OBJECTIVE: The present study aimed to examine the potential mediating effect of income level on the association between noise exposure and insomnia. METHODS: 706 individuals were evaluated in conjunction with 2014 noise map data from Seoul, South Korea. Cross-sectional analysis was performed to examine differences in noise level according to household income, while three separate logistic regression models were used to examine factors influencing insomnia. Odds ratios (ORs) were calculated after adjusting for depression, anxiety, auditory acuity and noise sensitivity in the first model. Analyses were adjusted for sociodemographic variables in the second model, lifestyle factors and medical illnesses in the third model. RESULTS: Noise level was significantly associated with an increased risk of insomnia in the low-income group, although no such association was observed in the high-income group. Groups exposed to >60 dB of noise (Lden; day-evening-night equivalent) exhibited a 1.79-fold increase in the incidence of insomnia relative to those exposed to <50 dB. The result was significant after adjusting sociodemographic variables, although not significant when adjusted for lifestyle factors and medical illnesses. CONCLUSION: Individuals with low income may be more vulnerable to the deleterious effects of noise exposure on health. Various aspects including income should be considered to ascertain the influence of noise on insomnia.
Anxiety ; Cross-Sectional Studies ; Depression ; Family Characteristics ; Incidence ; Korea ; Life Style ; Logistic Models ; Mental Health ; Negotiating ; Noise* ; Odds Ratio ; Seoul ; Sleep Initiation and Maintenance Disorders*

Background: A novel antiviral agent, remdesivir (RDV), is a promising candidate treatment for coronavirus disease 2019 (COVID-19) in the absence of any proven therapy.Materials and Methods: This retrospective case series included 10 patients with a clinically and laboratory confirmed diagnosis of severe COVID-19 pneumonia who had received RDV for 5 days (n = 5) or 10 days (n = 5) in the Phase III clinical trial of RDV (GS-US-540-5773) conducted by Gilead Sciences. The clinical and laboratory data for these patients were extracted. Results: One patient in the 10-day group received RDV for only 5 days because of nausea and elevated liver transaminases. No patient had respiratory comorbidity. Seven patients had bilateral lesions and three had unilateral lesions on imaging. All patients had received other medications for COVID-19, including lopinavir/ritonavir and hydroxychloroquine, before administration of RDV. Five patients required supplemental oxygen and one required mechanical ventilation. All patients showed clinical and laboratory evidence of improvement.Half of the patients developed elevated liver transaminases and three had nausea. There were no adverse events exceeding grade 2. Conclusion Our experience indicates that RDV could be a therapeutic option for COVID-19.A well-designed randomized controlled clinical trial is now needed to confirm the efficacy of RDV in patients with COVID-19.