1.Distress, Depression, Anxiety, and Spiritual Needs of Patients with Stomach Cancer.
Asian Oncology Nursing 2012;12(4):314-322
PURPOSE: This study was to investigate relationships among distress, depression, anxiety, and spiritual needs of hospitalized patients with stomach cancer. METHODS: The participants were 120 in-patients with stomach cancer for surgery or chemotherapy at C University in Seoul from December 2010 to February 2011. To measure emotional and spiritual states was used Distress management version 1 (National Comprehensive Cancer Network, NCCN), the Hospital anxiety and Depression Scale (HADS), and the Spiritual Needs Scale. The data were analyzed using SPSS 19.0, specifically descriptive statistics, t-test, ANOVA, Scheffe's test, and Pearson's correlation coefficients. RESULTS: Distress showed positive correlations with anxiety (r=.49, p<.001), and depression (r=.44, p<.001). Anxiety showed positive correlations with depression (r=.59, p<.001). While, depression showed negative correlations with spiritual needs (r=-.25, p<.001). CONCLUSION: This study's findings show that hospitalized patients with stomach cancer experienced distress, anxiety, depression and high spiritual needs. Distress, anxiety, and depression of patients with stomach cancer were positively correlated with each other. While the level of depression was negatively correlated with the level of spiritual needs, indicating the higher the level of depression, the lower the spiritual needs. Therefore, nursing interventions for emotional and spiritual support need to be developed for stomach cancer patients.
Anxiety*
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Depression*
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Drug Therapy
;
Humans
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Nursing
;
Seoul
;
Spirituality
;
Stomach Neoplasms*
2.CT of head and neck lymphoma.
Moung Sook LEE ; Hong Soo KIM ; Jung Ik JI ; Eun Young JO ; Ju Whan WI ; Hak Song REE
Journal of the Korean Radiological Society 1993;29(6):1151-1157
Lymphoma is the second most common neoplasm in the head and neck, and is the most common cause of unilateral neck mass in patients between 21 and 40 years of age. This report is a retrospective review of histologically proven lymphomas in 42 patients regarding histologic type, clinical stage, and CT imaging patterns. CT imaging plays an important role in making diagnosis, planning treatment, and evaluating recurrence after treatment. CT imaging patterns are classified into 4 types: Type 1 is nodal lymphoma, Type 2 extranodal lymphoma, Type 3 combined nodal and extranodal lymphoma, and Type 4 multifocal extranodal lymphoma. In conclusion, Lymphoma should be considered when multiple, nonnecrotic, homogenous lymph nodes are located in deep lymphatic chains (especially when they are large and bilateral or when both are the superficial and deep lymph node chains are involved simultaneously) and no mucosal abnormality of the aerodigestive tract is observed. Additionary, when a large nasopharyngeal mass lesion shows limited or equivocal bone destruction or a mass is identified on two sides of a nasal bone without frank destruction and when multiple sites of disease are identified in extranodal tissues.
Diagnosis
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Head*
;
Humans
;
Lymph Nodes
;
Lymphoma*
;
Nasal Bone
;
Neck*
;
Recurrence
;
Retrospective Studies
3.Clinical Characteristics and Outcomes of Pyogenic Liver Abscess in Elderly Korean Patients.
Jin Woo WI ; Eun Ae CHO ; Chung Hwan JUN ; Seon Young PARK ; Chang Hwan PARK ; Young Eun JOO ; Hyun Soo KIM ; Sung Kyu CHOI ; Jong Sun REW ; Sook In JUNG
The Korean Journal of Gastroenterology 2015;66(1):27-32
BACKGROUND/AIMS: Incidence of pyogenic liver abscess (PLA) has been increasing worldwide, especially in the elderly population. Therefore, the aim of this study is to elucidate the clinical features and outcomes of PLA in elderly patients. METHODS: A total of 602 patients diagnosed with PLA from January 2003 to January 2013 were analyzed retrospectively. The patients were divided according to two age groups; > or =65 years (n=296) and <65 years (n=306). RESULTS: The mean age was 73.59+/-5.98 (range, 65-93) years in the elderly group. Significantly higher incidence of females (52.4% vs. 29.1%, p<0.001), hepatobiliary disease (41.2% vs. 24.8%, p<0.001), hepatobiliary procedure (29.4% vs. 13.7%, p<0.001), underlying malignancy (18.2% vs. 4.6%, p<0.001), culture positivity of resistant organism (20.6% vs. 14.4%, p=0.047), occurrence of complication (19.6% vs. 12.8%, p=0.026), and higher white blood cell (13.44+/-6.56 vs. 12.26+/-5.89, p=0.021), but lower rates of right lobe abscess (67.2% vs. 80.4%, p<0.001), fever (68.6% vs. 79.3%, p=0.003), and lower CRP (16.79+/-9.67 vs. 18.80+/-9.86, p=0.012) was observed in elderly PLA patients, compared to younger patients. Regarding complications, elderly patients had higher incidence of septic shock (8.1% vs. 2.3%, p=0.001) and cardiovascular disease (2% vs. 0%, p=0.014). CONCLUSIONS: More atypical presentations and complications tend to occur in elderly PLA patients compared with younger patients. Clinicians should be aware of these age-related differences in PLA and devise management strategies accordingly.
Adolescent
;
Adult
;
Age Factors
;
Aged
;
Aged, 80 and over
;
Anti-Bacterial Agents/therapeutic use
;
Cardiovascular Diseases/epidemiology/etiology
;
Child
;
Drug Resistance, Bacterial
;
Escherichia coli/isolation & purification
;
Female
;
Humans
;
Incidence
;
Klebsiella pneumoniae/isolation & purification
;
Leukocyte Count
;
Liver Abscess, Pyogenic/*drug therapy/epidemiology/microbiology/*pathology
;
Male
;
Middle Aged
;
Prognosis
;
Republic of Korea/epidemiology
;
Retrospective Studies
;
Sex Factors
;
Shock, Septic/epidemiology/etiology
;
Young Adult
4.Source Analysis and Effective Control of a COVID-19 Outbreak in a University Teaching Hospital during a Period of Increasing Community Prevalence of COVID-19
Unhee LEE ; Seong Eun KIM ; Seung Yeob LEE ; Hang Nam WI ; Okja CHOI ; Ji-Won PARK ; Dahee KIM ; You Jung KIM ; Hwa Young SHIN ; Mihee KIM ; Eun Ji KIM ; Seung-Ji KANG ; Sook-In JUNG ; Kyung-Hwa PARK
Journal of Korean Medical Science 2021;36(24):e179-
Background:
South Korea has been experiencing a third wave of coronavirus disease 2019 (COVID-19) since mid-November 2020. Our hospital in Gwangju metropolitan city experienced a healthcare-associated COVID-19 outbreak early in the third wave. The first confirmed COVID-19 patient was a symptomatic neurosurgery resident with high mobility throughout the hospital. We analyzed the transmission routes of nosocomial COVID-19 and discussed infection control strategies.
Methods:
We retrospectively analyzed the severe acute respiratory syndrome coronavirus 2 reverse transcription-polymerase chain reaction (RT-PCR) testing results according to time point and evaluated transmission routes.
Results:
Since COVID-19 was first confirmed in a healthcare worker (HCW) on 11/13/2020, we performed RT-PCR tests for all patients and caregivers and four complete enumeration surveys for all HCWs. We detected three clusters of nosocomial spread and several sporadic cases. The first cluster originated from the community outbreak spot, where an asymptomatic HCW visited, which led to a total of 22 cases. The second cluster, which included patient-to-patient transmission, originated from a COVID-19 positive caregiver before diagnosis and the third cluster involved a radiologist and a banker. We took measures to isolate Building 1 of the hospital for 17 days and controlled the outbreak during a period of increasing community COVID-19 prevalence. Universal screening of all inpatients upon admission and resident caregivers was made mandatory and hospital-related employees are now screened monthly.
Conclusion
Infection control strategies to prevent the nosocomial transmission of emerging infectious diseases must correspond with community disease prevalence. Our data reinforce the importance of multi-time point surveillance of asymptomatic HCWs and routine surveillance of patients and caregivers during an epidemic.
5.Source Analysis and Effective Control of a COVID-19 Outbreak in a University Teaching Hospital during a Period of Increasing Community Prevalence of COVID-19
Unhee LEE ; Seong Eun KIM ; Seung Yeob LEE ; Hang Nam WI ; Okja CHOI ; Ji-Won PARK ; Dahee KIM ; You Jung KIM ; Hwa Young SHIN ; Mihee KIM ; Eun Ji KIM ; Seung-Ji KANG ; Sook-In JUNG ; Kyung-Hwa PARK
Journal of Korean Medical Science 2021;36(24):e179-
Background:
South Korea has been experiencing a third wave of coronavirus disease 2019 (COVID-19) since mid-November 2020. Our hospital in Gwangju metropolitan city experienced a healthcare-associated COVID-19 outbreak early in the third wave. The first confirmed COVID-19 patient was a symptomatic neurosurgery resident with high mobility throughout the hospital. We analyzed the transmission routes of nosocomial COVID-19 and discussed infection control strategies.
Methods:
We retrospectively analyzed the severe acute respiratory syndrome coronavirus 2 reverse transcription-polymerase chain reaction (RT-PCR) testing results according to time point and evaluated transmission routes.
Results:
Since COVID-19 was first confirmed in a healthcare worker (HCW) on 11/13/2020, we performed RT-PCR tests for all patients and caregivers and four complete enumeration surveys for all HCWs. We detected three clusters of nosocomial spread and several sporadic cases. The first cluster originated from the community outbreak spot, where an asymptomatic HCW visited, which led to a total of 22 cases. The second cluster, which included patient-to-patient transmission, originated from a COVID-19 positive caregiver before diagnosis and the third cluster involved a radiologist and a banker. We took measures to isolate Building 1 of the hospital for 17 days and controlled the outbreak during a period of increasing community COVID-19 prevalence. Universal screening of all inpatients upon admission and resident caregivers was made mandatory and hospital-related employees are now screened monthly.
Conclusion
Infection control strategies to prevent the nosocomial transmission of emerging infectious diseases must correspond with community disease prevalence. Our data reinforce the importance of multi-time point surveillance of asymptomatic HCWs and routine surveillance of patients and caregivers during an epidemic.
6.Prevalence of and risk factors for endogenous endophthalmitis in patients with pyogenic liver abscesses.
In Hyung PARK ; Chung Hwan JUN ; Jin Woo WI ; Seon Young PARK ; Wan Sik LEE ; Sook In JUNG ; Chang Hwan PARK ; Young Eun JOO ; Hyun Soo KIM ; Sung Kyu CHOI ; Jong Sun REW
The Korean Journal of Internal Medicine 2015;30(4):453-459
BACKGROUND/AIMS: Although pyogenic liver abscesses (PLAs) can be successfully treated, the visual prognosis of patients with endogenous endophthalmitis (EE) associated with a PLA is poor. Early diagnosis and prompt intervention may salvage useful vision. Therefore, we investigated risk factors for EE in patients with PLA, to facilitate early diagnosis. METHODS: Data from 626 patients diagnosed with PLA between January 2004 and July 2013 were analyzed retrospectively. Patients were divided into two groups: those with liver abscess-associated endogenous endophthalmitis (LAEE) and non-LAEE. RESULTS: The prevalence of EE in PLA patients was 1.92%. The mean age for all patients (373 males, 59.6%) was 62.8 years. Upon multivariate logistic regression, a liver abscess or another systemic infection (odds ratio [OR], 5.52; p = 0.005), an abscess in the right superior segment (OR, 5.26; p = 0.035), and Klebsiella pneumoniae infection (OR, 3.68; p = 0.039), were risk factors for LAEE. The final visual outcomes of patients with LAEE included no light perception in seven, hand motion only in three, and decreased visual acuity in two. Vitrectomy and early intravitreal injections of antibiotics improved visual acuity and preserved useful vision. CONCLUSIONS: PLA patients with other systemic infections, abscesses in the right superior segment, and K. pneumoniae infection require close monitoring and early intervention to treat LAEE. Intravitreal antibiotic injections or early vitrectomy may salvage useful vision.
Aged
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Anti-Bacterial Agents/administration & dosage
;
Chi-Square Distribution
;
Early Diagnosis
;
Endophthalmitis/diagnosis/*epidemiology/microbiology/therapy
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Female
;
Humans
;
Intravitreal Injections
;
Liver Abscess, Pyogenic/diagnosis/*epidemiology/microbiology
;
Logistic Models
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Male
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Middle Aged
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Multivariate Analysis
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Odds Ratio
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Predictive Value of Tests
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Prevalence
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Republic of Korea/epidemiology
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Retrospective Studies
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Risk Factors
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Tomography, X-Ray Computed
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Treatment Outcome
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Visual Acuity
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Vitrectomy
7.A Case of Hereditary Fructose Intolerance.
Eun Kyeong KANG ; Hye Ran YANG ; Jeong Kee SEO ; Sun Hoan BAI ; Joo Young JEONG ; Jae Sung KO ; Il Soo HA ; Jeong Han SONG ; Kyeong Ae WI ; Yoon Sook SHIN
Journal of the Korean Pediatric Society 2002;45(1):120-124
Hereditary fructose intolerance(HFI) is an autosomal recessive disease caused by catalytic deficiency of aldolase B in which affected homozygotes develop hypoglycemia and abdominal symptoms after taking foods containing fructose. Chronic exposure to fructose may lead to progressive hepatic injury, renal injury, growth retardation, and ultimately to liver and kidney failure. Herein, we report a case of HFI with presentation of episodic vomiting, diarrhea, cold sweating, abnormal liver function and failure to thrive after 12 months of her age. She developed an aversion to fruits and sweet-tasting foods. When she was admitted to hospital at the age of 30 months, hepatomegaly, and dysfunction of proximal renal tubule with renal tubular acidosis were noted. We confirmed the diagnosis via enzyme assay on biopsied liver and intestine. A fructose restrictied diet was recommended. The patient has been symptom free with normal liver functions since then.
Acidosis, Renal Tubular
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Diagnosis
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Diarrhea
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Diet
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Enzyme Assays
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Failure to Thrive
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Fructose
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Fructose Intolerance*
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Fructose-Bisphosphate Aldolase
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Fruit
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Hepatomegaly
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Homozygote
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Humans
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Hypoglycemia
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Intestines
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Kidney Tubules, Proximal
;
Liver
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Renal Insufficiency
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Sweat
;
Sweating
;
Vomiting
8.Clinical Characteristics and Risk Factors for Mortality in Critical Coronavirus Disease 2019 Patients 50 Years of Age or Younger During the Delta Wave: Comparison With Patients > 50 Years in Korea
Hye Jin SHI ; Eliel NHAM ; Bomi KIM ; Eun-Jeong JOO ; Hae Suk CHEONG ; Shin Hee HONG ; Miri HYUN ; Hyun ah KIM ; Sukbin JANG ; Ji-Young RHEE ; Jungok KIM ; Sungmin KIM ; Hyun Kyu CHO ; Yu Mi WI ; Shinhye CHEON ; Yeon-Sook KIM ; Seungjin LIM ; Hyeri SEOK ; Sook In JUNG ; Joong Sik EOM ; Kyong Ran PECK
Journal of Korean Medical Science 2022;37(22):e175-
Background:
Numerous patients around the globe are dying from coronavirus disease 2019 (COVID-19). While age is a known risk factor, risk analysis in the young generation is lacking. The present study aimed to evaluate the clinical features and mortality risk factors in younger patients (≤ 50 years) with a critical case of COVID-19 in comparison with those among older patients (> 50 years) in Korea.
Methods:
We analyzed the data of adult patients only in critical condition (requiring high flow nasal cannula oxygen therapy or higher respiratory support) hospitalized with PCR-confirmed COVID-19 at 11 hospitals in Korea from July 1, 2021 to November 30, 2021 when the delta variant was a dominant strain. Patients’ electronic medical records were reviewed to identify clinical characteristics.
Results:
During the study period, 448 patients were enrolled. One hundred and forty-two were aged 50 years or younger (the younger group), while 306 were above 50 years of age (the older group). The most common pre-existing conditions in the younger group were diabetes mellitus and hypertension, and 69.7% of the patients had a body mass index (BMI) > 25 kg/m 2 .Of 142 younger patients, 31 of 142 patients (21.8%, 19 women) did not have these pre-existing conditions. The overall case fatality rate among severity cases was 21.0%, and it differed according to age: 5.6% (n = 8/142) in the younger group, 28.1% in the older group, and 38% in the ≥ 65 years group. Age (odds ratio [OR], 7.902; 95% confidence interval [CI], 2.754–18.181), mechanical ventilation therapy (OR, 17.233; 95% CI, 8.439–35.192), highest creatinine > 1.5 mg/dL (OR, 17.631; 95% CI, 8.321–37.357), and combined blood stream infection (OR, 7.092;95% CI, 1.061–18.181) were identified as independent predictors of mortality in total patients.Similar patterns were observed in age-specific analyses, but most results were statistically insignificant in multivariate analysis due to the low number of deaths in the younger group.The full vaccination rate was very low among study population (13.6%), and only three patients were fully vaccinated, with none of the patients who died having been fully vaccinated in the younger group. Seven of eight patients who died had a pre-existing condition or were obese (BMI > 25 kg/m 2 ), and the one remaining patient died from a secondary infection.
Conclusion
About 22% of the patients in the young critical group did not have an underlying disease or obesity, but the rate of obesity (BMI > 25 kg/m2 ) was high, with a fatality rate of 5.6%. The full vaccination rate was extremely low compared to the general population of the same age group, showing that non-vaccination has a grave impact on the progression of COVID-19 to a critical condition. The findings of this study highlight the need for measures to prevent critical progression of COVID-19, such as vaccinations and targeting young adults especially having risk factors.
9.Current Status of Prophylaxis for Endocarditis.
Hyun Kyun KI ; Sun Hee KIM ; Kyung Mok SOHN ; Yu Mi WI ; Ji Young RHEE ; Chi Sook MOON ; Won Sup OH ; Kyong Ran PECK ; Eun Suk JEON ; Nam Yong LEE ; Jun Seop YEOM ; Choon Kwan KIM ; Jun Sung SON ; Yeon Suk KIM ; Suk In JUNG ; Hyun Ha JANG ; Shin Woo KIM ; Hyuck LEE ; Jae Hoon SONG
Korean Circulation Journal 2005;35(4):328-334
BACKGROUND AND OBJECTIVES: Antibiotic prophylaxis of infective endocarditis is required before high-risk procedures in patient with high-risk heart diseases. Although guidelines for the prevention of infective endocarditis were proposed by the American Heart Association in 1997, compliance to these recommendations has not been evaluated in Korea. SUBJECTS AND METHODS: This was a retrospective, multicentered study in 8 Korean university hospitals. Patients with high-risk heart diseases, having undergone invasive dental procedures between Jan. 1, 2000 and Dec. 31, 2003, were enrolled. The medical and dental records of the patients were reviewed to evaluate whether the prophylaxis had been appropriate. RESULTS: Of the initial 4,912 patients, 184 that had been treated with invasive dental procedures (255 total episodes, mean 1.4/patient) were evaluated. The most common high-risk heart disease was a prosthetic heart valve (233 procedures), followed by a previous history of infective endocarditis (22 procedures), cyanotic heart diseases (5 procedures) and systemic pulmonic venous shunts (2 procedures). Antibiotic prophylaxis was performed in 231 procedures (90.8%). Amoxicillin was the most common antibiotic used for prophylaxis (88.6%); however, the adequate dosage (2 gm) was administered in only 56% of these cases. Therefore, the appropriate prophylaxis, according to the AHA recommendations, was performed in only 14.1% (36 procedures). The mean duration of prophylaxis and number of antibiotic doses were 2.40 days (2.40+/-2.44) and 7.97 doses (7.97+/-7.18), respectively. A previous history of infective endocarditis (p=0.03) and dental extraction (p<0.01) resulted in a longer duration of prophylaxis. CONCLUSION: Only 14.1% of the high risk group procedures were given appropriate antibiotic prophylaxis according to the AHA recommendations. These data suggest that protocol-based education of both doctors and patients is required for appropriate antimicrobial therapy during high-risk procedures for the prevention of infective endocarditis in patients with high-risk heart disease.
American Heart Association
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Amoxicillin
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Antibiotic Prophylaxis
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Compliance
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Dental Records
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Education
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Endocarditis*
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Heart Diseases
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Heart Valves
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Hospitals, University
;
Humans
;
Korea
;
Retrospective Studies
10.Clinical Characteristics and Risk Factors for Mortality in Critical COVID-19 Patients Aged 50 Years or Younger During Omicron Wave in Korea:Comparison With Patients Older Than 50 Years of Age
Hye Jin SHI ; Jinyoung YANG ; Joong Sik EOM ; Jae-Hoon KO ; Kyong Ran PECK ; Uh Jin KIM ; Sook In JUNG ; Seulki KIM ; Hyeri SEOK ; Miri HYUN ; Hyun Ah KIM ; Bomi KIM ; Eun-Jeong JOO ; Hae Suk CHEONG ; Cheon Hoo JUN ; Yu Mi WI ; Jungok KIM ; Sungmin KYM ; Seungjin LIM ; Yoonseon PARK
Journal of Korean Medical Science 2023;38(28):e217-
Background:
The coronavirus disease 2019 (COVID-19) pandemic has caused the death of thousands of patients worldwide. Although age is known to be a risk factor for morbidity and mortality in COVID-19 patients, critical illness or death is occurring even in the younger age group as the epidemic spreads. In early 2022, omicron became the dominant variant of the COVID-19 virus in South Korea, and the epidemic proceeded on a large scale. Accordingly, this study aimed to determine whether young adults (aged ≤ 50 years) with critical COVID-19 infection during the omicron period had different characteristics from older patients and to determine the risk factors for mortality in this specific age group.
Methods:
We evaluated 213 critical adult patients (high flow nasal cannula or higher respiratory support) hospitalized for polymerase chain reaction-confirmed COVID-19 in nine hospitals in South Korea between February 1, 2022 and April 30, 2022. Demographic characteristics, including body mass index (BMI) and vaccination status; underlying diseases; clinical features and laboratory findings; clinical course; treatment received; and outcomes were collected from electronic medical records (EMRs) and analyzed according to age and mortality.
Results:
Overall, 71 critically ill patients aged ≤ 50 years were enrolled, and 142 critically ill patients aged over 50 years were selected through 1:2 matching based on the date of diagnosis. The most frequent underlying diseases among those aged ≤ 50 years were diabetes and hypertension, and all 14 patients who died had either a BMI ≥ 25 kg/m 2 or an underlying disease. The total case fatality rate among severe patients (S-CFR) was 31.0%, and the S-CFR differed according to age and was higher than that during the delta period. The S-CFR was 19.7% for those aged ≤ 50 years, 36.6% for those aged > 50 years, and 38.1% for those aged ≥ 65 years. In multivariate analysis, age (odds ratio [OR], 1.084; 95% confidence interval [CI], 1.043–1.127), initial low-density lipoprotein > 600 IU/L (OR, 4.782; 95% CI, 1.584–14.434), initial C-reactive protein > 8 mg/dL (OR, 2.940; 95% CI, 1.042–8.293), highest aspartate aminotransferase > 200 IU/L (OR, 12.931; 95% CI, 1.691–98.908), and mechanical ventilation implementation (OR, 3.671; 95% CI, 1.294–10.420) were significant independent predictors of mortality in critical COVID-19 patients during the omicron wave. A similar pattern was shown when analyzing the data by age group, but most had no statistical significance owing to the small number of deaths in the young critical group. Although the vaccination completion rate of all the patients (31.0%) was higher than that in the delta wave period (13.6%), it was still lower than that of the general population. Further, only 15 (21.1%) critically ill patients aged ≤ 50 years were fully vaccinated. Overall, the severity of hospitalized critical patients was significantly higher than that in the delta period, indicating that it was difficult to find common risk factors in the two periods only with a simple comparison.
Conclusion
Overall, the S-CFR of critically ill COVID-19 patients in the omicron period was higher than that in the delta period, especially in those aged ≤ 50 years. All of the patients who died had an underlying disease or obesity. In the same population, the vaccination rate was very low compared to that in the delta wave, indicating that non-vaccination significantly affected the progression to critical illness. Notably, there was a lack of prescription for Paxlovid for these patients although they satisfied the prescription criteria. Early diagnosis and active initial treatment was necessary, along with the proven methods of vaccination and personal hygiene. Further studies are needed to determine how each variant affects critically ill patients.