• Pediatric Infection and Vaccine
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• v.28 no.3
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• pp.173-180
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• 2021

After initial reports of multisystem inflammatory syndrome in children (MIS-C) in April 2020 in Europe, this disease has been known to occur in children with recent history of coronavirus disease 2019 (COVID-19) and most cases have been reported in Europe and the Unites States of America. We report a case of a 14-year-old girl who was diagnosed with MIS-C with acute myocarditis and successfully treated with intravenous immunoglobulin (IVIG), methylprednisolone, and anakinra. At initial presentation, she had persistent high fever, generalized rash, generalized swelling, abdominal pain, and low blood pressure. She showed a remarkably elevated level of inflammation and cardiac enzyme markers and had a previous history of COVID-19 5 weeks before the initial presentation. After extensive work up, other infectious and non-infectious causes were excluded. She was diagnosed with MIS-C and initially treated with IVIG and high-dose methylprednisolone; however, despite treatment, her heart function deteriorated and coronary artery dilatation progressed. Therefore, anakinra, an interleukin-1 receptor antagonist, was administered on hospital day 6, after which her cardiac function exhibited improvement. She was discharged on hospital day 19 without any symptoms, and follow-up echocardiography after 1 month revealed fully recovered heart function with normal coronary arteries.

• Anxiety and mood
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• v.19 no.2
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• pp.77-82
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• 2023

Objective : During the coronavirus disease 2019 (COVID-19) pandemic, hospital avoidance had a significant impact on public health. We investigated the factors associated with hospital avoidance and explored practical strategies hospitals could employ to address this phenomenon. Methods : We conducted a patient experience survey in a general hospital in Korea during the COVID-19 pandemic. Between July 6, 2020, and July 20, 2020, a total of 842 patients who had previously visited hospitals before the COVID-19 outbreak participated. Self-reported hospital avoidance, factors associated with hospital avoidance, and satisfaction with the hospital's infection control policies were the main outcomes. Binary logistic regression analysis was used to identify associated factors. Results : Data indicated that 29.9% (n=252) of the respondents avoided visiting the hospital after the COVID-19 outbreak. Satisfaction with the hospital infection control policy (odds ratio [OR]=2.297, p<0.001), female sex (OR=1.619, p<0.05), and higher educational level (OR=1.884, p<0.001) were associated with hospital avoidance. The "entrance body temperature check" was the most satisfactory policy among the hospital's infection control policies. Conclusion : To manage hospital avoidance during an infectious disease crisis, targeted policies for at-risk groups and hospital policies to reassure and satisfy patients are needed.

• IMMUNE NETWORK
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• v.23 no.5
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• pp.39.1-39.15
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• 2023

Coronavirus disease 2019 (COVID-19) vaccination may non-specifically alter the host immune system. This study aimed to evaluate the effect of COVID-19 vaccination on hepatitis B surface Ag (HBsAg) titer and host immunity in chronic hepatitis B (CHB) patients. Consecutive 2,797 CHB patients who had serial HBsAg measurements during antiviral treatment were included in this study. Changes in the HBsAg levels after COVID-19 vaccination were analyzed. The dynamics of NK cells following COVID-19 vaccination were also examined using serial blood samples collected prospectively from 25 healthy volunteers. Vaccinated CHB patients (n=2,329) had significantly lower HBsAg levels 1-30 days post-vaccination compared to baseline (median, -21.4 IU/ml from baseline), but the levels reverted to baseline by 91-180 days (median, -3.8 IU/ml). The velocity of the HBsAg decline was transiently accelerated within 30 days after vaccination (median velocity: -0.06, -0.39, and -0.04 log₁₀ IU/ml/year in pre-vaccination period, days 1-30, and days 31-90, respectively). In contrast, unvaccinated patients (n=468) had no change in HBsAg levels. Flow cytometric analysis showed that the frequency of NK cells expressing NKG2A, an NK inhibitory receptor, significantly decreased within 7 days after the first dose of COVID-19 vaccine (median, -13.1% from baseline; p<0.001). The decrease in the frequency of NKG2A⁺ NK cells was observed in the CD56^dimCD16⁺ NK cell population regardless of type of COVID-19 vaccine. COVID-19 vaccination leads to a rapid, transient decline in HBsAg titer and a decrease in the frequency of NKG2A⁺ NK cells.

• IMMUNE NETWORK
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• v.22 no.3
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• pp.22.1-22.25
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• 2022

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndromecoronavirus-2 (SARS-CoV-2), has spread over the world causing a pandemic which is still ongoing since its emergence in late 2019. A great amount of effort has been devoted to understanding the pathogenesis of COVID-19 with the hope of developing better therapeutic strategies. Transcriptome analysis using technologies such as RNA sequencing became a commonly used approach in study of host immune responses to SARS-CoV-2. Although substantial amount of information can be gathered from transcriptome analysis, different analysis tools used in these studies may lead to conclusions that differ dramatically from each other. Here, we re-analyzed four RNA-sequencing datasets of COVID-19 samples including human bronchoalveolar lavage fluid, nasopharyngeal swabs, lung biopsy and hACE2 transgenic mice using the same standardized method. The results showed that common features of COVID-19 include upregulation of chemokines including CCL2, CXCL1, and CXCL10, inflammatory cytokine IL-1β and alarmin S100A8/S100A9, which are associated with dysregulated innate immunity marked by abundant neutrophil and mast cell accumulation. Downregulation of chemokine receptor genes that are associated with impaired adaptive immunity such as lymphopenia is another common feather of COVID-19 observed. In addition, a few interferon-stimulated genes but no type I IFN genes were identified to be enriched in COVID-19 samples compared to their respective control in these datasets. These features are in line with results from single-cell RNA sequencing studies in the field. Therefore, our re-analysis of the RNA-seq datasets revealed common features of dysregulated immune responses to SARS-CoV-2 and shed light to the pathogenesis of COVID-19.

• Journal of Chest Surgery
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• v.54 no.1
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• pp.2-8
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• 2021

Since the first reported case of coronavirus disease 2019 (COVID-19) in December 2019, the numbers of confirmed cases and deaths have continued to increase exponentially despite multi-factorial efforts. Although various attempts have been made to improve the level of evidence for extracorporeal membrane oxygenation (ECMO) treatment over the past 10 years, most experts still hesitate to take an active position on whether to apply ECMO in COVID-19 patients. Several ECMO management guidelines have been published recently, but they reflect some important differences from the Korean medical system and aspects of real-world medical practice in Korea. We aimed to find evidence on the efficacy of ECMO for COVID-19 patients by reviewing the published literature and to propose expert recommendations by analyzing the Korean COVID-19 ECMO registry data.

• Journal of Christian Education in Korea
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• v.63
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• pp.13-37
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• 2020

The World Health Organisation(WHO), paying attention to the spread and fatality of the coronavirus(COVID-19), which first occurred in Wuhan, China, declared a global emergency. Although many countries implement strict measures to slow down the spread, WHO officially declared a pandemic. COVID-19 has sparked fears of an impending economic crisis and recession. Due to the economic crisis caused by social distancing, self-isolation and travel restrictions, the collapse of the world economic system centered on free trade and the decline of globalization are mentioned. Political leadership that has not responded properly to the pandemic is challenged, and nearly all of society is rapidly changing to a non-contact and immobile culture. COVID-19 has seriously affected all levels of the education system, from preschool to tertiary education. The so-called old concept of deschooling is realizing in the field of education through digital media paradoxically. Church education is facing a serious crisis as well. Churches are seeking now a new normal that includes theological reflection on the pandemic, online worship, education, and non-face-to-face ministry to overcome the worst unexpected crisis. In the post-corona era, church education must actively seek alternatives in response to rapidly changing surrounding conditions and reconstruct educational philosophy(theology) that focuses on Christian values. In addition, it is necessary to start operating a mobile(or online) church school that combines offline and online. It is necessary to introduce 'Blended Learning' method that combines non-face-to-face and face-to-face learning, and by combining church school and homeschooling, churches and families need to share the responsibility of education in faith.

• Journal of the Korean Society of Marine Environment & Safety
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• v.27 no.6
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• pp.763-774
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• 2021

The COVID-19 virus has generated major shockwaves in all spheres of human life since its outbreak. Maritime transport (both cargo and passenger) is one of the industries most heavily affected, yet over 80% of the world cargo is transported by sea. This study analyzes maritime port operational efficiencies before and after the start of the COVID-19 pandemic to determine whether the pandemic has caused major differences in the operational efficiencies of many leading Asian maritime container ports via data envelopment analysis (DEA). The results of both the CCR and BCC models reveal that overall, efficiency during the COVID-19 pandemic has been higher than before the pandemic despite a few inefficiencies. This implies that the pandemic has so far not has major consequences for the operational efficiency of maritime ports. However, two ports (Busan and Guangzhou) should adjust the scale sizes and technical capacities of their operations to improve performance.

• Journal of Korean Academy of Dental Administration
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• v.8 no.1
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• pp.1-7
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• 2020

Dental settings have unique characteristics that warrant specific infection control considerations, including (1) prioritizing the most critical dental services and provide care in a way that minimizes harm to patients due to delayed care, or harm to personnel from potential exposure to persons infected with the COVID-19 disease, and (2) proactively communicate to both personnel and patients the need for them to stay at home if sick. For health care, an interim infection prevention and control recommendation (COVID-19) is recommended for patients suspected of having coronavirus or those whose status has been confirmed. SARS-CoV-2, which is the virus that causes COVID-19, is thought to be spread primarily between people who are in close contact with one another (within 6 feet) through respiratory droplets that are produced when an infected person coughs, sneezes, or talks. Airborne transmission from person-to-person over long distances is unlikely. However, COVID-19 is a new disease, and there remain uncertainties about its mode of spreads and the severity of illness it causes. The virus has been shown to persist in aerosols for several hours, and on some surfaces for days under laboratory conditions. COVID-19 may also be spread by people who are asymptomatic. The practice of dentistry involves the use of rotary dental and surgical instruments, such as handpieces or ultrasonic scalers, and air-water syringes. These instruments create a visible spray that can contain particle droplets of water, saliva, blood, microorganisms, and other debris. While KF 94 masks protect the mucous membranes of the mouth and nose from droplet spatter, they do not provide complete protection against the inhalation of airborne infectious agents. If the patient is afebrile (temperature <100.4°F)* and otherwise without symptoms consistent with COVID-19, then dental care may be provided using appropriate engineering and administrative controls, work practices, and infection control considerations. It is necessary to provide supplies for respiratory hygiene and cough etiquette, including alcohol-based hand rub (ABHR) with 60%~95% alcohol, tissues, and no-touch receptacles for disposal, at healthcare facility entrances, waiting rooms, and patient check-ins. There is also the need to install physical barriers (e.g., glass or plastic windows) in reception areas to limit close contact between triage personnel and potentially infectious patients. Ideally, dental treatment should be provided in individual rooms whenever possible, with a spacing of at least 6 feet between the patient chairs. Further, the use of easy-to-clean floor-to-ceiling barriers will enhance the effectiveness of portable HEPA air filtration systems. Before and after all patient contact, contact with potentially infectious material, and before putting on and after removing personal protective equipment, including gloves, hand hygiene after removal is particularly important to remove any pathogens that may have been transferred to the bare hands during the removal process. ABHR with 60~95% alcohol is to be used, or hands should be washed with soap and water for at least 20 s.

• Journal of Environmental Health Sciences
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• v.46 no.6
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• pp.750-756
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• 2020

Objectives: After coronavirus disease 2019 (COVID-19) was declared a pandemic, the South Korean government announced guidelines on wearing masks to prevent its spread. The guidelines have changed depending on the severity of the spread of COVID-19. This study aimed to identify mask-wearing behaviours to counter the spread of COVID-19 in indoor and outdoor environments. Methods: The type of mask worn and proper wearing were observed in cafés, supermarkets, underground shopping malls, and streets in Seoul. Behavioral assessment was repeated in August at social distancing levels 1 and 2, in October at social distancing level 1, and in November after the mask mandates. Results: In August, 22.1% of subjects in cafés, 90.8% in supermarkets, 91.8% in underground shopping malls, and 83.6% on outdoor streets wore masks properly. In October, the proportion of correct wearers increased in all locations. After masks became mandatory in November, about 97% of users of supermarkets, underground shopping malls, and streets wore masks properly. In cafés, the proportion of proper wearers was 61.5% with both social distancing level 2 in August and the mandate in November. The number of KF-certified mask wearers continued to increase from August to November. Conclusion: This study investigated mask-wearing behaviors to counter COVID-19 through observations in indoor and outdoor places in Seoul. Mask-wearing behavior was different depending on the place and the government guidelines in place. The results could be used for evaluation of the current guidelines for COVID-19.

• The Journal of The Korea Institute of Intelligent Transport Systems
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• v.20 no.6
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• pp.55-65
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• 2021

In January 2020, the first COVID-19 confirmed patient occurred in Korea, and the pandemic continues to this day. In unprecedented situations, COVID-19 also affected the transportation sector, and there were no appropriate measures against changes in traffic volume and use of public transportation due to changes in citizens' lifestyles. Currently, each local government has not established separate measures for pandemic disease measures. In order to establish future disease countermeasures in the transportation sector, a predictive model was developed by analyzing the traffic volume and the number of public transportation uses, and conducting correlation analysis with the current status of COVID-19. As a result of the analysis, the traffic volume decreased, but the traffic volume decreased due to the increase in personal transportation, but it did not reach the number of public transportation uses. In addition, it was analyzed that the use of public transportation was initially affected by the number of confirmed cases, but over time, it was more sensitive to death and mortality than to the number of confirmed cases.