1.Characteristics and Prevalence of Sequelae after COVID-19: A Longitudinal Cohort Study
Se Ju LEE ; Yae Jee BAEK ; Su Hwan LEE ; Jung Ho KIM ; Jin Young AHN ; Jooyun KIM ; Ji Hoon JEON ; Hyeri SEOK ; Won Suk CHOI ; Dae Won PARK ; Yunsang CHOI ; Kyoung-Ho SONG ; Eu Suk KIM ; Hong Bin KIM ; Jae-Hoon KO ; Kyong Ran PECK ; Jae-Phil CHOI ; Jun Hyoung KIM ; Hee-Sung KIM ; Hye Won JEONG ; Jun Yong CHOI
Infection and Chemotherapy 2025;57(1):72-80
Background:
The World Health Organization has declared the end of the coronavirus disease 2019 (COVID-19) public health emergency. However, this did not indicate the end of COVID-19. Several months after the infection, numerous patients complain of respiratory or nonspecific symptoms; this condition is called long COVID. Even patients with mild COVID-19 can experience long COVID, thus the burden of long COVID remains considerable. Therefore, we conducted this study to comprehensively analyze the effects of long COVID using multi-faceted assessments.
Materials and Methods:
We conducted a prospective cohort study involving patients diagnosed with COVID-19 between February 2020 and September 2021 in six tertiary hospitals in Korea. Patients were followed up at 1, 3, 6, 12, 18, and 24 months after discharge. Long COVID was defined as the persistence of three or more COVID-19-related symptoms. The primary outcome of this study was the prevalence of long COVID after the period of COVID-19.
Results:
During the study period, 290 patients were enrolled. Among them, 54.5 and 34.6% experienced long COVID within 6 months and after more than 18 months, respectively. Several patients showed abnormal results when tested for post-traumatic stress disorder (17.4%) and anxiety (31.9%) after 18 months. In patients who underwent follow-up chest computed tomography 18 months after COVID-19, abnormal findings remained at 51.9%. Males (odds ratio [OR], 0.17; 95% confidence interval [CI], 0.05–0.53; P=0.004) and elderly (OR, 1.04; 95% CI, 1.00–1.09; P=0.04) showed a significant association with long COVID after 12–18 months in a multivariable logistic regression analysis.
Conclusion
Many patients still showed long COVID after 18 months post SARS-CoV-2 infection. When managing these patients, the assessment of multiple aspects is necessary.
2.Characteristics and Prevalence of Sequelae after COVID-19: A Longitudinal Cohort Study
Se Ju LEE ; Yae Jee BAEK ; Su Hwan LEE ; Jung Ho KIM ; Jin Young AHN ; Jooyun KIM ; Ji Hoon JEON ; Hyeri SEOK ; Won Suk CHOI ; Dae Won PARK ; Yunsang CHOI ; Kyoung-Ho SONG ; Eu Suk KIM ; Hong Bin KIM ; Jae-Hoon KO ; Kyong Ran PECK ; Jae-Phil CHOI ; Jun Hyoung KIM ; Hee-Sung KIM ; Hye Won JEONG ; Jun Yong CHOI
Infection and Chemotherapy 2025;57(1):72-80
Background:
The World Health Organization has declared the end of the coronavirus disease 2019 (COVID-19) public health emergency. However, this did not indicate the end of COVID-19. Several months after the infection, numerous patients complain of respiratory or nonspecific symptoms; this condition is called long COVID. Even patients with mild COVID-19 can experience long COVID, thus the burden of long COVID remains considerable. Therefore, we conducted this study to comprehensively analyze the effects of long COVID using multi-faceted assessments.
Materials and Methods:
We conducted a prospective cohort study involving patients diagnosed with COVID-19 between February 2020 and September 2021 in six tertiary hospitals in Korea. Patients were followed up at 1, 3, 6, 12, 18, and 24 months after discharge. Long COVID was defined as the persistence of three or more COVID-19-related symptoms. The primary outcome of this study was the prevalence of long COVID after the period of COVID-19.
Results:
During the study period, 290 patients were enrolled. Among them, 54.5 and 34.6% experienced long COVID within 6 months and after more than 18 months, respectively. Several patients showed abnormal results when tested for post-traumatic stress disorder (17.4%) and anxiety (31.9%) after 18 months. In patients who underwent follow-up chest computed tomography 18 months after COVID-19, abnormal findings remained at 51.9%. Males (odds ratio [OR], 0.17; 95% confidence interval [CI], 0.05–0.53; P=0.004) and elderly (OR, 1.04; 95% CI, 1.00–1.09; P=0.04) showed a significant association with long COVID after 12–18 months in a multivariable logistic regression analysis.
Conclusion
Many patients still showed long COVID after 18 months post SARS-CoV-2 infection. When managing these patients, the assessment of multiple aspects is necessary.
3.Characteristics and Prevalence of Sequelae after COVID-19: A Longitudinal Cohort Study
Se Ju LEE ; Yae Jee BAEK ; Su Hwan LEE ; Jung Ho KIM ; Jin Young AHN ; Jooyun KIM ; Ji Hoon JEON ; Hyeri SEOK ; Won Suk CHOI ; Dae Won PARK ; Yunsang CHOI ; Kyoung-Ho SONG ; Eu Suk KIM ; Hong Bin KIM ; Jae-Hoon KO ; Kyong Ran PECK ; Jae-Phil CHOI ; Jun Hyoung KIM ; Hee-Sung KIM ; Hye Won JEONG ; Jun Yong CHOI
Infection and Chemotherapy 2025;57(1):72-80
Background:
The World Health Organization has declared the end of the coronavirus disease 2019 (COVID-19) public health emergency. However, this did not indicate the end of COVID-19. Several months after the infection, numerous patients complain of respiratory or nonspecific symptoms; this condition is called long COVID. Even patients with mild COVID-19 can experience long COVID, thus the burden of long COVID remains considerable. Therefore, we conducted this study to comprehensively analyze the effects of long COVID using multi-faceted assessments.
Materials and Methods:
We conducted a prospective cohort study involving patients diagnosed with COVID-19 between February 2020 and September 2021 in six tertiary hospitals in Korea. Patients were followed up at 1, 3, 6, 12, 18, and 24 months after discharge. Long COVID was defined as the persistence of three or more COVID-19-related symptoms. The primary outcome of this study was the prevalence of long COVID after the period of COVID-19.
Results:
During the study period, 290 patients were enrolled. Among them, 54.5 and 34.6% experienced long COVID within 6 months and after more than 18 months, respectively. Several patients showed abnormal results when tested for post-traumatic stress disorder (17.4%) and anxiety (31.9%) after 18 months. In patients who underwent follow-up chest computed tomography 18 months after COVID-19, abnormal findings remained at 51.9%. Males (odds ratio [OR], 0.17; 95% confidence interval [CI], 0.05–0.53; P=0.004) and elderly (OR, 1.04; 95% CI, 1.00–1.09; P=0.04) showed a significant association with long COVID after 12–18 months in a multivariable logistic regression analysis.
Conclusion
Many patients still showed long COVID after 18 months post SARS-CoV-2 infection. When managing these patients, the assessment of multiple aspects is necessary.
4.Global, Regional, and National Trends in Liver Disease-Related Mortality Across 112 Countries From 1990 to 2021, With Projections to 2050:Comprehensive Analysis of the WHO Mortality Database
Jong Woo HAHN ; Selin WOO ; Jaeyu PARK ; Hyeri LEE ; Hyeon Jin KIM ; Jae Sung KO ; Jin Soo MOON ; Masoud RAHMATI ; Lee SMITH ; Jiseung KANG ; Damiano PIZZOL ; Mark A TULLY ; Elena DRAGIOTI ; Guillermo F. LÓPEZ SÁNCHEZ ; Kwanjoo LEE ; Yeonjung HA ; Jinseok LEE ; Hayeon LEE ; Sang Youl RHEE ; Yejun SON ; Soeun KIM ; Dong Keon YON
Journal of Korean Medical Science 2024;39(46):e292-
Background:
Liver disease causes over two million deaths annually worldwide, comprising approximately 4% of all global fatalities. We aimed to analyze liver disease-related mortality trends from 1990 to 2021 using the World Health Organization (WHO) Mortality Database and forecast global liver disease-related mortality rates up to 2050.
Methods:
This study examined age-standardized liver disease-related death rates from 1990 to 2021, employing data from the WHO Mortality Database across 112 countries across five continents. The rates over time were calculated using a locally weighted scatter plot smoother curve, with weights assigned based on the population of each country. Furthermore, this study projected liver disease-related mortality rates up to 2050 using a Bayesian age-periodcohort (BAPC) model. Additionally, a decomposition analysis was conducted to discern influencing factors such as population growth, aging, and epidemiological changes.
Results:
The estimated global age-standardized liver disease-related mortality rates surged significantly from 1990 to 2021 across 112 countries, rising from 103.4 deaths per 1,000,000 people (95% confidence interval [CI], 88.16, 118.74) in 1990 to 173.0 deaths per 1,000,000 people (95% CI, 155.15, 190.95) in 2021. This upward trend was particularly pronounced in low- and middle-income countries, in Africa, and in populations aged 65 years and older.Moreover, age-standardized liver disease-related mortality rates were correlated with a lower Human Development Index (P < 0.001) and sociodemographic index (P = 0.001). According to the BAPC model, the projected trend indicated a sustained and substantial decline in liver disease-related mortality rates, with an estimated decrease from 185.08 deaths per 1,000,000 people (95% CI, 179.79, 190.63) in 2021 to 156.29 (112.32, 214.77) in 2050. From 1990 to 2021, age-standardized liver disease-related deaths surged primarily due to epidemiological changes, whereas from 1990 to 2050, the impact of population aging and growth became the primary contributing factors to the overall increase.
Conclusion
Global age-standardized liver disease-related mortality has increased significantly and continues to emerge as a crucial global public health issue. Further investigation into liver disease-related mortality rates in Africa is needed, and updating policies is necessary to effectively manage the global burden of liver disease.
5.Global, Regional, and National Trends in Liver Disease-Related Mortality Across 112 Countries From 1990 to 2021, With Projections to 2050:Comprehensive Analysis of the WHO Mortality Database
Jong Woo HAHN ; Selin WOO ; Jaeyu PARK ; Hyeri LEE ; Hyeon Jin KIM ; Jae Sung KO ; Jin Soo MOON ; Masoud RAHMATI ; Lee SMITH ; Jiseung KANG ; Damiano PIZZOL ; Mark A TULLY ; Elena DRAGIOTI ; Guillermo F. LÓPEZ SÁNCHEZ ; Kwanjoo LEE ; Yeonjung HA ; Jinseok LEE ; Hayeon LEE ; Sang Youl RHEE ; Yejun SON ; Soeun KIM ; Dong Keon YON
Journal of Korean Medical Science 2024;39(46):e292-
Background:
Liver disease causes over two million deaths annually worldwide, comprising approximately 4% of all global fatalities. We aimed to analyze liver disease-related mortality trends from 1990 to 2021 using the World Health Organization (WHO) Mortality Database and forecast global liver disease-related mortality rates up to 2050.
Methods:
This study examined age-standardized liver disease-related death rates from 1990 to 2021, employing data from the WHO Mortality Database across 112 countries across five continents. The rates over time were calculated using a locally weighted scatter plot smoother curve, with weights assigned based on the population of each country. Furthermore, this study projected liver disease-related mortality rates up to 2050 using a Bayesian age-periodcohort (BAPC) model. Additionally, a decomposition analysis was conducted to discern influencing factors such as population growth, aging, and epidemiological changes.
Results:
The estimated global age-standardized liver disease-related mortality rates surged significantly from 1990 to 2021 across 112 countries, rising from 103.4 deaths per 1,000,000 people (95% confidence interval [CI], 88.16, 118.74) in 1990 to 173.0 deaths per 1,000,000 people (95% CI, 155.15, 190.95) in 2021. This upward trend was particularly pronounced in low- and middle-income countries, in Africa, and in populations aged 65 years and older.Moreover, age-standardized liver disease-related mortality rates were correlated with a lower Human Development Index (P < 0.001) and sociodemographic index (P = 0.001). According to the BAPC model, the projected trend indicated a sustained and substantial decline in liver disease-related mortality rates, with an estimated decrease from 185.08 deaths per 1,000,000 people (95% CI, 179.79, 190.63) in 2021 to 156.29 (112.32, 214.77) in 2050. From 1990 to 2021, age-standardized liver disease-related deaths surged primarily due to epidemiological changes, whereas from 1990 to 2050, the impact of population aging and growth became the primary contributing factors to the overall increase.
Conclusion
Global age-standardized liver disease-related mortality has increased significantly and continues to emerge as a crucial global public health issue. Further investigation into liver disease-related mortality rates in Africa is needed, and updating policies is necessary to effectively manage the global burden of liver disease.
6.Prevention of Cytomegalovirus Infection in Solid Organ Transplant Recipients:Guidelines by the Korean Society of Infectious Diseases and the Korean Society for Transplantation
Kyungmin HUH ; Sang-Oh LEE ; Jungok KIM ; Su Jin LEE ; Pyoeng Gyun CHOE ; Ji-Man KANG ; Jaeseok YANG ; Heungsup SUNG ; Si-Ho KIM ; Chisook MOON ; Hyeri SEOK ; Hye Jin SHI ; Yu Mi WI ; Su Jin JEONG ; Wan Beom PARK ; Youn Jeong KIM ; Jongman KIM ; Hyung Joon AHN ; Nam Joong KIM ; Kyong Ran PECK ; Myoung Soo KIM ; Sang Il KIM
Infection and Chemotherapy 2024;56(1):101-121
Cytomegalovirus (CMV) is the most important opportunistic viral pathogen in solid organ transplant (SOT) recipients.The Korean guideline for the prevention of CMV infection in SOT recipients was developed jointly by the Korean Society for Infectious Diseases and the Korean Society of Transplantation. CMV serostatus of both donors and recipients should be screened before transplantation to best assess the risk of CMV infection after SOT. Seronegative recipients receiving organs from seropositive donors face the highest risk, followed by seropositive recipients. Either antiviral prophylaxis or preemptive therapy can be used to prevent CMV infection. While both strategies have been demonstrated to prevent CMV infection post-transplant, each has its own advantages and disadvantages. CMV serostatus, transplant organ, other risk factors, and practical issues should be considered for the selection of preventive measures. There is no universal viral load threshold to guide treatment in preemptive therapy. Each institution should define and validate its own threshold.Valganciclovir is the favored agent for both prophylaxis and preemptive therapy. The evaluation of CMV-specific cellmediated immunity and the monitoring of viral load kinetics are gaining interest, but there was insufficient evidence to issue recommendations. Specific considerations on pediatric transplant recipients are included.
7.Online Interventions to Improve Mental Health of K-12 Teachers: A Scoping Review
Heeyeon KIM ; Hyeri PARK ; Heejung KIM
Journal of Korean Academy of Psychiatric and Mental Health Nursing 2024;33(2):194-209
Purpose:
To explore mental health interventions using online technologies for school teachers and identify characteristics and effects on teachers’ mental health improvement.
Methods:
The method of Arksey and O’Malley was referenced. Two researchers independently searched seven electronic databases. Eleven experimental studies of online mental health interventions for K-12 teachers were analyzed for publication information, intervention characteristics, and summaries of outcome evaluations.
Results:
Publication years ranged from 2014 to 2023. Most studies were conducted in Europe. Teleconferencing was the most frequently used. Virtual reality has seen recent development. Cognitive factors were frequently evaluated to ensure the program’s effectiveness, including mental health awareness and coping skills. Thus, cognitive behavior therapy was the most significant component of interventions to improve teachers’ health.
Conclusion
Our scoping review illustrates recent trends of online interventions to improve teachers’ mental health. Due to very limited information on Korean teachers, it is necessary to adopt available online interventions considering educational systems and teachers’ characteristics. Highly accessible modality, person-centered contents of mental health concern, and careful protection of teachers’ privacy are recommended for promoting mental health of teachers.
8.COVID-19’s Radiologic, Functional, and Serologic Consequences at 6-Month and 18-Month Follow-up: A Prospective Cohort Study
Cherry KIM ; Hyeri SEOK ; Jooyun KIM ; Dae Won PARK ; Marly van ASSEN ; Carlo N. De CECCO ; Hangseok CHOI ; Chohee KIM ; Sung Ho HWANG ; Hwan Seok YONG ; Yu-Whan OH ; Won Suk CHOI
Journal of Korean Medical Science 2024;39(32):e228-
Background:
We evaluated the radiologic, pulmonary functional, and antibody statuses of coronavirus disease 2019 (COVID-19) patients 6 and 18 months after discharge, comparing changes in status and focusing on risk factors for residual computed tomography (CT) abnormalities.
Methods:
This prospective cohort study was conducted on COVID-19 patients discharged between April 2020 and January 2021. Chest CT, pulmonary function testing (PFT), and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) immunoglobulin G (IgG) measurements were performed 6 and 18 months after discharge. We evaluated factors associated with residual CT abnormalities and the correlation between lesionvolume in CT (lesionvolume ), PFT, and IgG levels.
Results:
This study included 68 and 42 participants evaluated 6 and 18 months, respectively, after hospitalizations for COVID-19. CT abnormalities were noted in 22 participants (32.4%) at 6 months and 13 participants (31.0%) at 18 months. Lesionvolume was significantly lower at 18 months than 6 months (P < 0.001). Patients with CT abnormalities at 6 months showed lower forced expiratory volume in 1 second (FEV1) and FEV1/forced vital capacity (FVC), and patients with CT abnormalities at 18 months exhibited lower FVC. FVC significantly improved between 6 and 18 months of follow-up (all P < 0.0001). SARS-CoV-2 IgG levels were significantly higher in patients with CT abnormalities at 6 and 18 months (P < 0.001). At 18-month follow-up assessments, age was associated with CT abnormalities (odds ratio, 1.17; 95% confidence interval, 1.03–1.32; P = 0.01), and lesionvolume showed a positive correlation with IgG level (r = 0.643, P < 0.001).
Conclusion
At 18-month follow-up assessments, 31.0% of participants exhibited residual CT abnormalities. Age and higher SARS-CoV-2 IgG levels were significant predictors, and FVC was related to abnormal CT findings at 18 months. Lesionvolume and FVC improved between 6 and 18 months.
9.Global, Regional, and National Trends in Liver Disease-Related Mortality Across 112 Countries From 1990 to 2021, With Projections to 2050:Comprehensive Analysis of the WHO Mortality Database
Jong Woo HAHN ; Selin WOO ; Jaeyu PARK ; Hyeri LEE ; Hyeon Jin KIM ; Jae Sung KO ; Jin Soo MOON ; Masoud RAHMATI ; Lee SMITH ; Jiseung KANG ; Damiano PIZZOL ; Mark A TULLY ; Elena DRAGIOTI ; Guillermo F. LÓPEZ SÁNCHEZ ; Kwanjoo LEE ; Yeonjung HA ; Jinseok LEE ; Hayeon LEE ; Sang Youl RHEE ; Yejun SON ; Soeun KIM ; Dong Keon YON
Journal of Korean Medical Science 2024;39(46):e292-
Background:
Liver disease causes over two million deaths annually worldwide, comprising approximately 4% of all global fatalities. We aimed to analyze liver disease-related mortality trends from 1990 to 2021 using the World Health Organization (WHO) Mortality Database and forecast global liver disease-related mortality rates up to 2050.
Methods:
This study examined age-standardized liver disease-related death rates from 1990 to 2021, employing data from the WHO Mortality Database across 112 countries across five continents. The rates over time were calculated using a locally weighted scatter plot smoother curve, with weights assigned based on the population of each country. Furthermore, this study projected liver disease-related mortality rates up to 2050 using a Bayesian age-periodcohort (BAPC) model. Additionally, a decomposition analysis was conducted to discern influencing factors such as population growth, aging, and epidemiological changes.
Results:
The estimated global age-standardized liver disease-related mortality rates surged significantly from 1990 to 2021 across 112 countries, rising from 103.4 deaths per 1,000,000 people (95% confidence interval [CI], 88.16, 118.74) in 1990 to 173.0 deaths per 1,000,000 people (95% CI, 155.15, 190.95) in 2021. This upward trend was particularly pronounced in low- and middle-income countries, in Africa, and in populations aged 65 years and older.Moreover, age-standardized liver disease-related mortality rates were correlated with a lower Human Development Index (P < 0.001) and sociodemographic index (P = 0.001). According to the BAPC model, the projected trend indicated a sustained and substantial decline in liver disease-related mortality rates, with an estimated decrease from 185.08 deaths per 1,000,000 people (95% CI, 179.79, 190.63) in 2021 to 156.29 (112.32, 214.77) in 2050. From 1990 to 2021, age-standardized liver disease-related deaths surged primarily due to epidemiological changes, whereas from 1990 to 2050, the impact of population aging and growth became the primary contributing factors to the overall increase.
Conclusion
Global age-standardized liver disease-related mortality has increased significantly and continues to emerge as a crucial global public health issue. Further investigation into liver disease-related mortality rates in Africa is needed, and updating policies is necessary to effectively manage the global burden of liver disease.
10.Role of biomarkers in antimicrobial stewardship: physicians’ perspectives
The Korean Journal of Internal Medicine 2024;39(3):413-429
Biomarkers are playing an increasingly important role in antimicrobial stewardship. Their applications have included use in algorithms that evaluate suspected bacterial infections or provide guidance on when to start or stop antibiotic therapy, or when therapy should be repeated over a short period (6–12 h). Diseases in which biomarkers are used as complementary tools to determine the initiation of antibiotics include sepsis, lower respiratory tract infection (LRTI), COVID-19, acute heart failure, infectious endocarditis, acute coronary syndrome, and acute pancreatitis. In addition, cut-off values of biomarkers have been used to inform the decision to discontinue antibiotics for diseases such as sepsis, LRTI, and febrile neutropenia. The biomarkers used in antimicrobial stewardship include procalcitonin (PCT), C-reactive protein (CRP), presepsin, and interleukin (IL)-1β/IL-8. The cut-off values vary depending on the disease and study, with a range of 0.25–1.0 ng/mL for PCT and 8–50 mg/L for CRP. Biomarkers can complement clinical diagnosis, but further studies of microbiological biomarkers are needed to ensure appropriate antibiotic selection.

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