- Time-series comparison of COVID-19 case fatality rates across 21 countries with adjustment for multiple covariates
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Yongmoon Kim, Bryan Inho Kim, Sangwoo Tak
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Osong Public Health Res Perspect. 2022;13(6):424-434. Published online November 28, 2022
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DOI: https://doi.org/10.24171/j.phrp.2022.0212
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 Graphical Abstract
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Although it is widely used as a measure for mortality, the case fatality rate (CFR) ofcoronavirus disease 2019 (COVID-19) can vary over time and fluctuate for many reasons otherthan viral characteristics. To compare the CFRs of different countries in equal measure, weestimated comparable CFRs after adjusting for multiple covariates and examined the mainfactors that contributed to variability in the CFRs among 21 countries.Methods: For statistical analysis, time-series cross-sectional data were collected from OurWorld in Data, CoVariants.org, and GISAID. Biweekly CFRs of COVID-19 were estimated bypooled generalized linear squares regression models for the panel data. Covariates includedthe predominant virus variant, reproduction rate, vaccination, national economic status,hospital beds, diabetes prevalence, and population share of individuals older than age 65. Intotal, 21 countries were eligible for analysis.Results: Adjustment for covariates reduced variation in the CFRs of COVID-19 across countriesand over time. Regression results showed that the dominant spread of the Omicron variant,reproduction rate, and vaccination were associated with lower country-level CFRs, whereasage, the extreme poverty rate, and diabetes prevalence were associated with higher countrylevel CFRs.Conclusion: A direct comparison of crude CFRs among countries may be fallacious, especiallyin a cross-sectional analysis. Our study presents an adjusted comparison of CFRs over timefor a more proper comparison. In addition, our findings suggest that comparing CFRs amongdifferent countries without considering their context, such as the epidemic phase, medicalcapacity, surveillance strategy, and socio-demographic traits, should be avoided.
- Clinical outcomes of remdesivir-treated COVID-19 patients in South Korea
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Mi Yu, Bryan Inho Kim, Jungyeon Kim, Jin Gwack
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Osong Public Health Res Perspect. 2022;13(5):370-376. Published online October 18, 2022
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DOI: https://doi.org/10.24171/j.phrp.2022.0138
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Abstract
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This study analyzed the clinical outcomes of remdesivir treatment in coronavirus disease 2019 (COVID-19) patients in South Korea.
Methods
This retrospective cohort study involved the secondary analysis of epidemiological data. Among patients diagnosed with COVID-19 from July 2, 2020 to March 23, 2021 (12 AM), 4,868 who received oxygen therapy and were released from isolation after receiving remdesivir treatment were assigned to the treatment group, and 6,068 patients who received oxygen therapy but not remdesivir were assigned to the untreated group. The study subjects included children under the age of 19. The general characteristics and severity were compared between the groups. Differences in the time to death and mortality were also compared.
Results
In the untreated group, the hazard ratio [HR] for mortality was 1.59 among patients aged ≥70 years and 2.32 in patients with severe disease in comparison to the treatment group. In a comparison of survival time among patients with severe disease aged ≥70 years, the HR for mortality before 50 days was 2.09 in the untreated group compared to the treatment group.
Conclusion
Patients with remdesivir treatment showed better clinical outcomes in this study, but these results should be interpreted with caution since this study was not a fully controlled clinical trial.
- Changes in the pattern and disease burden of acute respiratory viral infections before and during the COVID-19 pandemic
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Chungmin Park, Donghan Lee, Bryan Inho Kim, Sujin Park, Gyehee Lee, Sangwoo Tak
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Osong Public Health Res Perspect. 2022;13(3):203-211. Published online June 30, 2022
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DOI: https://doi.org/10.24171/j.phrp.2022.0144
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We conducted a comparative analysis of the differences in the incidence of 8 acute respiratory viruses and the changes in their patterns before and during the coronavirus disease 2019 (COVID-19) pandemic. Methods: Three sentinel surveillance systems of the Korea Disease Control and Prevention Agency and data from the Health Insurance Review and Assessment Service were analyzed. The average numbers of reported cases and the related hospital admissions and outpatient data were compared between April 2018–2019 and 2020–2021. Changes in the disease burden and medical expenditures between these 2 time periods were evaluated. Results: During the COVID-19 pandemic, the number of reported cases of all acute respiratory viral infections, except for human bocavirus, decreased significantly. Data from the Health Insurance Review and Assessment Service also showed decreases in the actual amount of medical service usage and a marked reduction in medical expenditures. Conclusion: Non-pharmacological interventions in response to COVID-19 showed preventive effects on the transmission of other respiratory viruses, as well as COVID-19. Although COVID-19 had a tremendous impact on society as a whole, with high social costs, there were also positive effects, such as a reduction in the incidence of acute respiratory viral infections.
- COVID-19 outbreak in a religious village community in South Korea and risk factors for transmission
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Jiae Shim, Eunju Lee, Eunyoung Kim, Yeonhwa Choi, Giseok Kang, Bryan Inho Kim
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Received January 6, 2023 Accepted March 6, 2023 Published online March 24, 2023
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DOI: https://doi.org/10.24171/j.phrp.2023.0002
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Abstract
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This study aimed to assess the scale and transmission patterns of coronavirus disease 2019 (COVID-19) in a religious village community in South Korea, to determine the risk factors of transmission, and to evaluate vaccine effectiveness.
Methods
An epidemiological survey was conducted, and data were collected and analyzed from 602 villagers in the religious village community. Multivariate logistic regression analysis was used to identify the risk factors for COVID-19 infection and to evaluate vaccine effectiveness.
Results
The outbreak attack rate was 72.1% (434/602). The attack rate was high among women in their 60s, the unemployed, residents living near religious facilities (<500 m), and the unvaccinated. Age, the distance between religious facilities and residences, and the absence of vaccination were identified as risk factors for infection. Vaccine effectiveness was 49.0%, and the highest effectiveness was seen in the age group of 59 years or younger (65.8%).
Conclusion
This village community was isolated, with little communication with the outside world. However, the frequency of close contact between residents was relatively high, contributing to the spread of COVID-19 in the village even with relatively short exposure. Vaccination rates in the village community were also lower than those in the general public. Public health authorities should consider the potential impact of cultural factors, including religion, that could lead to the exponential spread of COVID-19 in closed village communities.
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