampling based on sex, age, and 17 metropolitan regions in Korea. The results showed that as the number of COVID-19 cases increased, the respondents' level of risk perception decreased significantly. As the information processing theory explains, people who are familiar with the frequent risks of COVID-19 are less worried about being blamed by others. Meanwhile, the regression analysis found that victim blaming of the pastor was significantly related to the respondent's religion. We can conclude that the Korean people may blame the victims of COVID-19 because they believe that the victims are very different from an ego-defensive viewpoint. Furthermore, the trust variable appeared to be important: the more the respondents trusted the government, the more they blamed the victims of COVID-19. We term this phenomenon the “trust paradox.”

Associations of symptom combinations with in-hospital mortality of coronavirus disease-2019 patients using South Korean National data.

BackgroundThere are various risk factors for death in coronavirus disease-2019 (COVID-19) patients. The effects of symptoms on death have been investigated, but symptoms were considered individually, rather than in combination, as predictors. We examined the effects of symptom combinations on in-hospital mortality.MethodsData from the Korea Disease Control and Prevention Agency were analyzed. A cohort of 5,153 patients confirmed with COVID-19 in South Korea was followed from hospitalization to death or discharge. An exploratory factor analysis was performed to identify symptom combinations, and the hazard ratios (HRs) of death were estimated using the Cox proportional hazard model.ResultsThree sets of symptom factors were isolated for symptom combination. Factor 1 symptoms were cold-like symptoms, factor 2 were neurological and gastrointestinal symptoms, and factor 3 were more severe symptoms such as dyspnea and altered state of consciousness. Factor 1 (HR 1.14, 95% confidence interval [95% CI] 1.01–1.30) and factor 3 (HR 1.25, 95% CI 1.19–1.31) were associated with a higher risk for death, and factor 2 with a lower risk (HR 0.71, 95% CI 0.71–0.96).ConclusionsThe effect on in-hospital mortality differed according to symptom combination. The results are evidence of the effects of symptoms on COVID-19 mortality and may contribute to lowering the COVID-19 mortality rate. Further study is needed to identify the biological mechanisms underlying the effects of symptom combinations on mortality.

Impact of pre-pandemic travel mobility patterns on the spatial diffusion of COVID-19 in South Korea

IntroductionPhysical mobility is critical for the spread of infectious diseases in humans. However, few studies have conducted empirical investigations on the impact of pre-pandemic travel mobility patterns on the diffusion of coronavirus disease 2019 (COVID-19). Therefore, this study examines its impact at the city-county level on the diffusion by the wave period during the two-year pandemic in South Korea. MethodsThis study first employs factor analysis by using the travel origin-destination data by travel mode at the county level as of 2019 to derive pre-pandemic travel mobility patterns. Next, the study identifies how they had affected the diffusion of COVID-19 over time by employing the negative binomial regression models on confirmed COVID-19 cases for each wave, including the entire pandemic period. ResultsThe study derived five pre-pandemic mobility patterns: 1) rail-oriented mobility, 2) intra-county bus-oriented mobility, 3) road-oriented mobility, 4) high-speed rail-oriented mobility, and 5) inter-county bus-oriented mobility. Among them, the biggest risk to the diffusion of COVID-19 was the rail-oriented mobility before the pandemic if controlling such measures as accessibility, physical environment, and demographic and socioeconomic indicators. In addition, the order of the magnitudes for the impact of pre-pandemic travel mobility factors on its spatial diffusion had not changed during experiencing the three different wave periods during the two-year pandemic in South Korea. ConclusionsThe study concludes that the rail-oriented travel mobility pattern before the pandemic could pose the greatest threat factor to the spatial spread of COVID-19 at any scale and time. Policymakers should develop strategies to prevent the spatial spread of COVID-19 by reducing human mobility for daily living in areas with strong rail mobility patterns formed before the pandemic.

An analysis of the dynamic spatial spread of COVID-19 across South Korea

The first case of coronavirus disease 2019 (COVID-19) in South Korea was confirmed on January 20, 2020, approximately three weeks after the report of the first COVID-19 case in Wuhan, China. By September 15, 2021, the number of cases in South Korea had increased to 277,989. Thus, it is important to better understand geographical transmission and design effective local-level pandemic plans across the country over the long term. We conducted a spatiotemporal analysis of weekly COVID-19 cases in South Korea from February 1, 2020, to May 30, 2021, in each administrative region. For the spatial domain, we first covered the entire country and then focused on metropolitan areas, including Seoul, Gyeonggi-do, and Incheon. Moran’s I and spatial scan statistics were used for spatial analysis. The temporal variation and dynamics of COVID-19 cases were investigated with various statistical visualization methods. We found time-varying clusters of COVID-19 in South Korea using a range of statistical methods. In the early stage, the spatial hotspots were focused in Daegu and Gyeongsangbuk-do. Then, metropolitan areas were detected as hotspots in December 2020. In our study, we conducted a time-varying spatial analysis of COVID-19 across the entirety of South Korea over a long-term period and found a powerful approach to demonstrating the current dynamics of spatial clustering and understanding the dynamic effects of policies on COVID-19 across South Korea. Additionally, the proposed spatiotemporal methods are very useful for understanding the spatial dynamics of COVID-19 in South Korea.

Clinical Manifestations and Maternal and Perinatal Outcomes in Pregnancy Following Laboratory-Confirmed SARS-CoV-2 Infection in South Korea

Purpose: To determine the clinical manifestations and maternal and perinatal outcomes in pregnant women with coronavirus disease 2019 (COVID-19).Methods: We conducted a retrospective observational study of pregnant women with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection who were admitted to National Health Insurance Service (NHIS) Ilsan Hospital between August 2020 and October 2021. The maternal and perinatal outcomes were investigated.Results: Among 184 pregnant women infected with SARS-CoV-2, 79 women delivered. Of the women who delivered, with 36 women giving birth during the quarantine period. At delivery, 45 women were positive for SARS-CoV-2 by polymerase chain reaction (PCR), whereas 34 women were negative. The most common clinical manifestations were cough (65.2%), fever (38.0%), and myalgia (33.2%). Regarding perinatal outcomes, none of the babies had an Apgar score <7 at 5 minutes, and none were intubated following the delivery. The preterm birth rate and small-for-gestational-age (SGA) rate were 15.2% and 16.5%, respectively. All babies who was delivered at NHIS Ilsan Hospital were negative for SARS-CoV-2 infection by PCR, which was evaluated using amniotic fluid, cord blood, neonatal nasopharyngeal and oropharyngeal swabs in the 1st and 2nd days following delivery, although 45 women were positive for SARS-CoV-2 infection by PCR at the time of delivery.Conclusion: Most pregnant women with COVID-19 in South Korea were unlikely to manifest symptoms or present with a severe disease progression. The observed preterm birth rate and SGA rate were higher in women with COVID-19 than in those without COVID-19. However, there was no evidence of vertical transmission, and all babies were negative for SARS-CoV-2 infection during pregnancy.

Antibody Responses to SARS-CoV-2 in Children With COVID-19.

BackgroundThe immunologic features of children with coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are not clearly delineated. This study was conducted to evaluate SARS-CoV-2-specific antibody responses in children with COVID-19.MethodsThe levels of anti-spike (S) IgG, anti-SARS-CoV-2 IgG, and neutralizing antibody (NAb) were measured during various time points in children <19 years of age with COVID-19 in South Korea from February 2020 to September 2020.ResultsOne hundred sixty-five blood samples from 114 children with COVID-19 (43.9% asymptomatic and 56.1% mildly symptomatic) were analyzed. In both asymptomatic and mildly symptomatic children, the positive rates of anti-S IgG, anti-SARS-CoV-2 IgG, and NAb were low within 7 days after onset, but they soon reached 100% 14 to <28 days after onset. In symptomatic children, the geometric mean titers (GMTs) of antibodies were all below the positive cutoff during the first 2 weeks from onset and peaked at 28 to <56 days (5.6 for anti-S IgG, 383.6 for anti-SARS-CoV-2 IgG, and 55.0 for NAb, P < .001, respectively). Antibody levels remained detectable up to 3 months after infection. The antibody GMTs during the period 14 to <56 days after symptom onset were highest in children aged 0-4 years.ConclusionsThese results collectively present the humoral immune responses during SARS-CoV-2 infection in children. A further longitudinal study is needed to thoroughly understand the immune system and for effective vaccine development in children during the COVID-19 pandemic.

Impact of COVID-19 on Heart Failure Patients in South Korea.

Cardiovascular diseases can affect the clinical course of coronavirus disease 2019 (COVID-19); however, evaluation of COVID-19 contribution to prognosis for each individual disease, such as heart failure, is lacking in South Korea. Therefore, this study aimed to investigate COVID-19 patients with heart failure by matching them with patients with heart failure only and those with COVID-19 only. We performed a nationwide population-based retrospective study using data from the National Health Insurance System. Based on patients with heart failure and COVID-19, up to 1:3 propensity score matching procedures were performed for patients with heart failure only and those with COVID-19 only. The outcome was the composite of complications. After matching, a multivariable-adjusted conditional logistic regression analysis was performed. The number of patients was 317 for heart failure and COVID-19, 951 for heart failure only, and 884 for COVID-19 only. The adjusted odds ratio (OR) and 95% confidence interval (CI) for the composite of complications of patients with heart failure and COVID-19 compared with those with heart failure only was 3.511 (2.501-4.928), and compared with those with COVID-19 only, they were 1.626 (1.112-2.376). In patients with heart failure and COVID-19, age per 10 years increase and diabetes were significant variables with the adjusted OR (95% CI) [2.206 (1.704-2.856) for age and 2.345 (1.244-4.420) for diabetes] for complications. This study demonstrated that patients with both heart failure and COVID-19 in South Korea are associated with a poor prognosis. Patients with heart failure require more surveillance and precautions for COVID-19, as recommended by the Center for Disease Control and Prevention.

COVID-19 in South Korea: Proper Timing for Easing Mask Mandates After COVID-19 Vaccination.

As of July 25, 2021, the Korea Disease Control and Prevention Agency reported 1,422 new coronavirus disease 2019 (COVID-19) cases, 188,848 total cases, and 2,073 total deaths (1.10% fatality rates). Since the first severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) case was reported, efforts to find a treatment and vaccine against COVID-19 have been widespread. Four vaccines are on the World Health Organization's (WHO's) emergency use listing and are approved of their usage; BNT162b2, mRNA-1273, AZD1222, and Ad26.COV2.S. Vaccines against SARS-CoV-2 need at least 14 d to achieve effectiveness. Thus, people should abide by prevention and control measures, including wearing masks, washing hands, and social distancing. However, a lot of new cases were reported after vaccinations, as many people did not follow the prevention control measures before the end of the 14-d period. There is no doubt we need to break free from mask mandates. But let us not decide the timing in haste. Even if the mask mandates are eased, they should be changed depending on the number of reported cases, vaccinations, as well as prevention and control measures on how circumstances are changing under the influence of mutant coronavirus.

Musculoskeletal Disorders, Pain Medication, and in-Hospital Mortality among Patients with COVID-19 in South Korea: A Population-Based Cohort Study.

We aimed to investigate whether comorbid musculoskeletal disorders (MSD)s and pain medication use was associated with in-hospital mortality among patients with coronavirus disease 2019 (COVID-19). Adult patients (≥20 years old) with a positive COVID-19 diagnosis until 5 June 2020 were included in this study, based on the National Health Insurance COVID-19 database in South Korea. MSDs included osteoarthritis, neck pain, lower back pain, rheumatoid arthritis, and others, while pain medication included paracetamol, gabapentin, pregabalin, glucocorticoid, nonsteroidal anti-inflammatory drugs (NSAIDs), opioids (strong and weak opioids), and benzodiazepine. Primary endpoint was in-hospital mortality. A total of 7713 patients with COVID-19 were included, and in-hospital mortality was observed in 248 (3.2%) patients. In multivariate logistic regression analysis, no MSDs (p > 0.05) were significantly associated with in-hospital mortality. However, in-hospital mortality was 12.73 times higher in users of strong opioids (odds ratio: 12.73, 95% confidence interval: 2.44–16.64; p = 0.002), while use of paracetamol (p = 0.973), gabapentin or pregabalin (p = 0.424), glucocorticoid (p = 0.673), NSAIDs (p = 0.979), weak opioids (p = 0.876), and benzodiazepine (p = 0.324) was not associated with in-hospital mortality. In South Korea, underlying MSDs were not associated with increased in-hospital mortality among patients with COVID-19. However, use of strong opioids was significantly associated with increased in-hospital mortality among the patients.

Mental Health Status and Its Influencing Factors: The Case of Nurses Working in COVID-19 Hospitals in South Korea.

The mental health of nurses participating in patient care is under threat amid the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to identify the mental health status (depression, anxiety, and stress) and its influencing factors on nurses who provided patient care at a specialized hospital for COVID-19 in South Korea. Of the 180 nurses who participated in this study, 30.6% had moderate or higher levels of depression, 41% had moderate or higher anxiety levels, and 19.4% had moderate or higher stress levels. In this study, stigma influenced nurses’ mental health, such that the higher the stigma, the higher the nurses’ depression, anxiety, and stress. Depression was higher in female nurses than in male nurses, and stress was higher in charge nurses than nurses in other job positions. Therefore, a management program should be designed to improve the mental health of nurses during the current pandemic. In particular, a solution to reduce stigma is required, and the mental health of female nurses and nurses in leadership roles requires special attention.

Statin Therapy and the Risk of COVID-19: A Cohort Study of the National Health Insurance Service in South Korea.

We aimed to investigate whether statin therapy is associated with the incidence of coronavirus disease 2019 (COVID-19) among the South Korean population. In addition, we examined whether statin therapy affects hospital mortality among COVID-19 patients. The National Health Insurance Service (NHIS)-COVID-19 database in South Korea was used for data extraction for this population-based cohort study. A total of 122,040 adult individuals, with 22,633 (18.5%) in the statin therapy group and 101,697 (91.5%) in the control group, were included in the analysis. Among them, 7780 (6.4%) individuals were diagnosed with COVID-19 and hospital mortality occurred in 251 (3.2%) COVID-19 cases. After propensity score matching, logistic regression analysis showed that the odds of developing COVID-19 were 35% lower in the statin therapy group than in the control group (odds ratio: 0.65, 95% confidence interval: 0.60 to 0.71; p < 0.001). Regarding hospital mortality among COVID-19 patients, the multivariable model indicated that there were no differences between the statin therapy and control groups (odds ratio: 0.74, 95% confidence interval: 0.52 to 1.05; p = 0.094). Statin therapy may have potential benefits for the prevention of COVID-19 in South Korea. However, we found that statin therapy does not affect the hospital mortality of patients who are diagnosed with COVID-19.

Comparison of All-Cause Mortality Between Individuals With COVID-19 and Propensity Score-Matched Individuals Without COVID-19 in South Korea.

BackgroundWe compared all-cause mortality between individuals in South Korea with and without coronavirus disease 2019 (COVID-19) using propensity score (PS) matching.MethodsThis population-based cohort study used data from the National Health Insurance Service COVID-19 cohort database. In the database, we included individuals (COVID-19 patients, control population, and test-negative individuals) aged 20 years or older, regardless of hospitalization. The primary end point was all-cause mortality between January 1, 2020, and August 27, 2020.ResultsA total of 328 374 adults were included in the study: 7713 and 320 660 in the COVID-19 group and the control group. After PS matching, a total of 15 426 individuals (7713 per group) were included in the analysis. All-cause mortality was 3.2% (248/7713) and 1.6% (126/7713) in the COVID-19 group and the control group, respectively. In Cox regression analysis after PS matching, the risk of death in the COVID-19 group was twice as high (hazard ratio, 2.00; 95% CI, 1.61–2.48; P < .001) as that in the control group. Among patients aged ≥60 years, the COVID-19 group had a 2.32-fold higher all-cause mortality compared with the control group, while statistically significant differences were not observed in the age groups 20–39 years (P = .339) and 40–59 years (P = .562).ConclusionsIn South Korea, all-cause mortality was twice as high among individuals with COVID-19 as among those with similar underlying risks, primarily because of the elevated COVID-19-associated mortality in those aged ≥60 years. Our results highlight the need for prevention of COVID-19 with respect to mortality as a public health outcome.

Genome Sequences of Two GH Clade SARS-CoV-2 Strains Isolated from Patients with COVID-19 in South Korea.

We report the genome sequences of two GH clade severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) strains isolated from nasopharyngeal swabs from patients with coronavirus disease 2019 (COVID-19) in South Korea. These strains had two mutations in the untranslated regions and seven nonsynonymous substitutions in open reading frames, compared with Wuhan/Hu-1/2019, showing 99.96% sequence identity.

Epidemiological and clinical characteristics of 5,628 patients with coronavirus disease 2019 in South Korea: A nationwide multicenter study

Purpose: There are limited data on the epidemiological and clinical characteristics and outcomes in Korean patients with labora tory-confirmed coronavirus disease 2019 (COVID-19). We aimed to describe the epidemiological and clinical characteristics and out comes of patients with COVID-19 using the Korean nationwide multicenter database. Methods: In this nationwide multicenter study, we included all confirmed patients of COVID-19 in South Korea from February 1 to April 30, 2020. Subjects were classified into 3 age groups: those at younger than 10 years (children), 10 to 20 years (adolescents), and 20 years or more (adults). Cases were confirmed by laboratory testing using real-time reverse transcriptase-polymerase chain reac tion assay and analyzed for epidemiological and clinical features and outcomes. Patents were followed up until April 30, 2020. Results: Of 5,628 patients with COVID-19 (2,320 males [41.2%] and 3,308 females [58.8%]), there were 66 children (1.2%), 206 ado lescents (3.7%), and 5,356 adults (95.2%). The common comorbidities were hypertension (1,201, 21.3%), diabetes (691, 12.3%), de mentia (224, 4.0%), chronic heart disease (179, 3.2%), cancer (145, 2.6%), and asthma (128, 2.3%). The common presenting symp toms were cough (2,341, 41.6%), sputum (1,619, 28.8%), fever (1,305, 23.2%), headache (967, 17.2%), myalgia (926, 16.5%), and pha ryngodynia (881, 15.7%). One hundred sixty-five patients (2.1%) were confirmed as having moderate or severe COVID-19 and 118 (2.1%) as having severe COVID-19. Conclusion: Our descriptive study provides the epidemiological and clinical characteristics and outcomes of patients with labora tory-confirmed COVID-19 in South Korea. (Allergy Asthma Respir Dis 2021;9:136-140)

A Clinical Risk Score to Predict In-hospital Mortality from COVID-19 in South Korea.

BackgroundEarly identification of patients with coronavirus disease 2019 (COVID-19) who are at high risk of mortality is of vital importance for appropriate clinical decision making and delivering optimal treatment. We aimed to develop and validate a clinical risk score for predicting mortality at the time of admission of patients hospitalized with COVID-19.MethodsCollaborating with the Korea Centers for Disease Control and Prevention (KCDC), we established a prospective consecutive cohort of 5,628 patients with confirmed COVID-19 infection who were admitted to 120 hospitals in Korea between January 20, 2020, and April 30, 2020. The cohort was randomly divided using a 7:3 ratio into a development (n = 3,940) and validation (n = 1,688) set. Clinical information and complete blood count (CBC) detected at admission were investigated using Least Absolute Shrinkage and Selection Operator (LASSO) and logistic regression to construct a predictive risk score (COVID-Mortality Score). The discriminative power of the risk model was assessed by calculating the area under the curve (AUC) of the receiver operating characteristic curves.ResultsThe incidence of mortality was 4.3% in both the development and validation set. A COVID-Mortality Score consisting of age, sex, body mass index, combined comorbidity, clinical symptoms, and CBC was developed. AUCs of the scoring system were 0.96 (95% confidence interval [CI], 0.85–0.91) and 0.97 (95% CI, 0.84–0.93) in the development and validation set, respectively. If the model was optimized for > 90% sensitivity, accuracies were 81.0% and 80.2% with sensitivities of 91.7% and 86.1% in the development and validation set, respectively. The optimized scoring system has been applied to the public online risk calculator (https://www.diseaseriskscore.com).ConclusionThis clinically developed and validated COVID-Mortality Score, using clinical data available at the time of admission, will aid clinicians in predicting in-hospital mortality.

Neurological Manifestations in Patients with COVID-19: Experiences from the Central Infectious Diseases Hospital in South Korea.

Background and PurposeTo investigate the incidence and characteristics of neurological manifestations associated with coronavirus disease 2019 (COVID-19).MethodsWe reviewed the medical records of the consecutive patients with COVID-19 who were admitted to the central infectious diseases hospital designated for the treatment of COVID-19 in South Korea between March 2020 and September 2020. Newly developed neurological manifestations associated with COVID-19 were investigated. The frequency and clinical features of the neurological manifestations were analyzed according to disease severity, which was classified according to World Health Organization interim guidance.ResultsOf the 306 symptomatic patients, 186 (60.8%) developed at least one neurological manifestation during hospitalization. The most common neurological symptom was headache (n=102, 33.3%), followed by myalgia (n=96, 31.4%) and anosmia/ageusia (n=54, 17.6%). Acute stroke (all ischemic stroke) occurred in three (1.0%) patients, and new-onset seizures occurred in two (0.7%). Neurological manifestation was a presenting symptom of COVID-19 in 72 (23.5%) patients, and was the only symptom of COVID-19 in 12 (3.9%). Stroke, seizure, and impaired consciousness were significantly associated with severe to critical COVID-19, whereas headache and anosmia/ageusia were frequently found in patients with mild to moderate disease.ConclusionsNeurological manifestations were commonly observed in patients with COVID-19. During the current pandemic, when patients present with new-onset neurological symptoms, COVID-19 may be considered as part of the differential diagnosis. Attention to severe neurological complications is needed, especially in patients with severe or critical COVID-19.

Association of COVID-19 with skin diseases and relevant biologics: a cross-sectional study using nationwide claim data in South Korea.

SummaryBackgroundAs the coronavirus disease 2019 (COVID‐19) pandemic has spread, information about COVID‐19 and skin disease or related biologics is still lacking.ObjectivesTo identify the association between COVID‐19 and skin diseases or biologics.MethodsA nationwide claim dataset relevant to COVID‐19 in South Korea was analysed. This dataset included insurance claim data before and during COVID‐19 treatment and clinical outcomes. Claim data related to skin diseases and relevant biologics were analysed to determine the association of COVID‐19 with skin diseases and relevant biologics.ResultsThe dataset contained a total of 234 427 individuals (111 947 male and 122 480 female) who underwent COVID‐19 testing. Of them, 7590 (3·2%) were confirmed as having COVID‐19, and 227 (3·0%) confirmed patients died. Among various skin diseases and biologics, no significant increase in the presence of specific skin diseases or exposure to biologics was observed in the COVID‐19‐positive group, even after adjusting for or matching covariates. The presence of skin diseases and exposure to biologics also did not seem to affect clinical outcomes including mortality.ConclusionsUnderlying skin diseases did not appear to increase susceptibility to COVID‐19 or mortality from COVID‐19. Considering the risks and benefits, biologics for dermatological conditions might be continuously used during the COVID‐19 pandemic.