COVID-19 In Korea Research Articles

Factors Influencing Post-Traumatic Stress Disorder in Hospital Clinical Nurses during COVID-19 in Korea: Resilience, Social Support, and Professional Pride in Nursing.

During the COVID-19 pandemic, clinical nurses in hospitals in South Korea were exposed to extreme stress, and many continue to suffer from post-traumatic stress disorder (PTSD). This study explores the factors influencing PTSD among hospital clinical nurses during COVID-19. In total, 121 hospital clinical nurses participated in 2022, providing demographic information and completing surveys designed to measure PTSD, resilience, social support, professional pride in nursing (PPN), and variables related to COVID-19. We observed statistically significantly higher levels of resilience (91.48 vs. 70.00), social support (47.37 vs. 35.41), and PPN (88.36 vs. 68.06) in the low-risk PTSD group compared with the high-risk PTSD group. Resilience was associated with a reduced risk of PTSD (OR, 0.91; 95% CI = 0.84-0.98). The subfactors of control (OR = 0.60; 95% CI = 0.43-0.86) and sociability (OR = 0.68; 95% CI = 0.44-0.97) decreased PTSD risk. Among the social support subfactors, family support had an OR of 0.47 (95% CI = 0.26-0.86) for reducing PTSD risk. Programs involving family participation that enhance resilience and provide psychological support can help hospital nurses affected by the COVID-19 pandemic manage their PTSD. Our findings serve as foundational data to develop interventions on psychological well-being for nurses dealing with new infectious diseases.

Atmosphere particulate matter and respiratory diseases during COVID-19 in Korea

We aimed to examine the impact of COVID-19 non-pharmaceutical interventions (NPIs) on the relationship between air pollutants and hospital admissions for respiratory and non-respiratory diseases in six metropolitan cities in South Korea. This study compared the associations between particulate matter (PM10 and PM2.5) and hospital admission for respiratory and non-respiratory diseases before (2016–2019) and during (2020) the implementation of COVID-19 NPIs by using distributed lag non-linear models. In the Pre-COVID-19 period, the association between PM10 and admission risk for asthma and COPD showed an inverted U-shaped pattern. For PM2.5, S-shaped and inverted U-shaped changes were observed in asthma and COPD, respectively. Extremely high and low levels of PM10 and extremely low levels of PM2.5 significantly decreased the risk of admission for asthma and COPD. In the Post-COVID-19 outbreak period, the overall cumulative relationship between PM10 and PM2.5 and respiratory diseases and the effects of extreme levels of PM10 and PM2.5 on respiratory diseases were completely changed. For non-respiratory diseases, PM10 and PM2.5 were statistically insignificant for admission risk during both periods. Our study may provide evidence that implementing NPIs and reducing PM10 and PM2.5 exposure during the COVID-19 pandemic has contributed to reducing hospital admissions for environment-based respiratory diseases.

Changes in Otitis Media During COVID-19.

During the COVID-19 pandemic, various non-pharmaceutical interventions such as individual hygiene practices like hand washing, social distancing, and mandates for the use of masks in public spaces were implemented to reduce the spread of the disease. Otitis media (OM) is a common infectious disease. How the changed environment due to the COVID-19 pandemic has influenced the prevalence of infectious diseases like OM is not known. This study aimed to investigate how OM prevalence and trends changed during COVID-19 in Korea. OM patient data from 2017 to 2021 were extracted from the Health Insurance Review and Assessment Service database. Patients diagnosed with disease code H66 (suppurative and unspecified otitis media) were selected for analysis. Data on OM prevalence, gender, region, medical institution, and number of ventilating-tube prescriptions were analyzed. All age groups were included, and ages were categorized into 5-year ranges. The number of patients diagnosed with the OM disease code decreased continuously from 2017 to 2021 (1 598 205, 1 560 178, 1 520 948, 983 701, and 734 901). The average OM prevalence per 1000 persons decreased by 45.0% from 30.2 in 2017 to 2019 to 16.6 in 2020 to 2021. The change of OM prevalence was greater for the 0 to 5 age group than other age groups. The decrease in average prevalence per 1000 persons was greatest in the 0 to 5 age group (48.6% decrease from 358.2 in 2017-2019 to 184.1 in 2020-2021). The impact of environmental changes on ventilation-tube insertion was smaller than on OM prevalence. The average number of ventilating-tube insertions decreased by 28.1% from 27 311 in 2017 to 2019 to 19 650 in 2020 to 2021. OM prevalence decreased by 45.0%, and the number of ventilating-tube insertions decreased by 28.1% in Korea during COVID-19.

Risk factors for critical COVID-19 illness during Delta- and Omicron-predominant period in Korea; using K-COV-N cohort in the National health insurance service.

This study evaluated the clinical characteristics of patients with COVID-19 in Korea, and examined the relationship between severe COVID-19 cases and underlying health conditions during the Delta (September 20, 2021 to December 4, 2021) and the Omicron (February 20, 2022 to March 31, 2022) predominant period. This study assessed the association between critical COVID-19 illness and various risk factors, including a variety of underlying health conditions, using multiple logistic regression models based on the K-COV-N cohort, a nationwide data of confirmed COVID-19 cases linked with COVID-19 vaccination status and the National Health Insurance claim information. We analyzed 137,532 and 8,294,249 cases of COVID-19 infection during the Delta and the Omicron variant dominant periods, respectively. During the Delta as well as the Omicron period, old age (≥80 years) showed the largest effect size among risk factors for critical COVID-19 illness (aOR = 18.08; 95% confidence interval [CI] = 14.71-22.23 for the Delta; aOR = 24.07; 95% CI = 19.03-30.44 for the Omicron period). We found that patients with solid organ transplant (SOT) recipients, unvaccinated, and interstitial lung disease had more than a two-fold increased risk of critical COVID-19 outcomes between the Delta and Omicron periods. However, risk factors such as urban residence, underweight, and underlying medical conditions, including chronic cardiac diseases, immunodeficiency, and mental disorders, had different effects on the development of critical COVID-19 illness between the Delta and Omicron periods. We found that the severity of COVID-19 infection was much higher for the Delta variant than for the Omicron. Although the Delta and the Omicron variant shared many risk factors for critical illness, several risk factors were found to have different effects on the development of critical COVID-19 illness between those two variants. Close monitoring of a wide range of risk factors for critical illness is warranted as new variants continue to emerge during the pandemic.

A 6-month exercise intervention clinical trial in women: effects of physical activity on multi-omics biomarkers and health during the first wave of COVID-19 in Korea

BackgroundCoronavirus disease 2019 (COVID-19) was first reported in December 2019 and the first case in Korea was confirmed on January 20, 2020. Due to the absence of therapeutic agents and vaccines, the Korean government implemented social distancing on February 29, 2020. This study aimed to examine the effect of physical activity (PA) on health through changes in multi-omics biomarkers with a 6-month of exercise intervention during the first wave of COVID-19 in Korea.MethodsTwenty-seven healthy middle-aged women were recruited and 14 subjects completed the exercise intervention. The mean age (± SD) was 46.3 (± 5.33) and the mean BMI (± SD) was 24.9 (± 3.88). A total of three blood and stool samples were collected at enrollment, after period 1, and after period 2 (3-month intervals). The amount of PA was measured with an accelerometer and by questionnaire. Clinical variables were used, including blood pressure, grip strength, flexibility, and blood glucose levels and lipid markers obtained from laboratory tests. The concentration of blood metabolites was measured by targeted metabolomics. Fecal microbiome data were obtained by 16 S rRNA gene amplicon sequencing.ResultsDuring the second half period (period 2), Coronavirus disease 2019 occurred and spread out in Korea, and PA decreased compared with the first half period (period 1) (185.9 ± 168.73 min/week to 102.5 ± 82.30 min/week; p = 0.0101). Blood pressure, hemoglobin A1c (HbA1c), and low-density lipoprotein cholesterol (LDL-C) decreased in period 1 (p < 0.05) and tended to increase again during period 2 (p < 0.05). Forty metabolites were changed significantly during period 1 (FDR p < 0.05), and we found that 6 of them were correlated with changes in blood pressure, HbA1c, and LDL-C via network analysis.ConclusionsOur results may suggest that exercise improves health through changes in biomarkers at multi-omics levels. However, reduced PA due to COVID-19 can adversely affect health, emphasizing the necessity for sustained exercise and support for home-based fitness to maintain health.Trial RegistrationThe trial is retrospectively registered on ClinicalTrials.gov (NCT05927675; June 30, 2023).

Caregiving Stress Experienced by Parents of Adult Children with Intellectual Disabilities During COVID-19 in Korea

ABSTRACT Many of community supports and resources were shattered in the COVID-19 pandemic, leaving parents to navigate caring for their adult child with intellectual disabilities with little support. This study explored caregiving stress experienced by parents of adult children with intellectual disabilities during the COVID-19 pandemic in Korea. In-depth interviews were conducted with 19 parents of an adult child with intellectual disabilities. Thematic analysis yielded two themes: caregiving burden and deteriorating health. Parents bore the brunt of the caregiving burden, spending much of their time helping their adult child with daily activities and managing their challenging behaviors, leaving the caregivers struggling physically and mentally. The heightened caregiver burden and associated deteriorating health among these parents raise serious concerns, indicating a need for immediate support to alleviate these issues and help parents navigate caring for their adult child with intellectual disabilities during the COVID-19 pandemic.

A Case Study on Community Treatment Center for Response to COVID-19 in Korea: Focusing on Surge Capacity 4S Component Analysis and Social Well-Being Perspective

ABSTRACT In March, 2020, during the COVID-19 pandemic in Korea, the first Community Treatment Center (CTC), which is a motel-type Alternate Care Site (ACS) for mild and asymptomatic patients, was opened. This is a case study of the first Community treatment center prepared to respond to COVID-19. One of the researchers worked as a medical doctor in one of the CTCs operated by the Korean government. The CTC’s eight medical staff members were interviewed in-depth one-on-one. Then the data obtained from observation, collection, and interview were triangulated. In this study, it was identified based on the 4S factor that evaluates the surge capacity to meet the medical needs of CTC. And how the CTC was operated from a medical and social welfare perspective and what problems appeared to patients during the operation were analyzed. Three dormitories of a national training center were used as the CTC. Each patient used a room equipped with a toilet, a shower, and a washbasin. Medical staff and government officials with various backgrounds were dispatched. Telemedicine was also used to prevent the spread of infection. The CTC made a significant contribution to both medical and social welfare fields. It provided patients psychological stability in a comfortable environment. But some patients had psychological problems and difficulties involving work and family care. Various efforts in conjunction with participation from social workers are required to reduce these problems.

한국 코로나19 유행에서의 보건의료정책 이슈와 과제

한국 코로나19 유행에서의 보건의료정책 이슈와 과제

Relationship Between Sports Policy, Policy Satisfaction, and Participation Intention During COVID-19 in Korea

This study aimed to identify the effect of trust in and contents of sports-related policies during COVID-19 on public policy satisfaction and examine the relationship between policy satisfaction and sports participation intention. People living in Korea were selected as the study population using convenience sampling, and 441 responses were collected using an online questionnaire. Data were analyzed using SPSS 23.0. The results indicated that policy trust had a positive effect on policy satisfaction in the order of consistency, expertise, and existing policy performance. In addition, social equity, market responsiveness, and policy effectiveness, which are sub-factors of policy content, had a positive effect on policy satisfaction. Furthermore, sports policy satisfaction had a negative effect on sports participation intention. This study suggests that the government should equally consider policy trust and content when establishing sports-related policies and strive to establish policies based on the positive functions of sports.

Analysis of compound health impacts of heatwave and COVID-19 in Korea from May to September in 2020

The number of non-accidental deaths and heat-related illnesses due to the co-occurrence of heatwaves and COVID-19 has been identified to estimate compound health impacts between two risks. We have analyzed data from historical years (2013–2019) to calculate the baseline values of the number of non-accidental deaths and heat-related illness patients from May to September using a quasi-Poisson generalized linear model and compared them to data from 2020 in Korea. We also assessed the relative risk and absolute cumulative number of non-accidental deaths and heat-related illnesses in the summer of 2020 in Seoul, Daegu, and Gyeongnam region of Korea. In the Summer of 2020, Korea experienced 0.8% of non-accidental excess deaths, with the highest in August, and 46% of reduction was observed in heat-related throughout the study period, except in Daegu, where excess of heat-related illness occurred in August. The relative risk (RR) of non-accidental deaths at 33.1 °C, was 1.00 (CI 0.99–1.01) and 1.04 (CI 1.02–1.07) in 2013–2019 and 2020, respectively. The RR of heat-related illness at 33.1 °C, was 1.44 (CI 1.42–1.45) and 1.59 (CI 1.54–1.64) in 2013–2019 and 2020, respectively. The absolute cumulative trends of non-accidental deaths and heat-related illnesses were similar in the three regions, indicating increased non-accidental deaths and decreased heat-related illnesses at similar temperatures in 2020. During the COVID-19 pandemic, the fear of infection by the virus and the limited access to healthcare services led to changes in health-seeking behaviors. These results indicate social distancing could have had adverse impacts on other health conditions. A comprehensive health risk assessment is important when facing simultaneous risks, such as heatwaves and pandemics, in the implementation of effective countermeasures.

국내 COVID-19 관련 음악치료 연구 동향 분석

본 연구는 팬데믹 시기에 국내에서 발표된 COVID-19 관련 음악치료 연구 동향을 살펴보고 자 한 것이다. 본 연구 결과를 통해 음악치료 영역에서의 새로운 변화를 알아보고 이후 미래 방향성을 제시하고자 한다. 특별히 양적연구가 충분히 수행되지 못한 상황에서 연구를 탐색적 으로 고찰할 수 있는 주제범위 문헌고찰 방법을 적용하였다. 이를 위해 2020년부터 2022년 상 반기까지 국내에서 출판된 COVID-19 관련 음악치료 연구를 대상으로 하였으며 총 23편이 선 정되었다. 23편의 연구를 주제범위 문헌고찰의 단계에 따라 분석한 결과는 다음과 같다. 첫째, 23편의 연구 중 실험연구는 3편, 문헌연구를 포함한 조사연구는 16편, 질적연구는 4편이 선정 되었으며 연구편수는 증가하는 경향성을 보인다. 둘째, 실험연구는 팬데믹 상황에서 취약한 대 상인 장애아동, 취업준비생, 코로나-19 자가격리자를 대상으로 진행되었다. 셋째, 조사연구를 내용별로 분석한 결과 음악치료 임상 현황 조사, 정서변화를 위한 음악사용, 비대면 음악치료 에 대한 인식조사로 구분할 수 있다. 본 연구는 음악치료사들이 변화에 적응하기 위해 어려움 을 경험하였지만 이러한 어려움을 통해 더욱 성장하는 기회가 되었으며 연구결과를 통해 제시 된 전략들을 현장에 적용하고 발전시키기 위한 노력이 필요함을 제시하였다.

Effectiveness of Molnupiravir Treatment in Patients with COVID-19 in Korea: A Propensity Score Matched Study.

The MOVe-OUT (efficacy and safety of molnupiravir [MK-4482] in non-hospitalized adult participants with COVID-19 [MK-4482-002]) trial reported that the administration of molnupiravir in unvaccinated patients with coronavirus disease 2019 (COVID-19) before the Omicron epidemic showed a preventive effect of 31% against hospitalization and death. However, studies on the preventive effect of molnupiravir against progression to severe disease and death in patients with COVID-19 during the Omicron epidemic are limited. This study aimed to evaluate the preventive effect of molnupiravir against severe/critical illness or death and death in Korean patients with COVID-19 who were vaccinated mostly during the Omicron epidemic. This study used large-scale retrospective cohort data to select patients with COVID-19 who were either treated or not treated with molnupiravir, between August 2022 and March 2023, at a ratio of 1 : 4 using the propensity score matching method. In total, 762,768 patients comprised the non- administered group, and 190,692 patients comprised the molnupiravir-administered group. The preventive effect of molnupiravir against severe/critical illness or death and death was analyzed using logistic regression analysis. The preventive effect of molnupiravir against severe/critical illness or death and death, represented by the odds ratio (OR) and 95% confidence interval (CI), in the molnupiravir-administered and non-administered group was (OR: 0.714; CI: 0.667 - 0.764) and (OR: 0.749; CI: 0.682 - 0.823), respectively. As age increased, the preventive effect against severe/critical illness or death and death increased. The preventive effect against severe/critical illness or death at ≥60 years was (OR: 0.669; CI: 0.624 - 0.717), at ≥70 years was (OR: 0.614; CI: 0.570 - 0.661), and at ≥80 years was (OR: 0.563; CI: 0.515 - 0.615). The preventive effect against death at ≥60 years was (OR: 0.729; CI: 0.663 - 0.802), at ≥70 years was (OR: 0.676; CI: 0.612 - 0.747), and at ≥80 years was (OR: 0.622; CI: 0.554 - 0.698). Although molnupiravir showed a relatively weak preventive effect against severe/critical illness or death (29%) and death (25%) among patients with COVID-19, it exhibited a stronger protective effect in older patients than in younger patients. In particular, the preventive effect against severe/critical illness or death (44%) and death (38%) in those aged ≥80 years was pronounced. This study strongly suggests that molnupiravir administration can alleviate the burden on the medical system, and treat patients with COVID-19 effectively by reducing its progression to severe disease and death.

Prediction model of intention to use digital fitness services for health promotion during the COVID-19 pandemic: a gender-based multi-group analysis

As the number of people infected with COVID-19 in Korea is increasing, several measures have been implemented to gradually restrict outdoor activities and indoor gatherings while promoting a non-face-to-face social culture. In this study, we performed a gender-based multi-group analysis using a technology acceptance model (TAM) as an external variable for COVID-19 risk perception to verify the model’s predictive ability to increase participation behavior toward digital fitness services. We analyzed the data of 433 Koreans using an online survey consisting of 23 items. A structural equation model was used to verify the perceived ease of use (PEOU), perceived usefulness (PU), intention to use and exercise participation behavior of the TAM with COVID-19 risk perception as an external variable. First, our results showed that COVID-19 risk perception had a statistically higher significant and positive effect on PEOU (β = 0.170, t = 3.296, p &lt; 0.001) than on PU (β = 0.130, t = 2.848, p = 0.004) of digital fitness services. Second, the PEOU of the digital fitness service was found to have a statistically higher significant positive effect on PU (β = 0.512, t = 9.728, p &lt; 0.001) than on intention to use (β = 0.130, t = −2.774, p = 0.006). Third, the PU of digital fitness services was found to have a statistically significant positive effect on the intention to use (β = 0.684, t = 12.909, p &lt; 0.001). Fourth, the intention to use the digital fitness service was found to have a statistically significant positive effect on exercise participation behavior (β = 0.796, t = 16.248, p &lt; 0.001). Lastly, we observed a significant difference between men and women in COVID-19 risk perception and PEOU among the six paths established. Digital environments that encourage participation in exercises could promote health during a pandemic. This study highlighted the need to consider digital environments that encourage exercise participation in creating physical exercise contents as there was no significant difference in the intention to use digital fitness services between men and women.

Cross-cultural differences and similarities in nurses' experiences during the early stages of COVID-19 in Korea and the United States: A qualitative descriptive study.

At the onset of the COVID-19 pandemic, governmental responses varied worldwide, which resulted in healthcare professionals and organizations having different experiences. As threats of global infectious disease and disasters increase, it is important to examine the collective experiences of nurses to leverage support across international settings and systems and to tailor specific policies to their local nursing workforce. To compare and contrast nurses' experiences working in hospitals at the onset of COVID-19 in South Korea and the United States. This was a qualitative descriptive study. Nurses in South Korea and the United States were recruited through social media using snowball sampling between April and May 2020. Semi-structured telephone interviews were audio-recorded, transcribed, and translated as needed. The transcripts were analyzed thematically, and each theme was compared and synthesized using NVivo 12. A total of 43 nurses from South Korea (n=21) and the United States (n=22) participated in the study. The majority of the participants were female and working as staff nurses in both countries. The work settings were similar between the participants from two countries. However, the participants in South Korea provided less direct care to patients with COVID-19 compared to the participants in the United States. Despite cultural and infrastructure differences, the nurses shared similar experiences. The overlapping similarities of nurses' experience highlight the need for national and global policies for a safe work environment and psychological well-being. The differences between the two countries also emphasize that specific policies and practice implications for the local contexts are needed in addition to global policies.

Cause-specific mortality in Korea during the first year of the COVID-19 pandemic.

This study aimed to examine the trends in total mortality between 1998 and 2020 and to compare the changes in a wide range of detailed causes of death between 2020 (i.e., during the coronavirus disease 2019 [COVID-19] pandemic) and the previous year in Korea. We used registered population and mortality data for the years 1998-2020 obtained from Statistics Korea. The age-standardized all-cause mortality rate and the annual percent change between 1998 and 2020 were determined. The rate ratio and rate difference of the age-standardized mortality rate between 2019 and 2020 were calculated. The age-standardized all-cause mortality rate in Korea has been on a downward trend since 1998, and the decline continued in 2020. In 2020, 950 people died from COVID-19, accounting for 0.3% of all deaths. Mortality decreased for most causes of death; however, the number of deaths attributed to sepsis and aspiration pneumonia increased between 2019 and 2020 for both men and women. Age-specific mortality rates decreased or remained stable between 2019 and 2020 for all age groups, except women aged 25-29. This increase was mainly attributed to a higher number of suicide deaths. This study shed light on the issues of sepsis and aspiration pneumonia despite the successful response to COVID-19 in Korea in 2020. Cases of death from sepsis and aspiration pneumonia should be identified and monitored. In addition, it is necessary to develop a proactive policy to address suicide among young people, especially young women.

Successful provision of hemodialysis to patients with confirmed COVID-19 in Korea: the role of a cooperative network between public and private medical systems.

Successful provision of hemodialysis to patients with confirmed COVID-19 in Korea: the role of a cooperative network between public and private medical systems.

Path algorithms for fused lasso signal approximator with application to COVID-19 spread in Korea.

The fused lasso signal approximator (FLSA) is a smoothing procedure for noisy observations that uses fused lasso penalty on unobserved mean levels to find sparse signal blocks. Several path algorithms have been developed to obtain the whole solution path of the FLSA. However, it is known that the FLSA has model selection inconsistency when the underlying signals have a stair-case block, where three consecutive signal blocks are either strictly increasing or decreasing. Modified path algorithms for the FLSA have been proposed to guarantee model selection consistency regardless of the stair-case block. In this paper, we provide a comprehensive review of the path algorithms for the FLSA and prove the properties of the recently modified path algorithms' hitting times. Specifically, we reinterpret the modified path algorithm as the path algorithm for local FLSA problems and reveal the condition that the hitting time for the fusion of the modified path algorithm is not monotone in a tuning parameter. To recover the monotonicity of the solution path, we propose a pathwise adaptive FLSA having monotonicity with similar performance as the modified solution path algorithm. Finally, we apply the proposed method to the number of daily-confirmed cases of COVID-19 in Korea to identify the change points of its spread.

형태초점 교수법을 기반으로 한 온라인 영어회화수업에 관한 연구

The purpose of this study was to investigate the effect of focus-on-form instruction (FFI) to increase the effect on online English conversation class for college EFL students. In the extracurricular program, 227 students who voluntarily participated in the non-faced online college English conversation class were recruited for the study. After 4 weeks of the program, participants were asked to complete the reflection reports. Since 2020, the pandemic period of COVID-19 in Korea, English conversation classes, which have more opportunities to have face-to-face interaction, have encouraged to be redesigned in accordance with the online English learning settings, and there were several studies to review the effect of online English learning. In this study, the isolated FFI is implemented to complement the interaction between the instructor and students during class, and participants’ reflections were collected and analyzed. In the finding, the isolated FFI, the English grammar-based instruction was reported as a positive facilitator to encourage more students to sustain in the class and showed the increased class satisfaction as a result. Since some meaningful suggestions have been found in this study, we expect the improved program to reflect these points in the future program process. The further pedagogical implication is discussed in the study

Impact of COVID-19 Pandemic on Thyroid Surgery in a University Hospital in South Korea.

Simple SummaryThe COVID-19 pandemic has changed healthcare systems around the world. Medical staff focused on managing infectious diseases and other treatments were postponed. We analyzed any changes in the treatment of thyroid cancer during the corona pandemic. Since the outbreak of COVID-19, the number of annual outpatients has significantly decreased, both for new patients and for follow-up patients, and the number of days from the first visit to surgery has increased significantly. After the onset of COVID-19, poor prognostic factors for thyroid cancer increased, and the size of follicular tumors increased.The COVID-19 pandemic has changed healthcare systems around the world. Medical personnel concentrated on infectious disease management and treatments for non-emergency diseases and scheduled surgeries were delayed. We aimed to investigate the change in the severity of thyroid cancer before and after the outbreak of COVID-19 in Korea. We collected three years of data (2019, 2020, and 2021) on patients who received thyroid surgery in a university hospital in South Korea and grouped them as “Before COVID-19”, “After COVID-19 1-year” and “After COVID-19 2-years”. The total number of annual outpatients declined significantly after the outbreak of COVID-19 in both new (1303, 939, and 1098 patients) and follow-up patients (5584, 4609, and 4739 patients). Clinical characteristics, including age, sex, BMI, preoperative cytology results, surgical extent, and final pathologic diagnosis, were not significantly changed after the outbreak of COVID-19. However, the number of days from the first visit to surgery was significantly increased (38.3 ± 32.2, 58.3 ± 105.2, 47.8 ± 124.7 days, p = 0.027). Papillary thyroid carcinoma (PTC) patients showed increased proportions of extrathyroidal extension, lymphatic invasion, vascular invasion, and cervical lymph node metastasis. Increased tumor size was observed in patients with follicular tumor (3.5 ± 2.2, 4.0 ± 1.9, 4.3 ± 2.3 cm, p = 0.019). After the COVID-19 outbreak, poor prognostic factors for thyroid cancer increased, and an increase in the size of follicular tumors was observed. Due to our study being confined to a single tertiary institution in Incheon city, Korea, nationwide studies that include primary clinics should be required to identify the actual impact of COVID-19 on thyroid disease treatment.

Incidence of Upper Respiratory Diseases During the COVID-19 Pandemic: A Nationwide Data-Based Epidemiological Study

Background and Objectives Nonpharmacologic interventions (NPIs), such as social distancing and preventive measures, were administered during the coronavirus disease (COVID-19) pandemic, which may influence the incidence of upper respiratory diseases (URDs). The present study compared the incidence of URDs during the COVID-19 pandemic and during the years prior to COVID-19, and investigated the effect of NPIs on URD in the nationwide general population.Subjects and Method This is an epidemiologic study based on the Korean National Health Insurance Database from March 2016 to February 2021. We compared the monthly incidence of URDs from March 2020 to February 2021 (12 months) with that of the past four years. A negative binomial regression model was used to evaluate the annual difference in the incidence of each URD and adjusting temperature, humidity, and the level of particulate matter 10 (PM10).Results The monthly incidence of ‘the five common URDs’ in 2020 was significantly lower than that in the past four years. The incidence of other chronic diseases, however, such as hypertension and diabetes mellitus, was comparable or higher in the past four years. Among the five common URDs, influenza virus infections decreased most dramatically, nearing 99%, from 296.4-377.1 per 100000 people during the period of 2016 to 2019 to 3.7 per 100000 people in 2020.Conclusion The present study shows that the incidence of ‘five common URDs’ significantly decreased during the era of COVID-19 in Korea. We believe that nationwide NPI might prevent the transmission of COVID-19 as well as other infectious sources associated with URDs.