Epidemiology and Health

COVID-19: Original Article

The medium-term consequences of a COVID-19 lockdown on lifestyle among Spanish older people with hypertension, pulmonary disease, cardiovascular disease, musculoskeletal disease, depression, and cancer: Irene Rodríguez-Gómez, Coral Sánchez-Martín, Francisco J. García-García, Esther García-Esquinas, Marta Miret, Germán Vicente-Rodriguez, Narcís Gusi, Asier Mañas, José A. Carnicero, Marcela Gonzalez-Gross, José L. Ayuso-Mateos, Fernando Rodríguez-Artalejo, Leocadio Rodríguez-Mañas, Ignacio Ara; Epidemiol Health. 2022;44:e2022026. Published online February 21, 2022; DOI: https://doi.org/10.4178/epih.e2022026

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Abstract

OBJECTIVES
This study investigated the associations of chronic diseases with changes in lifestyle and health behaviours in older people following the coronavirus disease 2019 (COVID-19) lockdown in Spain and compared the differences in changes over time.

METHODS

1,092 participants (80.3±5.6 years; 66.5% female) from 2 Spanish cohorts were included. Telephone-based questionnaires were conducted to evaluate lifestyle and health risk behaviours at the end of lockdown and 7 months post-lockdown. Participants were classified as having physician-diagnosed chronic diseases based on self-reported data. Cox proportional models adjusted for major confounders were used.

RESULTS

Compared to those without the corresponding chronic diseases, older people with hypertension were less likely to report increased alcohol consumption (hazard ratio [HR], 0.73; 95% confidence interval [CI], 0.55 to 0.99). Pulmonary diseases were associated with lower risks of increased sedentary time (HR, 0.58; 95% CI, 0.39 to 0.86) and worsened sleep quality (HR, 0.56; 95% CI, 0.36 to 0.87), while cardiovascular diseases were associated with a lower risk of decreased sedentary time (HR, 0.58; 95% CI, 0.38 to 0.88). Depression was linked to a higher likelihood of improved diet quality (HR, 1.53; 95% CI, 1.00 to 2.36). Cancer pacients were less likely to have worsened sleep quality (HR, 0.44; 95% CI, 0.22 to 0.89) but more likely to have reduced their frequency of social contact (HR, 2.05; 95% CI, 1.05 to 3.99).

CONCLUSIONS

Older people with chronic diseases showed beneficial changes in lifestyle and health risk behaviours after the COVID-19 lockdown. In particular, older people with hypertension, pulmonary disease, and cancer tended to make beneficial lifestyle and health behaviour changes. However, older people with cardiovascular disease and depression engaged in more health risk behaviours.

Summary

Key Message
Although the majority of older people with chronic diseases showed beneficial changes in lifestyle and health risk behaviors after the COVID-19 lockdown, public health interventions should be developed to prevent the dangerous long-term effects that COVID-19 pandemic-type situations may have on the health of older people, with a particular focus on older people with CVD and depression that seem to have experienced more health risk behaviors during the COVID-19 pandemic than older people with other chronic diseases.

Citations

Citations to this article as recorded by

Global burden of sleep disturbances among older adults and the disparities by geographical regions and pandemic periods
Min Du, Min Liu, Yaping Wang, Chenyuan Qin, Jue Liu
SSM - Population Health.2024; 25: 101588. CrossRef
Nut Consumption and Depression: Cross-Sectional and Longitudinal Analyses in Two Cohorts of Older Adults
R. Fernández-Rodríguez, R. Ortolá, Vicente Martínez-Vizcaíno, B. Bizzozero-Peroni, F. Rodríguez-Artalejo, E. García-Esquinas, E. López-García, A.E. Mesas
The Journal of nutrition, health and aging.2023; 27(6): 448. CrossRef

Original Articles

Association between levels of physical activity and low handgrip strength: Korea National Health and Nutrition Examination Survey 2014-2019: Hyungsoon Ahn, Hwa Young Choi, Moran Ki; Epidemiol Health. 2022;44:e2022027. Published online February 21, 2022; DOI: https://doi.org/10.4178/epih.e2022027

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Abstract

OBJECTIVES
This study aimed to investigate the association between levels of physical activity (PA) and low handgrip strength in Korean adults.

METHODS

Our cross-sectional study design included 24,109 Korean adults older than 19 years of age who participated in the Korea National Health and Nutrition Examination Survey 2014–2019. Low handgrip strength is described as hand strength less than the cut-off value of the 20th percentile of handgrip strength from a healthy population in each gender and age group. PA was categorized into three levels (inactive, active, and highly active) according to the World Health Organization’s global recommendations on PA for health. Multivariable logistic regression analysis was used to examine the association between levels of PA and low handgrip strength.

RESULTS

Odds ratios (ORs) for low handgrip strength were significantly higher in middle-aged women who were active (adjusted odds ratio [aOR], 1.40; 95% confidence interval [CI], 1.15 to 1.69) and inactive (aOR, 1.47; 95% CI, 1.23 to 1.76) than in those highly active in walking exercise. Most of older people had significantly higher ORs for low handgrip strength in active compared to highly active in the context of aerobic, muscle strengthening, and walking exercise.

CONCLUSIONS

Walking exercise was associated with a lower risk of sarcopenia in middle-aged women and older individuals. However, further studies are necessary to confirm the causal relationship between levels of PA and low handgrip strength.

Summary

Korean summary
본 연구는 국민건강영양조사 2014-2019년도 자료를 활용하여 한국인 만 19세 이상 건강한 성인을 대상으로 낮은 악력의 기준값을 성별 및 연령그룹별로 도출하고 유산소 운동, 근력 운동, 걷기 운동 수준과 낮은 악력의 연관성을 분석하였다. 분석 결과, 중년 여성과 노년층에서 걷기 운동이 근감소증 발생의 예방과 연관성이 있음을 알 수 있었다.

Key Message
The association between levels of physical activity and low handgrip strength was different by sex and age groups. For women, walking exercise was associated with low handgrip strength, but not for men. By age groups, muscle strengthening exercise could help prevent sarcopenia in the young population, aerobic exercise has the potential to prevent sarcopenia in middle-aged individuals, and walking exercise could reduce sarcopenia risk in older individuals.

Citations

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Examining factors contributing to the socioeconomic inequalities in handgrip strength among older adults in India: a decomposition analysis
Manacy Pai, T. Muhammad
Scientific Reports.2024;[Epub] CrossRef
Relationship between Handgrip Strength and Incident Diabetes in Korean Adults According to Gender: A Population-Based Prospective Cohort Study
Sung-Bum Lee, Min-Kyeung Jo, Ji-Eun Moon, Hui-Jeong Lee, Jong-Koo Kim
Journal of Clinical Medicine.2024; 13(2): 627. CrossRef
Association Between Dietary Fiber Intake and Low Muscle Strength Among Korean Adults
Sunhye Shin
Clinical Nutrition Research.2024; 13(1): 33. CrossRef
Association between composite dietary antioxidant index and handgrip strength in American adults: Data from National Health and Nutrition Examination Survey (NHANES, 2011-2014)
Dongzhe Wu, Hao Wang, Wendi Wang, Chang Qing, Weiqiang Zhang, Xiaolin Gao, Yongjin Shi, Yanbin Li, Zicheng Zheng
Frontiers in Nutrition.2023;[Epub] CrossRef
Assessment of dynapenia and undernutrition in primary care, a systematic screening study in community medicine
Marie Treuil, Meliha Mahmutovic, Paolo Di Patrizio, Phi-Linh Nguyen-Thi, Didier Quilliot
Clinical Nutrition ESPEN.2023; 57: 561. CrossRef
Water Intake and Handgrip Strength in US Adults: A Cross-Sectional Study Based on NHANES 2011–2014 Data
Dongzhe Wu, Chaoyi Qu, Peng Huang, Xue Geng, Jianhong Zhang, Yulin Shen, Zhijian Rao, Jiexiu Zhao
Nutrients.2023; 15(20): 4477. CrossRef
Hand Grip Strength, Osteoporosis, and Quality of Life in Middle-Aged and Older Adults
Hyo Jin Park, Byoungduck Han, So-youn Chang, Seung Ho Kang, Dae Wook Lee, Seok Kang
Medicina.2023; 59(12): 2148. CrossRef
Lower grip strength and insufficient physical activity can increase depressive symptoms among middle-aged and older European adults: a longitudinal study
Han Zheng, Qingwen He, Hongyan Xu, Xiaowei Zheng, Yanfang Gu
BMC Geriatrics.2022;[Epub] CrossRef

Seroprevalence of SARS-CoV-2 antibodies in the community based on participants in the 2020 Korea National Health and Nutrition Examination Survey: Ah-Ra Kim, Dohsik Minn, Su Hwan Kim, Hyeon Nam Do, Byoungguk Kim, Young Sill Choi, Dong-Hyun Kim, Eun-Jee Oh, Kyungwon Oh, Donghyok Kwon, Jun-Wook Kwon, Sung Soon Kim, June-Woo Lee; Epidemiol Health. 2022;44:e2022028. Published online February 21, 2022; DOI: https://doi.org/10.4178/epih.e2022028

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Abstract Summary PDF

Abstract

OBJECTIVES
The Korea National Health and Nutrition Examination Survey (KNHANES) is a nationwide cross-sectional surveillance system that assesses the health and nutritional status of the Korean population. To evaluate the occurrence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the community, we investigated the prevalence of anti-SARS-CoV-2 antibodies in the sera of KNHANES participants.

METHODS

Subjects were recruited between April 24 and December 12, 2020. In total, 5,284 subjects aged 10-90 years from 17 regions participated. SARS-CoV-2 antibodies were screened using the Elecsys Anti-SARS-CoV-2 assay. Positive samples were verified using 4 different SARS-CoV-2 antibody assays and the plaque reduction neutralizing test. The final seropositivity criteria were a positive screening test and at least 1 positive result from the 5 additional tests.

RESULTS

Almost half (49.2%; 2,600/5,284) of participants were from metropolitan areas, 48.9% were middle-aged (40-69 years), and 20.5% were in their 20s or younger. The seropositivity rate was 0.09% (5/5,284). Three of the 5 antibody-positive subjects had a history of infection, of whom 2 were infected abroad and 1 was infected in a local cluster outbreak.

CONCLUSIONS

The low SARS-CoV-2 antibody seroprevalence in Korea indicates that there have been few coronavirus disease 2019 (COVID-19) cases due to successful COVID-19 management measures (e.g., diagnostic tests for overseas arrivals, national social distancing, and strict quarantine measures). Moreover, asymptomatic infections were uncommon due to active polymerase chain reaction testing. However, hidden infections may exist in the community, requiring the continuation of quarantine and vaccination measures.

Summary

Korean summary
코로나19에 대한 방역대책 및 예방접종 정책 수립을 위한 과학적 근거를 확보하기 위하여 2020년도 국민건강영양조사(이하 국건영) 참여자 5,284명에 대해 코로나19 항체보유율을 조사함. 그 결과 2020년도 국건영 참여자의 항체양성률은 0.09%(5/5,284)였으며, 이중 확진 이력이 있는 사람은 3명이었음. 따라서 지역사회 미진단 감염자는 2명으로 확인됨. 국내 항체보유율은 해외 사례에 비해 낮으며, 이는 적극적인 방역관리에 따른 것으로 사료되며, 지역사회에 미진단 감염자가 존재함이 확인되어 이들에 대한 철저한 관리가 요구됨.

Key Message
The low SARS-CoV-2 antibody seroprevalence in Korea indicates that there have been few COVID-19 cases due to successful management measures, however, hidden infections may exist in the community, requiring the continuation of quarantine and vaccination measures.

Citations

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Protective effect of vaccination on the risk of cardiovascular disease after SARS-CoV-2 infection
Jihun Song, Seulggie Choi, Seogsong Jeong, Joo young Chang, Sun Jae Park, Yun Hwan Oh, Ji Soo Kim, Yoosun Cho, Kyeonghyang Byeon, Jun Yong Choi, Seju Lee, Sang Min Park
Clinical Research in Cardiology.2024; 113(2): 235. CrossRef
Realistic Estimation of COVID-19 Infection by Seroprevalence Surveillance of SARS-CoV-2 Antibodies: An Experience From Korea Metropolitan Area From January to May 2022
In Hwa Jeong, Jong-Hun Kim, Min-Jung Kwon, Jayoung Kim, Hee Jin Huh, Byoungguk Kim, Junewoo Lee, Jeong-hyun Nam, Eun-Suk Kang
Journal of Korean Medical Science.2024;[Epub] CrossRef
Accelerated Cognitive Function Decline in Community-Dwelling Older Adults during COVID-19 Pandemic: The Korean Frailty and Aging Cohort Study (KFACS)
Jaehoon Jung, Sunyoung Kim, Byungsung Kim, Miji Kim, Jisoo Yang, Dongmin Chung, Changwon Won
International Journal of Environmental Research and Public Health.2022; 19(17): 10666. CrossRef
Seroprevalence of SARS-CoV-2 antibodies during the third wave of COVID-19 in the Seoul metropolitan area of Korea
Kyuhyun Yoon, Jayeun Kim, Kyong Ran Peck, Hyun Soo Kim, Hyukmin Lee, Yoo-Sung Hwang, Soon Young Lee, Sung-il Cho, Hun Jae Lee, Yeong-gyeong Kim, Byoungguk Kim, June-Woo Lee, Ah-Ra Kim, Hyeon Nam Do, Dong-Hyun Kim
Epidemiology and Health.2022; 44: e2022085. CrossRef

Recent trends in opioid prescriptions in Korea from 2002 to 2015 based on the Korean NHIS-NSC cohort: Joungyoun Kim, Sang-Jun Shin, Jihyun Yoon, Hyeong-Seop Kim, Jae-woo Lee, Ye-seul Kim, Yonghwan Kim, Hyo-Sun You, Hee-Taik Kang; Epidemiol Health. 2022;44:e2022029. Published online February 21, 2022; DOI: https://doi.org/10.4178/epih.e2022029

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Opioids are prescribed to treat moderate to severe pain. We investigated recent trends in opioid (morphine, oxycodone, fentanyl, and hydromorphone) prescriptions using data from the Korean National Health Insurance Service-National Sample Cohort between 2002 and 2015.

METHODS

The morphine milligram equivalent (MME) was calculated to standardize the relative potency of opioids. The number (cases) or amount (MME) of annual opioid prescriptions per 10,000 registrants was computed to analyze trends in opioid prescriptions after age standardization. Joinpoint regression analysis was conducted to calculate the annual percentage change and average annual percentage change (AAPC).

RESULTS

The number (cases) of prescriptions per 10,000 registrants increased from 0.07 in 2002 to 41.23 in 2015 (AAPC, 76.0%; 95% confidence interval [CI], 61.6 to 91.7). The MME per 10,000 registrants increased from 15.06 in 2002 to 40,727.80 in 2015 (AAPC, 103.0%; 95% CI, 78.2 to 131.3). The highest AAPC of prescriptions and MME per 10,000 registrants were observed in the elderly (60-69 years) and in patients treated at general hospitals. Fentanyl prescriptions increased most rapidly among the 4 opioids.

CONCLUSIONS

Consumption of opioids greatly increased in Korea over the 14-year study period.

Summary

Korean summary
- 중강도 이상의 통증을 치료하기위해 아편유사체가 처방되고 있다. - 본 연구는 아편유사체(모르핀, 옥시코돈, 펜타닐, 히드로모르폰)의 처방 추세를 조인포인트 회귀분석으로 분석하였다. - 아편유사체의 사용은 증가하고 있다. 특히 노인과 종합병원에서 아편유사체의 처방은 지속적으로 증가하고 있으며, 펜타닐 처방이 제일 많이 증가하였다.

Key Message
- Opioid prescriptions (morphine, oxycodone, fentanyl, and hydromorphone) fentanyl to treat moderate to severe pain have increased. - Trends in opioid prescriptions were analyzed using Joinpoint regression analysis after age standardization, based on the Korean National Health Insurance Service-National Sample Cohort between 2002 and 2015. - Trends in opioid prescriptions have increased. - In particular, the highest increment in opioid prescription was observed in the elderly population (60-69 years) and patients admitted in general hospitals. - Fentanyl prescriptions among four types of opioids increased most rapidly.

Citations

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Current status of opioid prescription in South Korea using narcotics information management system
Soo-Hyuk Yoon, Jeongsoo Kim, Susie Yoon, Ho-Jin Lee
The Korean Journal of Pain.2024; 37(1): 41. CrossRef
Opioid Prescription and Long-Term Survival Outcomes in Adults: A Nationwide Cohort Study in Korea
Tak Kyu Oh, In-Ae Song
Journal of Korean Medical Science.2024;[Epub] CrossRef
Opioid Prescription and Long-term Survival Outcomes in Adults: A Nationwide Cohort Study in Korea
Tak Kyu Oh, In-Ae Song
Journal of Korean Medical Science.2024;[Epub] CrossRef
Expert Opinion Survey on Proposals for Safety Management of Prescription Opioids
Seunghyun Cheon, Seo-Yong Choi, Sang-Hyeon Oh, Myoungon Eun, Jungbo Kim, Songhee Park, Soyoung Park, Ryang Soon Im, Su Bin Lee, Hye Won Han, Jungwha Lee, Hyun-A Sohn, Younghee Lee, Sook Hee An, Jee-Eun Chung
Journal of Korean Society of Health-System Pharmacists.2023; 40(3): 326. CrossRef
Prevention, diagnosis, and treatment of opioid use disorder under the supervision of opioid stewardship programs: it’s time to act now
Eun-Ji Kim, Eun-Jung Hwang, Yeong-Min Yoo, Kyung-Hoon Kim
The Korean Journal of Pain.2022; 35(4): 361. CrossRef
Economic burden of opioid misuse focused on direct medical costs
Miryoung Kim, Siin Kim, Hae Sun Suh
Frontiers in Pharmacology.2022;[Epub] CrossRef

Association between dietary and suicidal behaviors in adolescents in Korea based on the Youth Risk Behavior Survey (2015-2020): Youngrong Lee, Ye Jin Jeon, Jee-Seon Shim, Sun Jae Jung; Epidemiol Health. 2022;44:e2022033. Published online March 12, 2022; DOI: https://doi.org/10.4178/epih.e2022033

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
This study explored the association between dietary and suicidal behaviors of Korean adolescents and investigated differences in this association in children of immigrant parents.

METHODS

The sample (n=368,138) was collected from the Korea Youth Risk Behavior Survey from 2015 to 2020. Participants who agreed to provide family information (n=313,689) were classified according to their parents’ nationality. The study variables were 11 self-reported dietary behaviors, and their composite dietary behaviors (i.e., nutrient deprivation and unhealthy food consumption) that resulted from principal component analysis. The association between study variables and suicide-related outcomes (i.e., suicidal ideation, suicide planning, and suicide attempts) was analyzed by multiple logistic regression with adjustment for covariates. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were calculated.

RESULTS

Participants who skipped key meals and foods were more likely to have attemped suicide (aOR [95% CI]: skipping breakfast ≥5 days/wk, 1.28 [1.21 to 1.35]; consuming fruits <1 times/wk: 1.42 [1.32 to 1.52]; consuming vegetables <1 times/wk: 1.72 [1.53 to 1.93]; consuming milk <3 times/wk: 1.07 [0.99 to 1.16]). The associations were prominent in third culture kids (TCKs) (aOR [95% CI]: 2.23 [1.61 to 3.09]; 2.32 [1.61 to 3.35]; 2.63 [1.50 to 4.60]; 1.69 [1.09 to 2.63], respectively). Participants who consumed unhealthy foods (fast food, caffeinated and sugary drinks) more frequently were more likely to have attempted suicide (aOR, 1.55; 95% CI, 1.38 to 1.73). This association was also more prominent in TCKs (aOR, 2.08; 95% CI, 1.08 to 4.01).

CONCLUSIONS

Our findings indicate a positive association between unfavorable dietary behaviors and outcomes related to suicide, and this association appears to be notable in adolescents with immigrant parents.

Summary

Korean summary
• 한국 청소년의 식이 행동과 자살 행동 사이의 연관성과 한국인 부모와 이민자 부모 자녀에서 위의 연관성 차이를 조사하였다. • 청소년의 결식 빈도 증가, 과일, 야채, 우유 섭취 감소는 자살 행동과 유의한 연관성이 있었으며 이민자 부모를 둔 청소년에서 연관성의 크기가 더 컸다. • 패스트푸드, 카페인, 가당 음료, 인스턴트 음식을 더 자주 섭취하는 청소년은 자살을 시도할 가능성이 더 높았으며 이민자 부모를 둔 청소년에서 더 큰 연관성을 보였다.

Key Message
The study found positive associations between undesirable dietary behaviors (e.g., skipping breakfast, increased consumption of fast food or instant food product) and outcomes related to suicide (i.e., suicide ideation, planning, and attempt) in Korean adolescents, and these associations appear to be prominent in adolescents with immigrant parents than those with Korean parents.

Citations

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Trends in health behaviors and mental health among Korean adolescents in Korea over 5 years, 2017–2021: focusing on the comparisons before and during the COVID-19 pandemic
Mi-Sun Lee, Dong Jun Kim, Hooyeon Lee
Frontiers in Public Health.2023;[Epub] CrossRef
Association between body shape misperception and unhealthy eating behaviors among Korean adolescents
Yejin Kim, Bomgyeol Kim, Vasuki Rajaguru, Sang Gyu Lee, Tae Hyun Kim
Nutrition Research and Practice.2023; 17(6): 1143. CrossRef

Model-based cost-effectiveness analysis of oral antivirals against SARS-CoV-2 in Korea: Youngji Jo, Sun Bean Kim, Munkhzul Radnaabaatar, Kyungmin Huh, Jin-Hong Yoo, Kyong Ran Peck, Hojun Park, Jaehun Jung; Epidemiol Health. 2022;44:e2022034. Published online March 12, 2022; DOI: https://doi.org/10.4178/epih.e2022034

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Many countries have authorized the emergency use of oral antiviral agents for patients with mild-to-moderate cases of coronavirus disease 2019 (COVID-19). We assessed the cost-effectiveness of these agents for reducing the number of severe COVID-19 cases and the burden on Korea’s medical system.

METHODS

Using an existing model, we estimated the number of people who would require hospital/intensive care unit (ICU) admission in Korea in 2022. The treatment scenarios included (1) all adult patients, (2) elderly patients only, and (3) adult patients with underlying diseases only, compared to standard care. Based on the current health system capacity, we calculated the incremental costs per severe case averted and hospital admission for each scenario.

RESULTS

We estimated that 236,510 COVID-19 patients would require hospital/ICU admission in 2022 with standard care only. Nirmatrelvir/ritonavir (87% efficacy) was predicted to reduce this number by 80%, 24%, and 17% when targeting all adults, adults with underlying diseases, and elderly patients (25, 8, and 4%, respectively, for molnupiravir, with 30% efficacy). Nirmatrelvir/ritonavir use is likely to be cost-effective, with predicted costs of US$8,878, US$8,964, and US$1,454, per severe patient averted for the target groups listed above, respectively, while molnupiravir is likely to be less cost-effective, with costs of US$28,492, US$29,575, and US$7,915, respectively.

CONCLUSIONS

In Korea, oral treatment using nirmatrelvir/ritonavir for symptomatic COVID-19 patients targeting elderly patients would be highly cost-effective and would substantially reduce the demand for hospital admission to below the capacity of the health system if targeted to all adult patients instead of standard care.

Summary

Korean summary
본 연구는 감염병 수리모형을 바탕으로 두가지 항바이러스제의 (nirmatrelvir/ritonavir와 molnupiravir) 비용 효익을 평가하였다. 본 모델에 따르면, 2022년 한국에서, 현재 의료시스템의 수용한계를 넘는 코로나 19 대유행이 발생할 때, nirmatrelvir/ritonavir 를 코로나 감염 및 증상 있는 고령층 환자들을 대상으로 투여할 경우 높은 비용 효익이 기대되고 (중증환자 1명 감소효과에$1,454 비용소요), 성인 환자 대상으로 투여할 경우, (molnupiravir이나 nirmatrelvir/ritonavir를 투여하지 않는) 일반 치료에 비해서 전체 입원 수요를 80% 줄일 것으로 기대된다.

Key Message
Given an expected high epidemic resurgence in 2022 that could exceed South Korea’s current health system capacity, oral treatment using nirmatrelvir/ritonavir for symptomatic COVID-19 patients may be a highly cost-effective solution if targeted to elderly patients ($1,454 per severe case averted) and substantially reduce the demand for hospital admission (80%, 188,478 patients) below the capacity of the health system if targeted to all adult patients compared to standard care.

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Cost-Utility Model of Nirmatrelvir/Ritonavir in Brazil: Analysis of a Vaccinated Population
Ricardo R.A. Fernandes, Bruno M. Barros, Milene R. da Costa, Carlos A.S. Magliano, Bernardo R. Tura, Quenia Cristina D. Morais, Marisa Santos
Value in Health Regional Issues.2024; 40: 74. CrossRef
Cost-effectiveness of nirmatrelvir/ritonavir for high-risk adult outpatients with COVID-19 in Japan
Takahito Mizuno, Yu Kondo, Mikiyasu Sakai, Kenichi Saneyasu, Ryota Kojima, Yoshio Miyake
Journal of Infection and Chemotherapy.2024;[Epub] CrossRef
Impact of the Use of Oral Antiviral Agents on the Risk of Hospitalization in Community Coronavirus Disease 2019 Patients (COVID-19)
Terry Cheuk-Fung Yip, Grace Chung-Yan Lui, Mandy Sze-Man Lai, Vincent Wai-Sun Wong, Yee-Kit Tse, Bosco Hon-Ming Ma, Elsie Hui, Maria K W Leung, Henry Lik-Yuen Chan, David Shu-Cheong Hui, Grace Lai-Hung Wong
Clinical Infectious Diseases.2023; 76(3): e26. CrossRef
Nirmatrelvir plus ritonavir in COVID-19: a profile of its use
Hannah A. Blair
Drugs & Therapy Perspectives.2023; 39(2): 41. CrossRef
Cost-effectiveness analysis of ritonavir boosted nirmatrelvir for adult outpatients with mild to moderate COVID-19 in a European health system
Philip Wikman-Jorgensen, José María Ibarra, Carlos Devesa, Jorge Peris, Jara Llenas-García
European Journal of Internal Medicine.2023; 118: 133. CrossRef
Assessing the cost-effectiveness of annual COVID-19 booster vaccination in South Korea using a transmission dynamic model
Wongyeong Choi, Eunha Shim
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Multi-Faceted Analysis of COVID-19 Epidemic in Korea Considering Omicron Variant: Mathematical Modeling-Based Study
Youngsuk Ko, Victoria May Mendoza, Renier Mendoza, Yubin Seo, Jacob Lee, Jonggul Lee, Donghyok Kwon, Eunok Jung
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Adjusting non-pharmaceutical interventions based on hospital bed capacity using a multi-operator differential evolution
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Jaehyun Jeon, BumSik Chin
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COVID-19: Brief Communication

Dynamics of hospitalizations and in-hospital deaths from COVID-19 in northeast Brazil: a retrospective analysis based on the circulation of SARS-CoV-2 variants and vaccination coverage: Paulo Ricardo Martins-Filho, Adriano Antunes de Souza Araújo, Lucindo José Quintans-Júnior, Bárbara dos Santos Soares, Waneska de Souza Barboza, Taise Ferreira Cavalcante, Victor Santana Santos; Epidemiol Health. 2022;44:e2022036. Published online April 5, 2022; DOI: https://doi.org/10.4178/epih.e2022036

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Abstract Summary PDF

Abstract

This study investigated the dynamics of hospitalizations and in-hospital deaths from coronavirus disease 2019 (COVID-19) throughout the pandemic in northeast Brazil, the Brazilian region with the worst socioeconomic indicators. In total, 141,445 cases, 8,213 hospital admissions, and 1,644 in-hospital deaths from COVID-19 were registered from March 14, 2020 to February 5, 2022. The overall rates of hospitalization and in-hospital deaths were 5.8% and 20.0%, respectively. The hospitalization and death rates significantly decreased over time, which may have been related to progress in vaccination. During the spread of the Gamma variant (January to June 2021), most hospitalized individuals were young adults, and approximately 40% of deaths occurred in this age group. During the predominance of Delta (July to December 2021), over 75% of deaths occurred among the elderly and unvaccinated or partially vaccinated individuals. This rate decreased to 42.3% during the transmission of the Omicron variant (January to February 2022), during which 34.6% of deaths were recorded among fully vaccinated individuals (2 doses) and 23.1% among those who received full vaccination and a booster. The Omicron-driven third wave was associated with a rise in the proportion of deaths among vaccinated individuals, especially among those who had not received a booster dose.

Summary

Key Message
The Omicron-driven third wave in Brazil was associated with a rise in the proportion of deaths among vaccinated individuals, especially among those who had not received a booster dose

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Diego Gomes Teixeira, João Firmino Rodrigues-Neto, Dayse Caroline Severiano da Cunha, Selma Maria Bezerra Jeronimo
Infection, Genetics and Evolution.2024; 118: 105556. CrossRef
Case-fatality rates and risk of death from COVID-19 and influenza A/H3N2 in Brazil: A nationwide ecological study
Paulo Ricardo Martins-Filho, Jerocílio Maciel de Oliveira Júnior, Cliomar Alves dos Santos
Enfermedades Infecciosas y Microbiología Clínica.2023; 41(3): 199. CrossRef
SARS-CoV-2 infection and mortality in pediatric patients with hematological malignancies and solid tumors
João Eduardo Andrade Tavares de Aguiar, Marcos Antônio Lima Carvalho, Simone Santana Viana, Paulo Ricardo Martins-Filho, Rosana Cipolotti
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Pediatric Infectious Disease Journal.2023; 42(2): 136. CrossRef
Case-fatality rates and risk of death from COVID-19 and influenza A/H3N2 in Brazil: A nationwide ecological study
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Paulo Ricardo Martins-Filho, Joyce Thayane da Conceição dos Santos, Márcia Santos Rezende, Fernanda Oliveira de Carvalho, Érica Santos dos Reis, Waneska de Souza Barboza, Taise Ferreira Cavalcante, Cliomar Alves dos Santos, Lucindo José Quintans-Júnior,
Epidemiology and Health.2023; 45: e2023025. CrossRef
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Taimoor Ahmad, Mujahid Abdullah, Abdul Mueed, Faisal Sultan, Ayesha Khan, Adnan Ahmad Khan, Huzaifa Ahmad Cheema
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Epidemiology and Health.2023; 45: e2023079. CrossRef

Cohort Profile

The Asenze Cohort Study in KwaZulu-Natal, South Africa: protocol and cohort profile: Chris Desmond, Gabriella A. Norwitz, Jane D. Kvalsvig, Rachel S. Gruver, Shuaib Kauchali, Kathryn G. Watt, Nonhlanhla P. Myeza, Adele Munsami, Leslie L. Davidson; Epidemiol Health. 2022;44:e2022037. Published online April 5, 2022; DOI: https://doi.org/10.4178/epih.e2022037

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Abstract Summary PDF

Abstract

The Asenze cohort is set in South Africa, a middle-income country impacted by one of the highest global rates of people living with HIV/AIDS and high levels of socioeconomic inequality. This longitudinal population-based cohort of children and their primary caregivers assesses household and caregiver functioning, child health, social well-being, and neuro-development from childhood through adolescence. Almost 1,600 children born at the peak of the human immunodeficiency virus epidemic (2003-2005) were followed (with their primary caregivers) in 3 waves, between 2008 and 2021, at average ages of 5, 7, and 16. Wave 3 is currently underway, having assessed over 1,100 of the original wave 1 children. Wave 4 begins in 2022. The study, with a dyadic structure, uses a broad range of measures, validated in South Africa or recommended for global use, that address physical, social and neuro-development in childhood and adolescence, and the social, health, and psychological status of children’s primary caregivers. The Asenze study deepens our understanding of childhood physical, cognitive, and social abilities and/or disabilities, including risk-taking behaviors, and biological, environmental, and social determinants of health. We anticipate the findings will contribute to the development of community-informed interventions to promote well-being in this South African population and elsewhere.

Summary

Key Message
The Asenze Cohort Study, one of a limited number of population-based studies set in low- and middle-income countries, with a high level of retention, provides an understanding of neuro-developmental, psychosocial, home environmental and economic exposures and outcomes of over 1100 adolescents and their primary caregivers in KwaZulu-Natal, South Africa.

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The impact of caregiver mental health on child prosocial behavior: A longitudinal analysis of children and caregivers in KwaZulu-Natal, South Africa
Gabriella A. Norwitz, Chris Desmond, Rachel S. Gruver, Jane D. Kvalsvig, Amaleah F. Mirti, Shuaib Kauchali, Leslie L. Davidson, Giulia Ballarotto
PLOS ONE.2023; 18(10): e0290788. CrossRef

Brief Communication

Occupational inequalities in mortality in Korea: an analysis using nationally representative mortality follow-up data from the late 2000s and after: Eunjeong Noh, Young-Ho Khang; Epidemiol Health. 2022;44:e2022038. Published online April 6, 2022; DOI: https://doi.org/10.4178/epih.e2022038

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Abstract Summary PDF Supplementary Material

Abstract

Many Korean and international studies have found higher mortality rates and poorer health conditions among manual workers than among non-manual workers. However, a recent study using unlinked data argued that since the economic crisis in Korea in the late 2000s, the mortality estimates of male Korean non-manual workers have been higher than those of manual workers. Our work using individually linked data from the late 2000s and after aimed to examine mortality inequality by occupational class. We analyzed Korea National Health and Nutrition Examination Survey data that were individually linked to cause-of-death data. Cox regression analysis was used to identify the hazard ratios for mortality by occupational class. Of 11,766 males aged between 35 and 64, 397 died between 2007 and 2018: 142 died from cancer, 68 from cardiovascular disease, 88 from external causes, and 99 from other causes. After controlling for age, the mortality estimates for manual workers were 1.85 times higher than those for upper non-manual workers (p<0.05). We observed no evidence of reversed mortality inequality among occupational classes in Korea since the 2000s; this previously reported finding might have been due to numerator-denominator bias arising from the use of unlinked data.

Summary

Korean summary
개인 단위 연계자료가 아닌 분모(센서스)-분자(사망신고) 집합 자료를 사용하여 2000년대 후반 경제위기 이후 한국 남성 비육체직의 사망률이 육체직보다 높게 나타난다고 기존의 한 연구가 주장했다. 이 연구는 2000년대 이후 개인 단위로 연계된 코호트 자료를 활용하여 여전히 한국에서 육체직의 사망위험이 비육체직보다 높다는 점을 보임으로써, 기존 연구가 비연계자료의 사용으로 인한 분자-분모 바이어스(numerator-denominator bias) 때문에 그와 같은 결과를 보였다고 지적하였다.

Key Message
This paper using individually linked data from the late 2000s and after observed no evidence of reversed mortality inequality among occupational classes in Korea since the 2000s. The previously reported finding showing reversed occupational mortality inequality might have been due to numerator-denominator bias arising from the use of unlinked data.

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Mortality of Suicide and Cerebro-Cardiovascular Diseases by Occupation in Korea, 1997–2020
Jungwon Jang, Inah Kim
International Journal of Environmental Research and Public Health.2022; 19(16): 10001. CrossRef

Original Articles

The association between fruit and vegetable consumption and metabolic syndrome in Korean adults: does multivitamin use matter?: Jihae Kim, Li-Juan Tan, Hyein Jung, Yumi Roh, Kyungjoon Lim, Sangah Shin; Epidemiol Health. 2022;44:e2022039. Published online April 19, 2022; DOI: https://doi.org/10.4178/epih.e2022039

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Metabolic syndrome (MetS) is closely associated with dietary intake; however, few studies have investigated whether the consumption of fruits and vegetables and multivitamin use affect MetS in the Korean population. This study aimed to examine these effects in Korean adults.

METHODS

This was a cross-sectional study of 89,548 participants aged between 40 years and 69 years selected from the baseline data of the Health Examinees study conducted in Korea. Fresh vegetable and fruit consumption was assessed using a validated 106-item food frequency questionnaire. MetS and its components were defined using the National Cholesterol Education Program, Adult Treatment Panel III criteria. Multivariate logistic regression analyses were conducted to identify associations of fresh vegetable, fruit, and fresh vegetable+fruit consumption and multivitamin use with the prevalence of MetS.

RESULTS

Female in the highest quartile of fresh vegetable, fruit, and fresh vegetable + fruit consumption exhibited a lower prevalence of MetS than those in the lowest quartile. An inverse association with the prevalence of MetS was observed among male with only fresh vegetable consumption. The interaction between the 3 categories and multivitamin intake on the prevalence of MetS was not significant (all pinteraction>0.05), regardless of sex.

CONCLUSIONS

Multivitamin use and consumption of fresh vegetables and fruits had no significant synergistic effects. Although fresh vegetable and fruit consumption showed an inverse association with the prevalence of MetS, this relationship was not altered by multivitamin use.

Summary

Korean summary
본 연구는 한국인 유전체역학조사사업의 도시코호트 조사에 참여한 40-69세 한국 성인 89 548명의 과일과 채소의 섭취와 종합비타민 섭취가 대사증후군에 미치는 영향을 분석하였다. 본 연구에서는 매일 다양한 과일과 채소를 섭취하면, 종합비타민의 섭취와 상관없이 대사증후군 유병 위험도를 낮추는 것을 확인하였다. 따라서, 대사증후군 예방을 위해서는 일상적인 식사에서 충분한 과일과 채소를 섭취하는 것이 권장된다.

Key Message
This study aimed to examine whether the consumption of fruits and vegetables and multivitamin use affect MetS among Korean middle-aged adults. Data was from the Health Examinees Study among 89 548 subjects. Results suggested that fruits and vegetables consumption was related with a decreased prevalence of MetS. However, there was no significant synergistic effect between the consumption of fruits and vegetables and multivitamin use in further reducing MetS prevalence.

Citations

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Association of serum water-soluble vitamin exposures with the risk of metabolic syndrome: results from NHANES 2003-2006
Xun Pei, Junjie Yao, Simiao Ran, Haifei Lu, Shuo Yang, Yini Zhang, Miyuan Wang, Heyuan Shi, Aihua Tan
Frontiers in Endocrinology.2023;[Epub] CrossRef

The association of pancreatic cancer incidence with smoking status and smoking amount in Korean men: Do Jin Nam, Chang-Mo Oh, Eunhee Ha, Min-Ho Kim, Eun Hye Yang, Hyo Choon Lee, Soon Su Shin, Woo Yeon Hwang, Ann Hee You, Jae-Hong Ryoo; Epidemiol Health. 2022;44:e2022040. Published online April 21, 2022; DOI: https://doi.org/10.4178/epih.e2022040

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Our study examined the dose-response relationship between smoking amounts (pack-years) and the risk of developing pancreatic cancer in Korean men.

METHODS

Of 125,743 participants who underwent medical health checkups in 2009, 121,408 were included in the final analysis and observed for the development of pancreatic cancer. We evaluated the associations between smoking amounts and incident pancreatic cancer in 4 groups classified by pack-year amounts. Cox proportional hazards models were used to estimate the adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of incident pancreatic cancer by comparing groups 2 (<20 pack-year smokers), 3 (20-≤40 pack-year smokers), and 4 (>40 pack-year smokers) with group 1 (never smokers).

RESULTS

During 527,974.5 person-years of follow-up, 245 incident cases of pancreatic cancer developed between 2009 and 2013. The multivariate-adjusted HRs (95% CIs) for incident pancreatic cancer in groups 2, 3, and 4 were 1.05 (0.76 to 1.45), 1.28 (0.91 to 1.80), and 1.57 (1.00 to 2.46), respectively (p for trend=0.025). The HR (95% CI) of former smokers showed a dose-response relationship in the unadjusted model, but did not show a statistically significant association in the multivariate-adjusted model. The HR (95% CI) of current smokers showed a dose-response relationship in both the unadjusted (p for trend=0.020) and multivariate-adjusted models (p for trend=0.050).

CONCLUSIONS

The risk of developing pancreatic cancer was higher in current smokers status than in former smokers among Korean men, indicating that smoking cessation may have a protective effect.

Summary

Korean summary
본 연구에서는 대한민국 남성을 대상으로 흡연양 및 흡연상태에 따른 췌장암 발병을 분석하였다. 흡연양이 많을수록, 현재 흡연상태일수록 췌장암 발병이 높았고, 금연한 경우 췌장암의 발병이 낮은 것을 확인할 수 있었다.

Key Message
As a result of analyzing the incidence of pancreatic cancer according to the amount of smoking and smoking status among Korean men, it was confirmed that the more smoked and the current smoking status, the higher the incidence of pancreatic cancer, and the lower the incidence of pancreatic cancer when quitting smoking.

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Associations between smoking status and infertility: a cross-sectional analysis among USA women aged 18-45 years
Sijie He, Li Wan
Frontiers in Endocrinology.2023;[Epub] CrossRef
Modifiable Pancreatic Ductal Adenocarcinoma (PDAC) Risk Factors
Natalia Michalak, Ewa Małecka-Wojciesko
Journal of Clinical Medicine.2023; 12(13): 4318. CrossRef
Childhood and adulthood passive and active smoking, and the ABO group as risk factors for pancreatic cancer in women
Anne‐Laure Vedie, Nasser Laouali, Amandine Gelot, Gianluca Severi, Marie‐Christine Boutron‐Ruault, Vinciane Rebours
United European Gastroenterology Journal.2023;[Epub] CrossRef

The impact of COVID-19 on cancer care in a tertiary hospital in Korea: possible collateral damage to emergency care: Shin Hye Yoo, Jin-Ah Sim, Jeongmi Shin, Bhumsuk Keam, Jun-Bean Park, Aesun Shin; Epidemiol Health. 2022;44:e2022044. Published online May 1, 2022; DOI: https://doi.org/10.4178/epih.e2022044

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
We investigated the impact of the COVID-19 pandemic on cancer care in a tertiary hospital in Korea without specific lockdown measures.

METHODS

A retrospective cohort of cancer patients from one of the largest tertiary hospitals in Korea was used to compare healthcare utilization in different settings (outpatient cancer clinic, the emergency department [ED], and admissions to the hematology/oncology ward) between January 1 and December 31, 2020 and the same time period in 2019. The percent changes in healthcare utilization between the 2 periods were calculated.

RESULTS

A total of 448,833 cases from the outpatient cohort, 26,781 cases from the ED cohort, and 14,513 cases from the admission cohort were reviewed for 2019 and 2020. The total number of ED visit cases significantly decreased from 2019 to 2020 by 18.04%, whereas the proportion of cancer patients remained stable. The reduction in ED visits was more prominent in patients with symptoms suspicious for COVID-19, high-acuity cases, and those who lived in non-capital city areas. There were no significant changes in the number of total visits, new cases in the outpatient clinic, or the total number of hospitalizations between the 2 periods.

CONCLUSIONS

During the pandemic, the number of ED visits significantly decreased, while the use of the outpatient clinic and hospitalizations were not affected. Cancer patients’ ED visits decreased after the COVID-19 outbreak, suggesting the potential for collateral damage outside the hospital if patients cannot reach the ED in a timely manner.

Summary

Korean summary
코로나19 이전인 2019년에 비해 코로나19 유행 첫 해인 2020년에 암환자의 1개 상급종합병원 응급실 방문이 유의하게 감소하였고, 특히 코로나19 의심 증상이 있거나, 중증도가 높거나, 비수도권 지역에 거주하는 환자에서 응급실 방문의 감소가 뚜렷하였다. 코로나19 이전과 코로나19 유행 시 외래 방문 암환자의 수, 신환 수는 큰 차이가 없었고, 입원한 암환자의 수 역시 유의한 차이가 없었다. 코로나19 대유행 시 암환자의 응급실 방문 감소는 병원 밖에서 적시에 응급실에 방문하지 못하는 부수적 피해의 가능성을 시사하여, 이에 대한 관심이 필요하다.

Key Message
The study identified a significant decrease in the emergency department visits of the cancer patients at a tertiary hospital in Korea during the COVID-19 pandemic. There were no significant changes in the number of total visits, new cases in the outpatient clinic, or the total number of hospitalizations between pre-COVID-19 and during-COVID-19 periods.

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Government Initiatives for Research Ethics During COVID-19 Pandemic in Korea
Young Su Park, Ock-Joo Kim
Journal of Korean Medical Science.2024;[Epub] CrossRef
Impact of coronavirus disease 2019 on cancer care: How the pandemic has changed cancer utilization and expenditures
Jinah Sim, Jihye Shin, Hyun Jeong Lee, Yeonseung Lee, Young Ae Kim, Chong-Chi Chiu
PLOS ONE.2024; 19(2): e0296808. CrossRef
Changes in the Utilization of Health Care Services by Cancer Patients during the COVID-19 Pandemic
Seung Hee Seo, Sooyoung Cho, Shin Hye Yoo, Bhumsuk Keam, Aesun Shin
Yonsei Medical Journal.2023; 64(7): 463. CrossRef
COVID-19 Outbreak in Daegu City, Korea and Response to COVID-19: How Have We Dealt and What Are the Lessons?
Shin-Woo Kim
Journal of Korean Medical Science.2022;[Epub] CrossRef

Spatial analysis of tuberculosis treatment outcomes in Shanghai: implications for tuberculosis control: Jing Zhang, Xin Shen, Chongguang Yang, Yue Chen, Juntao Guo, Decheng Wang, Jun Zhang, Henry Lynn, Yi Hu, Qichao Pan, Zhijie Zhang; Epidemiol Health. 2022;44:e2022045. Published online May 1, 2022; DOI: https://doi.org/10.4178/epih.e2022045

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
Tuberculosis (TB) treatment outcomes are a key indicator in the assessment of TB control programs. We aimed to identify spatial factors associated with TB treatment outcomes, and to provide additional insights into TB control from a geographical perspective.
METHODS
We collected data from the electronic TB surveillance system in Shanghai, China and included pulmonary TB patients registered from January 1, 2009 to December 31, 2016. We examined the associations of physical accessibility to hospitals, an autoregression term, and random hospital effects with treatment outcomes in logistic regression models after adjusting for demographic, clinical, and treatment factors.
RESULTS
Of the 53,475 pulmonary TB patients, 49,002 (91.6%) had successful treatment outcomes. The success rate increased from 89.3% in 2009 to 94.4% in 2016. The successful treatment outcome rate varied among hospitals from 78.6% to 97.8%, and there were 12 spatial clusters of poor treatment outcomes during the 8-year study period. The best-fit model incorporated spatial factors. Both the random hospital effects and autoregression terms had significant impacts on TB treatment outcomes, ranking 6th and 10th, respectively, in terms of statistical importance among 14 factors. The number of bus stations around the home was the least important variable in the model.
CONCLUSIONS
Spatial autocorrelation and hospital effects were associated with TB treatment outcomes in Shanghai. In highly-integrated cities like Shanghai, physical accessibility was not related to treatment outcomes. Governments need to pay more attention to the mobility of patients and different success rates of treatment among hospitals.; Summary

Key Message
Tuberculosis treatment outcomes, a key indicator in the assessment of TB control programs, were associated with spatial autocorrelation and hospital effects in Shanghai; however, they were not associated with physical accessibility to hospitals.

Changes in cancer screening before and during COVID‐19: findings from the Korean National Cancer Screening Survey 2019 and 2020: Thao Thi Kim Trinh, Yun Yeong Lee, Mina Suh, Jae Kwan Jun, Kui Son Choi; Epidemiol Health. 2022;44:e2022051. Published online May 30, 2022; DOI: https://doi.org/10.4178/epih.e2022051

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
The coronavirus disease 2019 (COVID-19) pandemic has negatively affected every aspect of medical care. However, information regarding the impact of the pandemic on cancer screening is lacking. This study aimed to explore cancer screening changes by geographic region before and during the pandemic in Korea.

METHODS

Korean National Cancer Screening Survey data for 2019 and 2020 were used. Changes in the screening rate before and during the COVID-19 pandemic were calculated by subtracting the rate in 2020 from the rate in 2019. Multivariate logistic regression analyses examined the differences in screening rates at the national and 16 provincial levels before and after the COVID-19 outbreak.

RESULTS

The 1-year screening rates for the four types of cancer decreased during the pandemic (stomach cancer: -5.1, colorectal cancer: -3.8, breast cancer: -2.5, cervical cancer: -1.5%p). In metropolitan areas, the odds of undergoing screening tests during the pandemic were significantly lower than before the pandemic for stomach (adjusted odds ratio [aOR], 0.66; 95% confidence interval [CI], 0.56 to 0.76), colorectal (aOR, 0.63; 95% CI, 0.50 to 0.79), and breast cancers (aOR, 0.75; 95% CI, 0.60 to 0.94). Furthermore, the likelihood of undergoing stomach cancer screening during the pandemic was significantly lower than before the pandemic in non-metropolitan urban areas (aOR, 0.81; 95% CI, 0.70 to 0.94), while it was higher in rural areas (aOR, 1.54; 95% CI, 1.10 to 2.16).

CONCLUSIONS

Since the COVID-19 pandemic, the cancer screening rate has decreased significantly, especially in large cities. Public health efforts are required to improve cancer screening rates.

Summary

Korean summary
• 코로나 대유행 이전과 이후의 최근 1년간 암검진 수검률을 비교한 결과, 위암 (5% 포인트), 대장암 (3.8% 포인트), 유방암 (2.5% 포인트), 자궁경부암 (1.5% 포인트) 수검률이 통계적으로 유의하게 감소하였음 • 특히 위암, 대장암, 유방암의 경우 대도시 지역에서의 수검률이 현저하게 감소하였음

Key Message
The 1-year screening rates for stomach, colorectal, breast, and cervical cancer decreased significantly during the pandemic in Korea, especially in large cities.

Citations

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Mining Google Trends data for nowcasting and forecasting colorectal cancer (CRC) prevalence
Cristiana Tudor, Robert Aurelian Sova
PeerJ Computer Science.2023; 9: e1518. CrossRef

Effect modification of consecutive high concentration days on the association between fine particulate matter and mortality: a multi-city study in Korea: Hyungryul Lim, Sanghyuk Bae, Jonghyuk Choi, Kyung-Hwa Choi, Hyun-Joo Bae, Soontae Kim, Mina Ha, Ho-Jang Kwon; Epidemiol Health. 2022;44:e2022052. Published online June 9, 2022; DOI: https://doi.org/10.4178/epih.e2022052

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
Although there is substantial evidence for the short-term effect of fine particulate matter (PM2.5) on daily mortality, few epidemiological studies have explored the effect of prolonged continuous exposure to high concentrations of PM2.5. This study investigated how the magnitude of the mortality effect of PM2.5 exposure is modified by persistent exposure to high PM2.5 concentrations.
METHODS
We analyzed data on the daily mortality count, simulated daily PM2.5 level, mean daily temperature, and relative humidity level from 7 metropolitan cities from 2006 to 2019. Generalized additive models (GAMs) with quasi-Poisson distribution and random-effects meta-analyses were used to pool city-specific effects. To investigate the effect modification of continuous exposure to prolonged high concentrations, we applied categorical consecutive-day variables to the GAMs as effect modification terms for PM2.5.
RESULTS
The mortality risk increased by 0.33% (95% confidence interval [CI], 0.16 to 0.50), 0.47% (95% CI, -0.09 to 1.04), and 0.26% (95% CI, -0.08 to 0.60) for all-cause, respiratory, and cardiovascular diseases, respectively, with a 10 μg/m3 increase in PM2.5 concentration. The risk of all-cause mortality per 10 μg/m3 increase in PM2.5 on the first and fourth consecutive days significantly increased by 0.63% (95% CI, 0.20 to 1.06) and 0.36% (95% CI, 0.01 to 0.70), respectively.
CONCLUSIONS
We found increased risks of all-cause, respiratory, and cardiovascular mortality related to daily PM2.5 exposure on the day when exposure to high PM2.5 concentrations began and when exposure persisted for more than 4 days with concentrations of ≥35 μg/m3. Persistently high PM2.5 exposure had a stronger effect on seniors.; Summary

Korean summary
한국의 7개 대도시를 배경으로 수행한 본 시계열 연구를 통하여 2006년부터 2019년까지의 기간 동안에 초미세먼지의 단기 노출이 일별 사망률을 증가시키며, 교호작용모형을 통해 일평균 35 μg/m3 이상의 고농도 지속기간이 처음 시작되는 날과 넷째 지속일에 이러한 사망효과가 커짐을 보고하였다. 이러한 고농도 지속기간의 교호작용은 65세 이상 연령군에서 더욱 두드러졌다.

Key Message
With our Korean multi-city study design from 2006 to 2019, the short-term effects of PM2.5 on mortality were greater when the high PM2.5 concentration duration began during the day and lasted for approximately 4 days, and the elderly may be more affected by persistently high PM2.5.

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