• Journal of Preventive Medicine and Public Health
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• v.54 no.1
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• pp.17-21
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• 2021

In 2020, the coronavirus disease 2019 (COVID-19) pandemic has caused unprecedented disruptions to global health systems. The Korea has taken full-fledged actions against this novel infectious disease, swiftly implementing a testing-tracing-treatment strategy. New obligations have therefore been given to the Health Insurance Review and Assessment Service (HIRA) to devote the utmost effort towards tackling this global health crisis. Thanks to the universal national health insurance and state-of-the-art information communications technology (ICT) of the Korea, HIRA has conducted far-reaching countermeasures to detect and treat cases early, prevent the spread of COVID-19, respond quickly to surging demand for the healthcare services, and translate evidence into policy. Three main factors have enabled HIRA to undertake pandemic control preemptively and systematically: nationwide data aggregated from all healthcare providers and patients, pre-existing ICT network systems, and real-time data exchanges. HIRA has maximized the use of data and pre-existing network systems to conduct rapid and responsive measures in a centralized way, both of which have been the most critical tactics and strategies used by the Korean healthcare system. In the face of new obligations, our promise is to strive for a more responsive and resilient health system during this prolonged crisis.

• Safety and Health at Work
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• v.13 no.1
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• pp.66-72
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• 2022

Background: The aim of the present study was to evaluate the psychological well-being (PWB) during the coronavirus disease (COVID-19) pandemic in workers of a multinational company. Methods: Employees (aged ≥18 years) were recruited from Latin American, North American, New Zealand, and European sites of a multinational company operative during all the pandemic period. The self-reported Psychological General Well-Being Index was used to assess the global PWB and the effects on six subdomains: anxiety, depressed mood, positive well-being, self-control, general health, and vitality. The influencing role of age, gender, geographical location, COVID-19 epidemiology, and restrictive measures adopted to control the pandemic was explored. Results: A total of 1335 workers completed the survey. The aggregate median PWB global score was in a positive range, with significantly better outcomes detected in the Mexican and Colombian Latin American sites compared with the other worldwide countries (p < 0.001). Among the European locations, a significantly higher PWB score was determined in Spain compared with the German and French sites (p < 0.05). Comparable geographical trends were demonstrated for all the PWB subdomains. Male workers had a significantly better PWB compared with females (p < 0.05), whereas a negative correlation emerged with aging (p = 0.01). COVID-19 epidemiology and pandemic control measures had no clear effects on PWB. Conclusion: Monitoring PWB and the impact of individual and pandemic-related variables may be helpful to clarify the mental health effects of pandemic, define targeted psychological-supporting measures, also in the workplace, to face such a complex situation in a more constructive way.

• Clinical Nutrition Research
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• v.12 no.4
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• pp.269-282
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• 2023

Vitamin D participates in the biological function of the innate and adaptive immune system and inflammation. We aim to specify the effectiveness of the vitamin D supplementation on the side effects BioNTech, Pfizer vaccination, and immunoglobulin G response against severe acute respiratory syndrome coronavirus 2 in subjects tested positive for coronavirus disease 2019 (COVID-19). In this multi-center randomized clinical trial, 498 people tested positive for COVID-19 were divided into 2 groups, receiving vitamin D capsules or a placebo (1 capsule daily, each containing 600 IU of vitamin D) over 14-16 weeks. Anthropometric indices and biochemical parameters were measured before and after the second dose of vaccination. Fourteen to 16 weeks after supplementation, the intervention group had an immunoglobulin G (IgG) increase of 10.89 ± 1.2 g/L, while the control group had 8.89 ± 1.3 g/L, and the difference was significant between both groups (p = 0.001). After the second dose of vaccination, the supplement group significantly increased their 25-hydroxy vitamin D from initially 28.73 ± 15.6 ng/mL and increased to 46.48 ± 27.2 ng/mL, and the difference between them was significant. Those with a higher body mass index (BMI) had the most of symptoms, and the difference of side effects according to BMI level was significantly different. In 8 weeks after supplementation obese participants had the lowest IgG levels than overweight or normal subjects. The proportion of all types of side effects on the second dose was significantly diminished compared with the first dose in the intervention group. Supplementation of 600 IU of vitamin D3 can reduce post-vaccination side effects and increase IgG levels in participants who received BioNTech, Pfizer vaccine.

• KSII Transactions on Internet and Information Systems (TIIS)
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• v.18 no.6
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• pp.1478-1499
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• 2024

Coronavirus disease (COVID-19) is an infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus. COVID-19 become an active epidemic disease due to its spread around the globe. The main causes of the spread are through interaction and transmission of the droplets through coughing and sneezing. The spread can be minimized by isolating the susceptible patients. However, it necessitates remote monitoring to check the breathing issues of the patient remotely to minimize the interactions for spread minimization. Thus, in this article, we offer a wearable-IoTs-centered framework for remote monitoring and recognition of the breathing pattern and abnormal breath detection for timely providing the proper oxygen level required. We propose wearable sensors accelerometer and gyroscope-based breathing time-series data acquisition, temporal features extraction, and machine learning algorithms for pattern detection and abnormality identification. The sensors provide the data through Bluetooth and receive it at the server for further processing and recognition. We collect the six breathing patterns from the twenty subjects and each pattern is recorded for about five minutes. We match prediction accuracies of all machine learning models under study (i.e. Random forest, Gradient boosting tree, Decision tree, and K-nearest neighbor. Our results show that normal breathing and Bradypnea are the most correctly recognized breathing patterns. However, in some cases, algorithm recognizes kussmaul well also. Collectively, the classification outcomes of Random Forest and Gradient Boost Trees are better than the other two algorithms.

• Clinical and Experimental Reproductive Medicine
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• v.49 no.1
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• pp.2-8
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• 2022

Humanity is in the midst of the coronavirus disease 2019 (COVID-19) pandemic, and vaccines-including mRNA vaccines-have been developed at an unprecedented speed. It is necessary to develop guidelines for vaccination for people undergoing treatment with assisted reproductive technology (ART) and for pregnancy-related situations based on the extant laboratory and clinical data. COVID-19 vaccines do not appear to adversely affect gametes, embryos, or implantation; therefore, active vaccination is recommended for women or men who are preparing for ART. The use of intravenous immunoglobulin G (IVIG) for the treatment of immune-related infertility is unlikely to impact the effectiveness of the vaccines, so COVID-19 vaccines can be administered around ART cycles in which IVIG is scheduled. Pregnant women have been proven to be at risk of severe maternal and neonatal complications from COVID-19. It does not appear that COVID-19 vaccines harm pregnant women or fetuses; instead, they have been observed to deliver antibodies against severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) to the fetus. Accordingly, it is recommended that pregnant women receive COVID-19 vaccination. There is no rationale for adverse effects, or clinical cases of adverse reactions, in mothers or neonates after COVID-19 vaccination in lactating women. Instead, antibodies to SARS-CoV-2 can be delivered through breast milk. Therefore, breastfeeding mothers should consider vaccination. In summary, active administration of COVID-19 vaccines will help ensure the safe implementation of ART, pregnancy, and breastfeeding.

• Clinics in Shoulder and Elbow
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• v.24 no.3
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• pp.156-165
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• 2021

Background: This study aimed to determine: the perspectives of the patient cohort that underwent telehealth consultation and shoulder rehabilitation during coronavirus disease 2019 (COVID-19) and the differences in the patients' perspectives with the two different telehealth video applications (apps) used in the study. Methods: This is a prospective study carried out during the COVID lockdown period of April to July 2020. Thirty consecutive patients from the orthopedics department of a tertiary institute in India underwent their first-ever session of a video app-based (Zoom or WhatsApp) telehealth consultation with shoulder rehabilitation exercises on a handheld mobile, tablet, or laptop device. After the virtual consultation, the patients were sent a validated telehealth usability questionnaire (TUQ) to evaluate their perspectives. Scores obtained from the TUQ were the primary outcome measure. Results: The study was completed by 30 patients (16 men and 14 women) with an average age of 56 years (range, 20-77 years). The patients who contacted us during the lockdown period with either a stiff shoulder or a conservatively treated shoulder fracture were included in the study. The average TUQ score was 13.6 (median, 14.5; range, 6-21) out of a maximum of 21 points. Eighty percent of the patients were satisfied and found the telehealth service useful. Use of the Zoom app scored significantly higher (median, 17; average, 15.6) than the WhatsApp app (median, 8.5; average, 9.6) (p=0.004). Conclusions: Patients who received telehealth consultation and shoulder rehabilitation were overall satisfied. Telehealth apps with advanced video calling features such as Zoom should be preferred for higher patient satisfaction.

• Health Policy and Management
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• v.33 no.1
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• pp.29-39
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• 2023

Background: Breaking the chain of disease transmission from overseas is necessary to control new infectious diseases such as coronavirus disease 2019 effectively. In this study, we developed a mobile app called Self-Symptom Checker (SSC) to monitor the health of inbound travelers. Methods: SSC was developed for general users and administrators. The functions of SSC include non-repudiation using QR (quick response) codes, monitoring fever and respiratory symptoms, and requiring persons showing symptoms to undergo polymerase chain reaction tests at nearby screening stations following a review of reported symptoms by the Korea Disease Control and Prevention Agency, as well as making phone calls, via artificial intelligence or public health personnel, to individuals who have not entered symptoms to provide the necessary information. Results: From February 12 to March 27, 2020, 165,000 people who were subjected to the special entry procedure installed SSC. The expected number of public health officers and related resources needed per day would be 800 if only the phone was used to perform symptom monitoring during the above period. Conclusion: By applying SSC, more effective symptom monitoring was possible. The daily average number of health officers decreased to 100, or 13% of the initial estimate. SSC reduces the work burden on public healthcare personnel. SSC is an electronic solution conceived in response to health questionnaires completed by inbound travelers specified in the World Health Organization International Health Regulations as a requirement in the event of a pandemic.

• Journal of Preventive Medicine and Public Health
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• v.57 no.5
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• pp.480-489
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• 2024

Objectives: Excess deaths, an indicator that compares total mortality rates before and during a pandemic, offer a comprehensive view of the pandemic's impact. However, discrepancies may arise from variations in estimating expected deaths. This study aims to compare excess deaths in Korea during the coronavirus disease 2019 pandemic using 3 methods and to analyze patterns using the most appropriate method. Methods: Expected deaths from 2020 to 2022 were estimated using mortality data from 2015-2019 as reference years. This estimation employed 3 approaches: (1) simple average, (2) age-adjusted average, and (3) age-adjusted linear regression. Excess deaths by age, gender, and cause of death were also presented. Results: The number of excess deaths varied depending on the estimation method used, reaching its highest point with the simple average and its lowest with the age-adjusted average. Age-adjusted linear regression, which accounts for both the aging population and declining mortality rates, was considered most appropriate. Using this model, excess deaths were estimated at 0.3% for 2020, 4.0% for 2021, and 20.7% for 2022. Excess deaths surged among individuals in their 20s throughout the pandemic, largely attributed to a rise in self-harm and suicide. Additionally, the results indicated sharp increases in deaths associated with "endocrine, nutritional, and metabolic diseases" and "symptoms, signs, and abnormal clinical and laboratory findings, not elsewhere classified." Conclusions: Substantial variations in excess deaths were evident based on estimation method, with a notable increase in 2022. The heightened excess deaths among young adults and specific causes underscore key considerations for future pandemic responses.

• Pediatric Infection and Vaccine
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• v.31 no.1
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• pp.83-93
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• 2024

Purpose: Since the start of the coronavirus disease 2019 (COVID-19) pandemic, various variants of concern have emerged. We divided the representative COVID-19 mutation period into four waves and aimed to analyze the clinical and laboratory features of children with COVID-19 from pre-mutation wave to the middle of omicron wave. Methods: We retrospectively reviewed the medical records of hospitalized patients aged ≤19 years with laboratory confirmed COVID-19. Clinical and laboratory findings during pre-mutation (February 1st 2020 to September 30th 2020), alpha/beta (October 1st 2020 to May 31st 2021), delta (June 1st 2021 to October 31st 2021), and omicron (November 1st 2021 to May 31st 2022) waves were compared. Results: Among total 827 patients, 163 (19.7%) were asymptomatic, and the frequency of fever and cough was 320 (38.7%) and 399 (48.2%), respectively. The proportion of fever ≥38.5℃ was observed to be high during the omicron wave in the age group under 12 years. Lymphopenia was observed highly in the omicron wave in the age group under 12 years, and in the delta wave in the age group older than 12 years. Neutropenia was highly observed in the delta wave in the 0-4 years age group. Conclusions: There were distinct characteristics during all epidemic waves of COVID-19. Children with COVID-19 had more frequent persistent fever during delta wave and children during the omicron wave had a higher peak fever.

• Korean Journal of Clinical Laboratory Science
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• v.53 no.3
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• pp.208-216
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• 2021

Coronavirus disease 2019 (COVID-19) is a contagious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This study aimed to investigate the status of renal function in patients with COVID-19. The study surveyed a total of 649 patients hospitalized with COVID-19 at a hospital located in southern Gyeonggi Province, South Korea over a one month period in January 2021. The parameters analyzed were blood urea nitrogen (BUN), creatinine, sodium, potassium, chloride, and estimated glomerular filtration rate (eGFR). The BUN and creatinine of the COVID-19 patients were found to be higher than the normal reference range, specially in males, and in the elderly (60s and 80s or older). The serum electrolyte levels of the patients were observed to be within the reference intervals. Of the subjects, males over 80 years of age had a Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) of 60 mL/min/1.73 m² or less. Recent research suggests that some severe cases of COVID-19 are showing signs of kidney damage, even in those with no prior underlying kidney disease. Thus, assessment of kidney function using multiple indicators could help diagnose abnormal renal function in patients with COVID-19.