In this study, we describe the isolation and characterization of previously unreported Y280-lineage H9N2 viruses from two live bird markets in Korea in June 2020. Genetic analysis revealed that they were distinct from previous H9N2 viruses circulating in Korea and had highest homology to A/chicken/Shandong/1844/2019(H9N2) viruses. Their genetic constellation showed they belonged to genotype S, which is the predominant genotype in China since 2010, where genotype S viruses have infected humans and acted as internal gene donors to H5 and H7 zoonotic influenza viruses. Active surveillance and control measures need to be enhanced to protect the poultry industry and public health.

Background/Aims: Although it is near concluded that renin-angiotensin system inhibitors do not have a harmful effect on coronavirus disease 2019 (COVID-19), there is no report about whether angiotensin receptor blockers (ARBs) and angiotensin-converting enzyme inhibitors (ACEIs) offer any protective role. This study aimed to compare the association of ARBs and ACEIs with COVID-19-related mortality. Methods: All patients with COVID-19 in Korea between January 19 and April 16, 2020 were enrolled. The association of ARBs and ACEIs with mortality within 60 days were evaluated. A comparison of hazard ratio (HR) was performed between COVID-19 patients and a retrospective cohort of pneumonia patients hospitalized in 2019 in Korea. Results: Among 10,448 COVID-19 patients, ARBs and ACEIs were prescribed in 1,231 (11.7%) and 57 (0.6%) patients, respectively. After adjusting for age, sex, and history of comorbidities, the ARB group showed neutral association (HR, 1.034; 95% CI, 0.765 to 1.399; p = 0.8270) and the ACEI groups showed no significant associations likely owing to the small population size (HR, 0.736; 95% CI, 0.314 to 1.726; p = 0.4810). When comparing HR between COVID-19 patients and a retrospective cohort of patients hospitalized with pneumonia in 2019, the trend of ACEIs showed similar benefits, whereas the protective effect of ARBs observed in the retrospective cohort was absent in COVID-19 patients. Meta-analyses showed significant positive correlation with survival of ACEIs, whereas a neutral association between ARBs and mortality. Conclusions Although ARBs or ACEIs were not associated with fatal outcomes, potential beneficial effects of ARBs observed in pneumonia were attenuated in COVID-19.

Background/Aims: Although it is near concluded that renin-angiotensin system inhibitors do not have a harmful effect on coronavirus disease 2019 (COVID-19), there is no report about whether angiotensin receptor blockers (ARBs) and angiotensin-converting enzyme inhibitors (ACEIs) offer any protective role. This study aimed to compare the association of ARBs and ACEIs with COVID-19-related mortality. Methods: All patients with COVID-19 in Korea between January 19 and April 16, 2020 were enrolled. The association of ARBs and ACEIs with mortality within 60 days were evaluated. A comparison of hazard ratio (HR) was performed between COVID-19 patients and a retrospective cohort of pneumonia patients hospitalized in 2019 in Korea. Results: Among 10,448 COVID-19 patients, ARBs and ACEIs were prescribed in 1,231 (11.7%) and 57 (0.6%) patients, respectively. After adjusting for age, sex, and history of comorbidities, the ARB group showed neutral association (HR, 1.034; 95% CI, 0.765 to 1.399; p = 0.8270) and the ACEI groups showed no significant associations likely owing to the small population size (HR, 0.736; 95% CI, 0.314 to 1.726; p = 0.4810). When comparing HR between COVID-19 patients and a retrospective cohort of patients hospitalized with pneumonia in 2019, the trend of ACEIs showed similar benefits, whereas the protective effect of ARBs observed in the retrospective cohort was absent in COVID-19 patients. Meta-analyses showed significant positive correlation with survival of ACEIs, whereas a neutral association between ARBs and mortality. Conclusions Although ARBs or ACEIs were not associated with fatal outcomes, potential beneficial effects of ARBs observed in pneumonia were attenuated in COVID-19.

In this study, we describe the isolation and characterization of previously unreported Y280-lineage H9N2 viruses from two live bird markets in Korea in June 2020. Genetic analysis revealed that they were distinct from previous H9N2 viruses circulating in Korea and had highest homology to A/chicken/Shandong/1844/2019(H9N2) viruses. Their genetic constellation showed they belonged to genotype S, which is the predominant genotype in China since 2010, where genotype S viruses have infected humans and acted as internal gene donors to H5 and H7 zoonotic influenza viruses. Active surveillance and control measures need to be enhanced to protect the poultry industry and public health.

Cutaneous pseudolymphoma is a heterogeneous group of benign reactive T- or B-cell lymphoproliferative diseases of the skin that simulate cutaneous lymphomas histologically and, sometimes, clinically. Thus far, only a few cases of pseudolymphomas showing atypical clinical manifestations have been reported. A 10-month-old boy presented with multiple flesh-colored, yellowish erythematous disseminated papules on the face, abdomen, and arms. The cutaneous lesions morphologically resembled molluscum contagiosum, Langerhans cell histiocytosis, or juvenile xanthogranuloma. Punch biopsy and immunohistochemistry studies were performed, and the lesion was identified as a cutaneous B-cell pseudolymphoma. Most of the lesions were cleared within a month with systemic corticosteroids and oral antihistamine administration. In this report, we present an interesting rare case of infantile cutaneous B-cell pseudolymphoma mimicking many other dermatological diseases in addition to a cutaneous lymphoma.

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is an adverse drug reaction that is difficult to predict. It is characterized by fever, skin rash, and internal organ involvement that usually manifests 2∼6 weeks after use of the culprit drug. The antihyperglycemic agent sitagliptin is commonly used for treating diabetes mellitus, and sitagliptin-induced DRESS syndrome has not been previously reported in Korea. Herein, we report a case of DRESS syndrome after sitagliptin use; these observations may contribute to the timely diagnosis of sitagliptin induced DRESS syndrome and help reduce associated complications or morbidities.

Kawasaki disease is an acute inflammatory syndrome affecting middle-sized arteries. It is diagnosed when a fever lasts longer than 5 days, and four out of the five diagnostic criteria are satisfied. Some skin lesions are not included in the criteria, but are associated with Kawasaki disease. They can be helpful when the patient has an incomplete presentation. Herein, we report a Kawasaki patient who presented with simultaneous orange-brown chromonychia on all 20 nails and black crusted lips.