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Article ; Online: Strategies for the Prevention of the Intra-Hospital Transmission of COVID-19

Min Cheol Chang / Jian Hur / Donghwi Park

Healthcare, Vol 8, Iss 195, p

A Retrospective Cohort Study

2020 Volume 195

Abstract: Coronavirus disease (COVID-19) has spread rapidly worldwide. We aimed to review the strategies used by our university hospital in Daegu (South Korea) to prevent the transmission of COVID-19 within our institution. We also investigated the actual ... ...

Abstract	Coronavirus disease (COVID-19) has spread rapidly worldwide. We aimed to review the strategies used by our university hospital in Daegu (South Korea) to prevent the transmission of COVID-19 within our institution. We also investigated the actual situation at our hospital against the recommended guidelines. We conducted a survey among patients and staff in our hospital. Additionally, patients’ electronic medical records were reviewed along with closed-circuit television (CCTV) recordings. Various strategies and guidelines developed by our hospital have been implemented. A total of 303 hospital staff and patients had exposure to 29 confirmed COVID-19 patients. Of them, three tested positive for COVID-19 without further transmission. The intra-hospital infection of the disease occurred when the recommended strategies and guidelines such as wearing a mask and isolating for 2 weeks were not followed. In conclusion, the implementation of robust guidelines for preventing the intra-hospital transmission of COVID-19 is essential.
Keywords	COVID-19 ; hospital infection ; secondary infection ; mask ; isolation ; Medicine ; R ; covid19
Subject code	360
Language	English
Publishing date	2020-07-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Analysis of SARS-CoV-2 Screening Clinic (Including Drive-Through System) Data at a Single University Hospital in South Korea from 27 January 2020 to 31 March 2020 during the COVID-19 Outbreak

Min Cheol Chang / Wan-Seok Seo / Donghwi Park / Jian Hur

Healthcare, Vol 8, Iss 145, p

2020 Volume 145

Abstract: In this study, we evaluated the efficiency of a drive-through (DT) screening system for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by comparing it with a conventional screening system. We reviewed and analyzed the SARS-CoV-2 screening ... ...

Abstract	In this study, we evaluated the efficiency of a drive-through (DT) screening system for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by comparing it with a conventional screening system. We reviewed and analyzed the SARS-CoV-2 screening data obtained at our university hospital. We compared the number of tests for SARS-CoV-2 (using real-time polymerase chain reaction) performed using two different specimen collection systems—DT and conventional—during the coronavirus disease 2019 (COVID-19) outbreak in Daegu. Based on the results, the DT screening system collected 5.8 times more specimens for testing than the conventional screening system. From January 27 to 31 March 2020, 6211 individuals were screened for SARS-CoV-2 infection using either the DT or conventional system. In total, 217 individuals tested positive for SARS-CoV-2 (positive rate: 3.50%). Of the 6211 individuals, 3368 were symptomatic or had a history of contact with COVID-19 patients, and 142 of them tested positive for SARS-CoV-2 (positive rate: 4.22%). Further, 2843 individuals were asymptomatic and had no history of contact with COVID-19 patients, and 75 of them tested positive for SARS-CoV-2 (positive rate: 2.64%). In conclusion, the DT system allowed clinicians to collect specimens for SARS-CoV-2 screening more efficiently than the conventional system. Furthermore, as there might be several COVID-19 patients who remain asymptomatic, expanding the screening test to asymptomatic individuals would be necessary.
Keywords	COVID-19 ; drive-through screening system ; real-time polymerase chain reaction ; Medicine ; R
Subject code	360
Language	English
Publishing date	2020-05-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Yeungnam University type drive-through (YU-Thru) coronavirus disease 2019 (COVID-19) screening system

Wan Seok Seo / Seong Ho Kim / Si Youn Song / Jian Hur / Jun Lee / Sunho Choi / Yoojung Lee / Dai Seg Bai

Yeungnam University Journal of Medicine, Vol 37, Iss 4, Pp 349-

a rapid and safe screening system

2020 Volume 355

Abstract: Active and prompt scale-up screening tests are essential to efficiently control the coronavirus disease 2019 (COVID-19) outbreak. The goal of this work was to identify shortcomings in the conventional screening system (CSS) implemented in the beginning ... ...

Abstract	Active and prompt scale-up screening tests are essential to efficiently control the coronavirus disease 2019 (COVID-19) outbreak. The goal of this work was to identify shortcomings in the conventional screening system (CSS) implemented in the beginning of the outbreak. To overcome these shortcomings, we then introduced a novel, independently developed system called the Yeungnam University type drive-through (YU-Thru), and distributed it nationwide in Korea. This system is similar to the drive-throughs utilized by fast food restaurants. YU-Thru system has shortened the time taken to test a single person to 2–4 minutes, by completely eliminating the time required to clean and ventilate the specimen collection room. This time requirement was a major drawback of the CSS. YU-Thru system also reduced the risk of subjects and medical staff infecting one another by using a separate and closed examination system. On average, 50 to 60 tests were conducted per day when using the CSS, while now up to 350 tests per day are conducted with the YU-Thru system. We believe that the YU-Thru system has made an important contribution to the rapid detection of COVID-19 in Daegu, South Korea. Here, we will describe the YU-Thru system in detail so that other countries experiencing COVID-19 outbreaks can take advantage of this system.
Keywords	conventional screening system ; covid-19 ; rapid screening system ; yu-thru system ; Medicine (General) ; R5-920
Subject code	531
Language	English
Publishing date	2020-10-01T00:00:00Z
Publisher	Yeungnam University College of Medicine
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Risk Factors and a Scoring System to Predict ARDS in Patients with COVID-19 Pneumonia in Korea

Jun-Won Seo / Seong Eun Kim / Eun Young Choi / Kyung Soo Hong / Tae Hoon Oh / Uh. Jin Kim / Seung-Ji Kang / Kyung-Hwa Park / Sook-In Jung / Da Young Kim / Na Ra Yun / Dong-Min Kim / Hwa Pyung Kim / Jian Hur / Hee-Chang Jang

Disease Markers, Vol

A Multicenter Cohort Study

2021 Volume 2021

Abstract: Predictive studies of acute respiratory distress syndrome (ARDS) in patients with coronavirus disease 2019 (COVID-19) are limited. In this study, the predictors of ARDS were investigated and a score that can predict progression to ARDS in patients with ... ...

Abstract	Predictive studies of acute respiratory distress syndrome (ARDS) in patients with coronavirus disease 2019 (COVID-19) are limited. In this study, the predictors of ARDS were investigated and a score that can predict progression to ARDS in patients with COVID-19 pneumonia was developed. All patients who were diagnosed with COVID-19 pneumonia between February 1, 2020, and May 15, 2020, at five university hospitals in Korea were enrolled. Their demographic, clinical, and epidemiological characteristics and the outcomes were collected using the World Health Organization COVID-19 Case Report Form. A logistic regression analysis was performed to determine the predictors for ARDS. The receiver operating characteristic (ROC) curves were constructed for the scoring model. Of the 166 patients with COVID-19 pneumonia, 37 (22.3%) patients developed ARDS. The areas under the curves for the infiltration on a chest X-ray, C-reactive protein, neutrophil/lymphocyte ratio, and age, for prediction of ARDS were 0.91, 0.90, 0.87, and 0.80, respectively (all P<0.001). The COVID-19 ARDS Prediction Score (CAPS) was constructed using age (≥60 years old), C-reactive protein (≥5 mg/dL), and the infiltration on a chest X-ray (≥22%), with each predictor allocated 1 point. The area under the curve of COVID-19 ARDS prediction score (CAPS) for prediction of ARDS was 0.90 (95% CI 0.86–0.95; P<0.001). It provided 100% sensitivity and 75% specificity when the CAPS score cutoff value was 2 points. CAPS, which consists of age, C-reactive protein, and the area of infiltration on a chest X-ray, was predictive of the development of ARDS in patients with COVID-19 pneumonia.
Keywords	Medicine (General) ; R5-920
Subject code	610
Language	English
Publishing date	2021-01-01T00:00:00Z
Publisher	Hindawi Limited
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The Risk of Diabetes on Clinical Outcomes in Patients with Coronavirus Disease 2019

Seung Min Chung / Yin Young Lee / Eunyeong Ha / Ji Sung Yoon / Kyu Chang Won / Hyoung Woo Lee / Jian Hur / Kyung Soo Hong / Jong Geol Jang / Hyun Jung Jin / Eun Young Choi / Kyeong-Cheol Shin / Jin Hong Chung / Kwan Ho Lee / June Hong Ahn / Jun Sung Moon

Diabetes & Metabolism Journal, Vol 44, Iss 3, Pp 405-

A Retrospective Cohort Study

2020 Volume 413

Abstract: BackgroundTo determine the role of diabetes mellitus (DM) in the coronavirus disease 2019 (COVID-19), we explored the clinical characteristics of patients with DM and compared risk factors such as age, glycemic control, and medications to those without ... ...

Abstract	BackgroundTo determine the role of diabetes mellitus (DM) in the coronavirus disease 2019 (COVID-19), we explored the clinical characteristics of patients with DM and compared risk factors such as age, glycemic control, and medications to those without DM.MethodsThis was a retrospective cohort study of 117 confirmed patients with COVID-19 which conducted at a tertiary hospital in Daegu, South Korea. The primary outcome was defined as the severe and critical outcome (SCO), of which the composite outcomes of acute respiratory distress syndrome, septic shock, intensive care unit care, and 28-day mortality. We analyzed what clinical features and glycemic control-related factors affect the prognosis of COVID-19 in the DM group.ResultsAfter exclusion, 110 participants were finally included. DM patients (n=29) was older, and showed higher blood pressure compared to non-DM patients. DM group showed higher levels of inflammation-related biomarkers and severity score, and highly progressed to SCO. After adjustment with other risk factors, DM increased the risk of SCO (odds ratio [OR], 10.771; P<0.001). Among the DM patients, SCO was more prevalent in elderly patients of ≥70 years old and age was an independent risk factor for SCO in patients with DM (OR, 1.175; P=0.014), while glycemic control was not. The use of medication did not affect the SCO, but the renin-angiotensin system inhibitors showed protective effects against acute cardiac injury (OR, 0.048; P=0.045).ConclusionThe COVID-19 patients with DM had higher severity and resulted in SCO. Intensive and aggressive monitoring of COVID-19 clinical outcomes in DM group, especially in elderly patients is warranted.
Keywords	aged ; covid-19 ; diabetes mellitus ; prognosis ; risk factors ; severe acute respiratory syndrome coronavirus 2 ; Diseases of the endocrine glands. Clinical endocrinology ; RC648-665 ; covid19
Subject code	610 ; 616
Language	English
Publishing date	2020-06-01T00:00:00Z
Publisher	Korean Diabetes Association
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The clinical and economic burden of community-onset complicated skin and skin structure infections in Korea

Yong Kyun Cho / Heung Jeong Woo / Shin Woo Kim / In-Gyu Bae / Young Goo Song / Hee Jin Cheong / Hyuck Lee / Sang Hoon Han / Hee Jung Choi / Chisook Moon / Seong Yeol Ryu / Jian Hur / Ja Cob Lee / Yu Mi Jo / Young Joo Kim

The Korean Journal of Internal Medicine, Vol 35, Iss 6, Pp 1497-

2020 Volume 1506

Abstract: Background/Aims To investigate epidemiologic characteristics, clinical and economic burdens, and factors associated with mortality in complicated skin and skin structure infection (cSSSI) patients in Korea. Methods A retrospective, observational, ... ...

Abstract	Background/Aims To investigate epidemiologic characteristics, clinical and economic burdens, and factors associated with mortality in complicated skin and skin structure infection (cSSSI) patients in Korea. Methods A retrospective, observational, nationwide study was conducted between April to July 2012 at 14 tertiary-hospitals in Korea. Eligible patients were hospitalized adults with community acquired cSSSI, who underwent surgical intervention and completed treatment between November 2009 and October 2011. Data on demography, clinical characteristics, outcomes and medical resource utilization were collected through medical record review. Direct medical costs were calculated by multiplying quantities of resources utilized by each unit price in Korea. Results Of 473 patients enrolled, 449 patients (except 24 patients with no record on surgical intervention) were eligible for analysis. Microbiological testing was performed on 66.1% of patients and 8.2% had multiple pathogens. Among culture confirmed pathogens (n = 297 patients, 340 episodes), 76.2% were gram-positive (Staphylococcus aureus; 41.2%) and 23.8% were gram-negative. The median duration of hospital stay was 16 days. Among treated patients, 3.3% experienced recurrence and 4.2% died in-hospital. The mean direct medical costs amounted to $4,195/ person, with the greatest expenses for hospitalization and antibiotics. The in-hospital mortality and total medical costs were higher in combined antibiotics therapy than monotherapy (p < 0.05). Charlson’s comorbidity index ≥ 3, standardized early warning scoring ≥ 4, sub-fascia infections and combined initial therapy, were all found to be associated with higher mortality. Conclusions Korean patients with community-onset cSSSI suffer from considerable clinical and economic burden. Efforts should be made to reduce this burden through appropriate initial treatment.
Keywords	complicated skin and skin structure infection ; economic ; clinical burden ; initial antibiotics ; Medicine ; R
Subject code	610 ; 616
Language	English
Publishing date	2020-11-01T00:00:00Z
Publisher	The Korean Association of Internal Medicine
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Effects of steroid therapy in patients with severe fever with Thrombocytopenia syndrome

Sook In Jung / Ye Eun Kim / Na Ra Yun / Choon-Mee Kim / Dong-Min Kim / Mi Ah Han / Uh Jin Kim / Seong Eun Kim / Jieun Kim / Seong Yeol Ryu / Hyun Ah Kim / Jian Hur / Young Keun Kim / Hye Won Jeong / Jung Yeon Heo / Dong Sik Jung / Hyungdon Lee / Kyungmin Huh / Yee Gyung Kwak /

Sujin Lee / Seungjin Lim / Sun Hee Lee / Sun Hee Park / Joon-Sup Yeom / Shin-Woo Kim / In-Gyu Bae / Juhyung Lee / Eu Suk Kim / Jun-Won Seo

PLoS Neglected Tropical Diseases, Vol 15, Iss 2, p e

A multicenter clinical cohort study.

2021 Volume 0009128

Abstract: Background Severe fever with thrombocytopenia syndrome (SFTS) is an acute, febrile, and potentially fatal tick-borne disease caused by the SFTS Phlebovirus. Here, we evaluated the effects of steroid therapy in Korean patients with SFTS. Methods A ... ...

Abstract	Background Severe fever with thrombocytopenia syndrome (SFTS) is an acute, febrile, and potentially fatal tick-borne disease caused by the SFTS Phlebovirus. Here, we evaluated the effects of steroid therapy in Korean patients with SFTS. Methods A retrospective study was performed in a multicenter SFTS clinical cohort from 13 Korean university hospitals between 2013 and 2017. We performed survival analysis using propensity score matching of 142 patients with SFTS diagnosed by genetic or antibody tests. Results Overall fatality rate was 23.2%, with 39.7% among 58 patients who underwent steroid therapy. Complications were observed in 37/58 (63.8%) and 25/83 (30.1%) patients in the steroid and non-steroid groups, respectively (P < .001). Survival analysis after propensity score matching showed a significant difference in mean 30-day survival time between the non-steroid and steroid groups in patients with a mild condition [Acute Physiology and Chronic Health Evaluation II (APACHE II) score <14; 29.2 (95% CI 27.70-30.73] vs. 24.9 (95% CI 21.21-28.53], P = .022]. Survival times for the early steroid (≤5 days from the start of therapy after symptom onset), late steroid (>5 days), and non-steroid groups, were 18.4, 22.4, and 27.3 days, respectively (P = .005). Conclusions After steroid therapy, an increase in complications was observed among patients with SFTS. Steroid therapy should be used with caution, considering the possible negative effects of steroid therapy within 5 days of symptom onset or in patients with mild disease (APACHE II score <14).
Keywords	Arctic medicine. Tropical medicine ; RC955-962 ; Public aspects of medicine ; RA1-1270
Subject code	610 ; 616
Language	English
Publishing date	2021-02-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Comparison of RT-PCR, RT-nested PCRs, and real-time PCR for diagnosis of severe fever with thrombocytopenia syndrome

Scientific Reports, Vol 11, Iss 1, Pp 1-

a prospective study

2021 Volume 8

Abstract: Abstract We designed a highly sensitive reverse transcription nested polymerase chain reaction targeting the M-segment (NPCR-M) of severe fever with thrombocytopenia syndrome (SFTS) virus. NPCR-M was performed in parallel with three other referenced PCR ... ...

Abstract	Abstract We designed a highly sensitive reverse transcription nested polymerase chain reaction targeting the M-segment (NPCR-M) of severe fever with thrombocytopenia syndrome (SFTS) virus. NPCR-M was performed in parallel with three other referenced PCR assays QPCR-S, PCR-M, and NPCR-S to assess their clinical usefulness as routine diagnostic techniques for SFTS. In this multi-centered prospective study, 122 blood samples from 38 laboratory-confirmed SFTS patients and 85 control samples were used. The results demonstrated that QPCR-S and NPCR-S had better sensitivity rate up to 21 days after symptom onset however, the PCR-M showed poor sensitivity after 7 days of symptom onset. Our designed NPCR-M had a higher detection rate up to 40 days from symptom onset and revealed the persistence of SFTSV RNA in the early convalescent phase. No false-positive results were seen for the control samples. Additionally, NPCR-M showed positive results for a sample that initially showed negative results from other PCRs and for many other samples collected in the convalescent phase of SFTS. Our designed nested PCR is suitable for SFTSV detection in patients’ blood collected in the acute and early convalescent phase of SFTS, and shows better sensitivity and high specificity even up to 40 days after symptom onset.
Keywords	Medicine ; R ; Science ; Q
Subject code	616
Language	English
Publishing date	2021-08-01T00:00:00Z
Publisher	Nature Portfolio
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The Clinical Characteristics and Outcomes of Patients with Moderate-to-Severe Coronavirus Disease 2019 Infection and Diabetes in Daegu, South Korea

Mi Kyung Kim / Jae-Han Jeon / Sung-Woo Kim / Jun Sung Moon / Nan Hee Cho / Eugene Han / Ji Hong You / Ji Yeon Lee / Miri Hyun / Jae Seok Park / Yong Shik Kwon / Yeon-Kyung Choi / Ki Tae Kwon / Shin Yup Lee / Eon Ju Jeon / Jin-Woo Kim / Hyo-Lim Hong / Hyun Hee Kwon / Chi Young Jung /

Yin Young Lee / Eunyeoung Ha / Seung Min Chung / Jian Hur / June Hong Ahn / Na-young Kim / Shin-Woo Kim / Hyun Ha Chang / Yong Hoon Lee / Jaehee Lee / Keun-Gyu Park / Hyun Ah Kim / Ji-Hyun Lee

Diabetes & Metabolism Journal, Vol 44, Iss 4, Pp 602-

2020 Volume 613

Abstract: BackgroundCoronavirus disease 2019 (COVID-19) is a global pandemic that had affected more than eight million people worldwide by June 2020. Given the importance of the presence of diabetes mellitus (DM) for host immunity, we retrospectively evaluated the ...

Abstract	BackgroundCoronavirus disease 2019 (COVID-19) is a global pandemic that had affected more than eight million people worldwide by June 2020. Given the importance of the presence of diabetes mellitus (DM) for host immunity, we retrospectively evaluated the clinical characteristics and outcomes of moderate-to-severe COVID-19 in patients with diabetes.MethodsWe conducted a multi-center observational study of 1,082 adult inpatients (aged ≥18 years) who were admitted to one of five university hospitals in Daegu because of the severity of their COVID-19-related disease. The demographic, laboratory, and radiologic findings, and the mortality, prevalence of severe disease, and duration of quarantine were compared between patients with and without DM. In addition, 1:1 propensity score (PS)-matching was conducted with the DM group.ResultsCompared with the non-DM group (n=847), patients with DM (n=235) were older, exhibited higher mortality, and required more intensive care. Even after PS-matching, patients with DM exhibited more severe disease, and DM remained a prognostic factor for higher mortality (hazard ratio, 2.40; 95% confidence interval, 1.38 to 4.15). Subgroup analysis revealed that the presence of DM was associated with higher mortality, especially in older people (≥70 years old). Prior use of a dipeptidyl peptidase-4 inhibitor or a renin-angiotensin system inhibitor did not affect mortality or the clinical severity of the disease.ConclusionDM is a significant risk factor for COVID-19 severity and mortality. Our findings imply that COVID-19 patients with DM, especially if elderly, require special attention and prompt intensive care.
Keywords	covid-19 ; diabetes mellitus ; mortality ; prognosis ; Diseases of the endocrine glands. Clinical endocrinology ; RC648-665 ; covid19
Subject code	610
Language	English
Publishing date	2020-08-01T00:00:00Z
Publisher	Korean Diabetes Association
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Severe Fever with Thrombocytopenia Syndrome in South Korea, 2013-2015.

PLoS Neglected Tropical Diseases, Vol 10, Iss 12, p e

2016 Volume 0005264

Abstract: Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease that was recently identified in China, South Korea and Japan. The objective of the study was to evaluate the epidemiologic and clinical characteristics of SFTS in South ... ...

Abstract	Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease that was recently identified in China, South Korea and Japan. The objective of the study was to evaluate the epidemiologic and clinical characteristics of SFTS in South Korea.SFTS is a reportable disease in South Korea. We included all SFTS cases reported to the Korea Centers for Disease Control and Prevention (KCDC) from January 2013 to December 2015. Clinical information was gathered by reviewing medical records, and epidemiologic characteristics were analyzed using both KCDC surveillance data and patient medical records. Risk factors for mortality in patients with SFTS were assessed. A total of 172 SFTS cases were reported during the study period. SFTS occurred throughout the country, except in urban areas. Hilly areas in the eastern and southeastern regions and Jeju island (incidence, 1.26 cases /105 person-years) were the main endemic areas. The yearly incidence increased from 36 cases in 2013 to 81 cases in 2015. Most cases occurred from May to October. The overall case fatality ratio was 32.6%. The clinical progression was similar to the 3 phases reported in China: fever, multi-organ dysfunction, and convalescence. Confusion, elevated C-reactive protein, and prolonged activated partial thromboplastin times were associated with mortality in patients with SFTS. Two outbreaks of nosocomial SFTS transmission were observed.SFTS is an endemic disease in South Korea, with a nationwide distribution and a high case-fatality ratio. Confusion, elevated levels of C-reactive protein, and prolonged activated partial thromboplastin times were associated with mortality in patients with SFTS.
Keywords	Arctic medicine. Tropical medicine ; RC955-962 ; Public aspects of medicine ; RA1-1270
Subject code	610
Language	English
Publishing date	2016-12-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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