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  1. Article ; Online: Identifying susceptibility of children and adolescents to the Omicron variant (B.1.1.529)

    June Young Chun / Hwichang Jeong / Yongdai Kim

    BMC Medicine, Vol 20, Iss 1, Pp 1-

    2022  Volume 9

    Abstract: Abstract Background The Omicron variant (B.1.1.529) is estimated to be more transmissible than previous strains of SARS-CoV-2 especially among children, potentially resulting in croup which is a characteristic disease in children. Current coronavirus ... ...

    Abstract Abstract Background The Omicron variant (B.1.1.529) is estimated to be more transmissible than previous strains of SARS-CoV-2 especially among children, potentially resulting in croup which is a characteristic disease in children. Current coronavirus disease 2019 (COVID-19) cases among children might be higher because (i) school-aged children have higher contact rates and (ii) the COVID-19 vaccination strategy prioritizes the elderly in most countries. However, there have been no reports confirming the age-varying susceptibility to the Omicron variant to date. Methods We developed an age-structured compartmental model, combining age-specific contact matrix in South Korea and observed distribution of periods between each stage of infection in the national epidemiological investigation. A Bayesian inference method was used to estimate the age-specific force of infection and, accordingly, age-specific susceptibility, given epidemic data during the third (pre-Delta), fourth (Delta driven), and fifth (Omicron driven) waves in South Korea. As vaccine uptake increased, individuals who were vaccinated were excluded from the susceptible population in accordance with vaccine effectiveness against the Delta and Omicron variants, respectively. Results A significant difference between the age-specific susceptibility to the Omicron and that to the pre-Omicron variants was found in the younger age group. The rise in susceptibility to the Omicron/pre-Delta variant was highest in the 10–15 years age group (5.28 times [95% CI, 4.94–5.60]), and the rise in susceptibility to the Omicron/Delta variant was highest in the 15–19 years age group (3.21 times [95% CI, 3.12–3.31]), whereas in those aged 50 years or more, the susceptibility to the Omicron/pre-Omicron remained stable at approximately twofold. Conclusions Even after adjusting for contact pattern, vaccination status, and waning of vaccine effectiveness, the Omicron variant of SARS-CoV-2 tends to propagate more easily among children than the pre-Omicron strains.
    Keywords SARS-CoV-2 ; COVID-19 ; B.1.1.529 SARS-CoV-2 variant ; Mathematical model ; Bayesian analysis ; Child ; Medicine ; R
    Language English
    Publishing date 2022-11-01T00:00:00Z
    Publisher BMC
    Document type Article ; Online
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  2. Article ; Online: Identifying susceptibility of children and adolescents to the Omicron variant (B.1.1.529).

    Chun, June Young / Jeong, Hwichang / Kim, Yongdai

    BMC medicine

    2022  Volume 20, Issue 1, Page(s) 451

    Abstract: Background: The Omicron variant (B.1.1.529) is estimated to be more transmissible than previous strains of SARS-CoV-2 especially among children, potentially resulting in croup which is a characteristic disease in children. Current coronavirus disease ... ...

    Abstract Background: The Omicron variant (B.1.1.529) is estimated to be more transmissible than previous strains of SARS-CoV-2 especially among children, potentially resulting in croup which is a characteristic disease in children. Current coronavirus disease 2019 (COVID-19) cases among children might be higher because (i) school-aged children have higher contact rates and (ii) the COVID-19 vaccination strategy prioritizes the elderly in most countries. However, there have been no reports confirming the age-varying susceptibility to the Omicron variant to date.
    Methods: We developed an age-structured compartmental model, combining age-specific contact matrix in South Korea and observed distribution of periods between each stage of infection in the national epidemiological investigation. A Bayesian inference method was used to estimate the age-specific force of infection and, accordingly, age-specific susceptibility, given epidemic data during the third (pre-Delta), fourth (Delta driven), and fifth (Omicron driven) waves in South Korea. As vaccine uptake increased, individuals who were vaccinated were excluded from the susceptible population in accordance with vaccine effectiveness against the Delta and Omicron variants, respectively.
    Results: A significant difference between the age-specific susceptibility to the Omicron and that to the pre-Omicron variants was found in the younger age group. The rise in susceptibility to the Omicron/pre-Delta variant was highest in the 10-15 years age group (5.28 times [95% CI, 4.94-5.60]), and the rise in susceptibility to the Omicron/Delta variant was highest in the 15-19 years age group (3.21 times [95% CI, 3.12-3.31]), whereas in those aged 50 years or more, the susceptibility to the Omicron/pre-Omicron remained stable at approximately twofold.
    Conclusions: Even after adjusting for contact pattern, vaccination status, and waning of vaccine effectiveness, the Omicron variant of SARS-CoV-2 tends to propagate more easily among children than the pre-Omicron strains.
    MeSH term(s) Child ; Adolescent ; Humans ; Aged ; Young Adult ; Adult ; COVID-19/epidemiology ; COVID-19/prevention & control ; Bayes Theorem ; COVID-19 Vaccines ; SARS-CoV-2/genetics
    Chemical Substances COVID-19 Vaccines
    Language English
    Publishing date 2022-11-23
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2131669-7
    ISSN 1741-7015 ; 1741-7015
    ISSN (online) 1741-7015
    ISSN 1741-7015
    DOI 10.1186/s12916-022-02655-z
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  3. Article ; Online: Age-Varying Susceptibility to the Delta Variant (B.1.617.2) of SARS-CoV-2.

    Chun, June Young / Jeong, Hwichang / Kim, Yongdai

    JAMA network open

    2022  Volume 5, Issue 3, Page(s) e223064

    Abstract: ... and the fourth wave (ie, the Delta-driven wave, from June 27 to August 21, 2021) in Korea were ...

    Abstract Importance: The Delta variant (B.1.617.2) is estimated to be more transmissible than previous strains of SARS-CoV-2, especially among children and adolescents. However, to our knowledge, there are no reports confirming this to date.
    Objective: To gain a better understanding of the association of age with susceptibility to the Delta variant of SARS-CoV-2.
    Design, setting, and participants: This decision analytic model used an age-structured compartmental model using the terms symptom onset (S), exposure (E), infectious (I), and quarantine (Q) (SEIQ) to estimate the age-specific force of infection, combining age-specific contact matrices and observed distribution of periods between each stage of infection (E to I [ie, latent period], I given S, and S to Q [ie, diagnostic delay]) developed in a previous contact tracing study. A bayesian inference method was used to estimate the age-specific force of infection (S to E) and, accordingly, age-specific susceptibility. The age-specific susceptibility during the third wave (ie, before Delta, from October 15 to December 22, 2020, when the COVID-19 vaccination campaign was not yet launched) and the fourth wave (ie, the Delta-driven wave, from June 27 to August 21, 2021) in Korea were compared. As vaccine uptake increased, individuals who were vaccinated were excluded from the susceptible population in accordance with vaccine effectiveness against the Delta variant. This nationwide epidemiologic study included individuals who were diagnosed with COVID-19 during the study period in Korea. Data were analyzed from September to November 2021.
    Exposures: Age group during the third wave (ie, before Delta) and fourth wave (ie, Delta-driven) of the COVID-19 pandemic in South Korea.
    Main outcomes and measures: Age-specific susceptibility during the third and fourth waves was estimated.
    Results: Among 106 866 confirmed COVID-19 infections (including 26 597 infections and 80 269 infections during the third and fourth waves of COVID-19 in Korea, respectively), a significant difference in age-specific susceptibility to the Delta vs pre-Delta variant was found in the younger age group. After adjustment for contact pattern and vaccination status, the increase in susceptibility to the Delta vs pre-Delta variant was estimated to be highest in the group aged 10 to 15 years, approximately doubling (1.92-fold increase [95% CI, 1.86-fold to 1.98-fold]), whereas in the group aged 50 years or more, susceptibility to the Delta vs pre-Delta variant remained stable at an approximately 1-fold change (eg, among individuals aged 50-55 years: 0.997-fold [95% CI, 0.989-fold to 1.001-fold).
    Conclusions and relevance: In this study, the Delta variant of SARS-CoV-2 was estimated to propagate more easily among children and adolescents than pre-Delta strains, even after adjusting for contact pattern and vaccination status.
    MeSH term(s) Adolescent ; Bayes Theorem ; COVID-19/epidemiology ; COVID-19 Vaccines ; Child ; Delayed Diagnosis ; Humans ; Middle Aged ; Pandemics ; SARS-CoV-2
    Chemical Substances COVID-19 Vaccines
    Language English
    Publishing date 2022-03-01
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ISSN 2574-3805
    ISSN (online) 2574-3805
    DOI 10.1001/jamanetworkopen.2022.3064
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  4. Article ; Online: Contact-adjusted Immunity Levels against SARS-CoV-2 in Korea and Prospects for Achieving Herd Immunity.

    Chun, June Young / Jeong, Hwichang / Kim, Yongdai

    Journal of Korean medical science

    2021  Volume 36, Issue 38, Page(s) e272

    Abstract: ... immunity scenarios. As of June 21, 2021, when a quarter of the population received at least one dose ... since the risks of COVID-19 for the young are less than the elderly, and the long-term safety of vaccines is still ...

    Abstract The proportion of population vaccinated cannot be directly translated into the herd immunity. We have to account for the age-stratified contact patterns to calculate the population immunity level, since not every individual gathers evenly. Here, we calculated the contact-adjusted population immunity against severe acute respiratory syndrome coronavirus 2 in South Korea using age-specific incidence and vaccine uptake rate. We further explored options to achieve the theoretical herd immunity with age-varying immunity scenarios. As of June 21, 2021, when a quarter of the population received at least one dose of a coronavirus disease 2019 (COVID-19) vaccine, the contact-adjusted immunity level was 12.5% under the social distancing level 1. When 80% of individuals aged 10 years and over gained immunity, we could achieve a 58.2% contact-adjusted immunity level. The pros and cons of vaccinating children should be weighed since the risks of COVID-19 for the young are less than the elderly, and the long-term safety of vaccines is still obscure.
    MeSH term(s) COVID-19/immunology ; COVID-19/prevention & control ; COVID-19 Vaccines/immunology ; Humans ; Immunity, Herd/immunology ; Mass Vaccination ; Republic of Korea ; SARS-CoV-2/immunology ; Social Interaction
    Chemical Substances COVID-19 Vaccines
    Language English
    Publishing date 2021-10-04
    Publishing country Korea (South)
    Document type Journal Article
    ZDB-ID 639262-3
    ISSN 1598-6357 ; 1011-8934
    ISSN (online) 1598-6357
    ISSN 1011-8934
    DOI 10.3346/jkms.2021.36.e272
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    Zs.B 3163: Show issues Location:
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  5. Article ; Online: Infection-related Hospitalizations During Immune Checkpoint Inhibitor Treatment Without Immunosuppressants.

    Jeung, Ye Sul / Chun, June Young / Choi, Beom Kyu / Park, Seog Yun / Lim, Hyun-Ju / Park, Jong Woong / Han, Ji-Youn / Lee, Youngjoo

    Journal of immunotherapy (Hagerstown, Md. : 1997)

    2024  Volume 47, Issue 4, Page(s) 139–147

    Abstract: Immunosuppressants are increasingly being used in the clinic to manage immune-related adverse effects. Consequently, the incidence of secondary infections associated with immunosuppression is increasing. However, little is known about primary infections ... ...

    Abstract Immunosuppressants are increasingly being used in the clinic to manage immune-related adverse effects. Consequently, the incidence of secondary infections associated with immunosuppression is increasing. However, little is known about primary infections during immune checkpoint inhibitor (ICI) treatment without immunosuppressants. We aimed to evaluate primary infectious diseases during antiprogrammed death ligand-1 immunotherapy without immunosuppressants. We retrospectively screened medical records of 233 patients who underwent ICI treatment for advanced non-small cell lung cancer between January 2014 and May 2018 at National Cancer Center, Republic of Korea. Subsequently, we evaluated the clinical characteristics and treatment outcomes of selected patients hospitalized for potential infectious disease without immunosuppressive treatment (n=80). Eight cases (3.4%) were identified as bacterial pneumonia (n=5) and cellulitis, inflamed epidermoid cyst, and wound infection (n=1 each). The bacterial pathogens Streptococcus pneumoniae and Haemophilus influenzae were identified in 4 patients with pneumonia. The period between the start of ICI treatment and infection varied between 3 and 189 days (median, 24.5 days). Five (62.5%) patients were infected within a month after ICI treatment initiation. All patients were treated with empirical antibiotics and discharged without complications. The median progression-free and overall survival for ICI treatment was 11.5 and 25.5 months, respectively. Six patients experienced ICI-associated adverse effects postinfection: Herpes zoster infection (n=4) and pneumonitis (n=2). Infectious disease independent of immunosuppression is a rare, but possible event in patients with lung cancer receiving ICI treatment. Clinical awareness would enable prompt diagnosis of primary infection during immunotherapy.
    MeSH term(s) Humans ; Carcinoma, Non-Small-Cell Lung ; Lung Neoplasms/drug therapy ; Immune Checkpoint Inhibitors/adverse effects ; Immunosuppressive Agents/adverse effects ; Retrospective Studies ; Antineoplastic Agents, Immunological/therapeutic use ; Pneumonia/epidemiology ; Pneumonia/etiology ; Communicable Diseases/chemically induced ; Communicable Diseases/drug therapy ; Hospitalization
    Chemical Substances Immune Checkpoint Inhibitors ; Immunosuppressive Agents ; Antineoplastic Agents, Immunological
    Language English
    Publishing date 2024-01-29
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1064067-8
    ISSN 1537-4513 ; 1053-8550 ; 1524-9557
    ISSN (online) 1537-4513
    ISSN 1053-8550 ; 1524-9557
    DOI 10.1097/CJI.0000000000000504
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    Zs.A 1778: Show issues Location:
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  6. Article ; Online: Performance of the galactomannan test for the diagnosis of invasive pulmonary aspergillosis using non-invasive proximal airway samples.

    Chun, June Young / Jeong, Sahng-Joon / Kim, Sinae / Choi, Soyoung / Lee, Jong Hyuk / Chung, Hyun Sung / Park, Seungman / Lee, Hyewon / Kim, Hyae Young / Hwangbo, Bin / Choi, Young Ju

    The Journal of infection

    2024  Volume 88, Issue 6, Page(s) 106159

    Abstract: Objective: To diagnose invasive pulmonary aspergillosis (IPA), galactomannan (GM) detection in serum or bronchoalveolar lavage fluid (BALF) is widely used. However, the utility of proximal airway GM test (from induced sputum or tracheal aspirate) has ... ...

    Abstract Objective: To diagnose invasive pulmonary aspergillosis (IPA), galactomannan (GM) detection in serum or bronchoalveolar lavage fluid (BALF) is widely used. However, the utility of proximal airway GM test (from induced sputum or tracheal aspirate) has not been well elucidated.
    Methods: In this retrospective cohort study, we evaluated the diagnostic performance of proximal airway GM in diagnosis of IPA including COVID-19 associated pulmonary aspergillosis (CAPA). Between January 2022 and January 2023, patients who had been tested for GM with clinical suspicion or for surveillance from any specimen (serum, induced sputum, tracheal aspirate, and BALF) were screened. IPA was diagnosed using EORTC/MSGERC criteria, and CAPA was diagnosed following the 2020 ECMM/ISHAM consensus criteria.
    Results: Of 624 patients with GM results, 70 met the criteria for proven/probable IPA and 427 had no IPA. The others included possible IPA and chronic form of aspergillosis. The sensitivities and specificities of serum, proximal airway, and BALF GM for proven/probable IPA versus no IPA were 78.9% and 70.6%, 93.1% and 78.7%, and 78.6% and 91.0%, respectively. Areas under the receiver operating characteristic curve (AUCs) were 0.742 for serum GM, 0.935 for proximal airway GM, and 0.849 for BALF GM (serum GM vs proximal airway GM, p = 0.014; proximal airway GM vs BALF GM, p = 0.334; serum GM vs BALF GM, p = 0.286).
    Conclusion: This study demonstrates that the performance of GM test from non-invasive proximal airway samples is comparable or even better than those from serum and distal airway sample (BALF).
    Language English
    Publishing date 2024-04-18
    Publishing country England
    Document type Journal Article
    ZDB-ID 424417-5
    ISSN 1532-2742 ; 0163-4453
    ISSN (online) 1532-2742
    ISSN 0163-4453
    DOI 10.1016/j.jinf.2024.106159
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  7. Article ; Online: Delirium in patients with COVID-19 treated in the intensive care unit.

    Jae Hoon Lee / Won Ho Han / June Young Chun / Young Ju Choi / Mi Ra Han / Jee Hee Kim

    PLoS ONE, Vol 18, Iss 11, p e

    2023  Volume 0289662

    Abstract: Coronavirus disease 2019 (COVID-19) can lead to acute organ dysfunction, and delirium is associated with long-term cognitive impairment and a prolonged hospital stay. This retrospective single-center study aimed to investigate the risk factors for ... ...

    Abstract Coronavirus disease 2019 (COVID-19) can lead to acute organ dysfunction, and delirium is associated with long-term cognitive impairment and a prolonged hospital stay. This retrospective single-center study aimed to investigate the risk factors for delirium in patients with COVID-19 infection receiving treatment in an intensive care unit (ICU). A total of 111 patients aged >18 years with COVID-19 pneumonia who required oxygen therapy from February 2021 to April 2022 were included. Data on patient demographics, past medical history, disease severity, delirium, and treatment strategies during hospitalization were obtained from electronic health records. Patient characteristics and risk factors for delirium were analyzed. Old age (P < 0.001), hypertension (P < 0.001), disease severity (Sequential Organ Failure Assessment score) (P < 0.001), mechanical ventilator support (P < 0.001), neuromuscular blocker use (P < 0.001), and length of stay in the ICU (P < 0.001) showed statistically significant differences on the univariable analysis. Multivariable analysis with backward selection revealed that old age (odds ratio, 1.149; 95% confidence interval, 1.037-1.273; P = 0.008), hypertension (odds ratio, 8.651; 95% confidence interval, 1.322-56.163; P = 0.024), mechanical ventilator support (odds ratio, 226.215; 95% confidence interval, 15.780-3243.330; P < 0.001), and length of stay in the ICU (odds ratio, 30.295; 95% confidence interval, 2.539-361.406; P = 0.007) were significant risk factors for delirium. In conclusion, old age, ICU stay, hypertension, mechanical ventilator support, and neuromuscular blocker use were predictive factors for delirium in COVID-19 patients in the ICU. The study findings suggest the need for predicting the occurrence of delirium in advance and preventing and treating delirium.
    Keywords Medicine ; R ; Science ; Q
    Subject code 610
    Language English
    Publishing date 2023-01-01T00:00:00Z
    Publisher Public Library of Science (PLoS)
    Document type Article ; Online
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  8. Article ; Online: Ambient Air Pollution and Kawasaki Disease in Korean Children: A Study of the National Health Insurance Claim Data.

    Kwon, Dayoon / Choe, Young June / Kim, Sun-Young / Chun, Byung Chul / Choe, Seung-Ah

    Journal of the American Heart Association

    2022  Volume 11, Issue 9, Page(s) e024092

    Abstract: Background Kawasaki disease (KD) is a systemic vasculitis of unknown etiology that primarily affects children under 5 years of age. Some researchers suggested a potential triggering effect of air pollution on KD, but the findings are inconsistent and ... ...

    Abstract Background Kawasaki disease (KD) is a systemic vasculitis of unknown etiology that primarily affects children under 5 years of age. Some researchers suggested a potential triggering effect of air pollution on KD, but the findings are inconsistent and limited by small sample size. We investigated the association between ambient air pollution and KD among the population of South Korea younger than 5 years using the National Health Insurance claim data between 2007 and 2019. Methods and Results We obtained the data regarding particulate matter ≤10 or 2.5 µm in diameter, nitrogen dioxide, sulfur dioxide, carbon monoxide, and ozone from 235 regulatory monitoring stations. Using a time-stratified case-crossover design, we performed conditional logistic regression to estimate odds ratios (OR) of KD according to interquartile range increases in each air pollutant concentration on the day of fever onset after adjusting for temperature and relative humidity. We identified 51 486 children treated for KD during the study period. An interquartile range increase (14.67 μg/m
    MeSH term(s) Air Pollution/adverse effects ; Air Pollution/analysis ; Child ; Child, Preschool ; Humans ; Mucocutaneous Lymph Node Syndrome/diagnosis ; Mucocutaneous Lymph Node Syndrome/epidemiology ; Mucocutaneous Lymph Node Syndrome/etiology ; National Health Programs ; Particulate Matter/adverse effects ; Particulate Matter/analysis ; Sulfur Dioxide/adverse effects
    Chemical Substances Particulate Matter ; Sulfur Dioxide (0UZA3422Q4)
    Language English
    Publishing date 2022-04-27
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2653953-6
    ISSN 2047-9980 ; 2047-9980
    ISSN (online) 2047-9980
    ISSN 2047-9980
    DOI 10.1161/JAHA.121.024092
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  9. Article ; Online: Corrigendum to "Transmission onset distribution of COVID-19" [Int. J. Infect. Dis. 99(October) (2020) 403-407].

    Chun, June Young / Baek, Gyuseung / Kim, Yongdai

    International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases

    2020  Volume 103, Page(s) 645

    Language English
    Publishing date 2020-12-14
    Publishing country Canada
    Document type Published Erratum
    ZDB-ID 1331197-9
    ISSN 1878-3511 ; 1201-9712
    ISSN (online) 1878-3511
    ISSN 1201-9712
    DOI 10.1016/j.ijid.2020.11.186
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  10. Article ; Online: Predicting factors associated with prolonged intensive care unit stay of patients with COVID-19.

    Han, Won Ho / Lee, Jae Hoon / Chun, June Young / Choi, Young Ju / Kim, Youseok / Han, Mira / Kim, Jee Hee

    Acute and critical care

    2023  Volume 38, Issue 1, Page(s) 41–48

    Abstract: Background: Predicting the length of stay (LOS) for coronavirus disease 2019 (COVID-19) patients in the intensive care unit (ICU) is essential for efficient use of ICU resources. We analyzed the clinical characteristics of patients with severe COVID-19 ... ...

    Abstract Background: Predicting the length of stay (LOS) for coronavirus disease 2019 (COVID-19) patients in the intensive care unit (ICU) is essential for efficient use of ICU resources. We analyzed the clinical characteristics of patients with severe COVID-19 based on their clinical care and determined the predictive factors associated with prolonged LOS.
    Methods: We included 96 COVID-19 patients who received oxygen therapy at a high-flow nasal cannula level or above after ICU admission during March 2021 to February 2022. The demographic characteristics at the time of ICU admission and results of severity analysis (Sequential Organ Failure Assessment [SOFA], Acute Physiology and Chronic Health Evaluation [APACHE] II), blood tests, and ICU treatments were analyzed using a logistic regression model. Additionally, blood tests (C-reactive protein, D-dimer, and the PaO2 to FiO2 ratio [P/F ratio]) were performed on days 3 and 5 of ICU admission to identify factors associated with prolonged LOS.
    Results: Univariable analyses showed statistically significant results for SOFA score at the time of ICU admission, C-reactive protein level, high-dose steroids, mechanical ventilation (MV) care, continuous renal replacement therapy, extracorporeal membrane oxygenation, and prone position. Multivariable analysis showed that MV care and P/F ratio on hospital day 5 were independent factors for prolonged ICU LOS. For D-dimer, no significant variation was observed at admission; however, after days 3 and 5 days of admission, significant between-group variation was detected.
    Conclusions: MV care and P/F ratio on hospital day 5 are independent factors that can predict prolonged LOS for COVID-19 patients.
    Language English
    Publishing date 2023-02-22
    Publishing country Korea (South)
    Document type Journal Article
    ZDB-ID 3003021-3
    ISSN 2586-6060 ; 2586-6052
    ISSN (online) 2586-6060
    ISSN 2586-6052
    DOI 10.4266/acc.2022.01235
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