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PHRP : Osong Public Health and Research Perspectives

OPEN ACCESS. pISSN: 2210-9099. eISSN: 2233-6052

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Original Articles

Methodology of comparative studies on the relative effectiveness of COVID-19 vaccines: a systematic review
Erdenetuya Bolormaa, Jiae Shim, Young-Sook Choi, Donghyok Kwon, Young June Choe, Seung-Ah Choe
Osong Public Health Res Perspect 2024;15(5):395-408.
Published online October 15, 2024
DOI: https://doi.org/10.24171/j.phrp.2024.0063
Methodology of comparative studies on the relative effectiveness of COVID-19 vaccines: a systematic review
Objectives
This study aimed to comprehensively outline the methodological approaches used in published research comparing the vaccine effectiveness (VE) of coronavirus disease 2019 (COVID-19) vaccines.
Methods
A systematic search was conducted on June 13, 2024, to identify comparative studies evaluating the effectiveness of mRNA versus non-mRNA and monovalent versus bivalent COVID-19 vaccines. We screened titles, abstracts, and full texts, collecting data on publication year, country, sample size, study population composition, study design, VE estimates, outcomes, and covariates. Studies that reported relative VE (rVE) were analyzed separately from those that did not.
Results
We identified 25 articles comparing rVE between mRNA and non-mRNA COVID-19 vaccines, as well as between monovalent and bivalent formulations. Among the studies assessing VE by vaccine type, 126 did not provide rVE estimates. Comparative VE studies frequently employed retrospective cohort designs. Among the definitions of rVE used, the most common were hazard ratio and absolute VE, calculated as (1−odds ratio)×100. Studies were most frequently conducted in the United Kingdom and the United States, and the most common outcome was infection. Most targeted the general population and assessed the VE of mRNA vaccines using the AstraZeneca vaccine as a reference. A small proportion, 7.3% (n=11), did not adjust for any variables. Only 3 studies (2.0%) adjusted for all core confounding variables recommended by the World Health Organization.
Conclusion
Few comparative studies of COVID-19 vaccines have incorporated rVE methodologies. Reporting rVE and employing a consistent set of covariates can broaden our understanding of COVID-19 vaccines.
  • 4,671 View
  • 78 Download
  • 1 Web of Science
Prevalence and patterns of post-COVID-19 symptoms in recovered patients of Delhi, India: a population-based study
Nidhi Bhatnagar, Mongjam Meghachandra Singh, Hitakshi Sharma, Suruchi Mishra, Gurmeet Singh, Shivani Rao, Amod Borle, Tanu Anand, Naresh Kumar, Binita Goswami, Sarika Singh, Mahima Kapoor, Sumeet Singla, Bembem Khuraijam, Nita Khurana, Urvi Sharma, Suneela Garg
Osong Public Health Res Perspect 2024;15(3):229-237.
Published online May 17, 2024
DOI: https://doi.org/10.24171/j.phrp.2023.0251
Prevalence and patterns of post-COVID-19 symptoms in recovered patients of Delhi, India: a population-based study
Objectives
Post-coronavirus disease 2019 (COVID-19) symptoms were widely reported. However, data on post-COVID-19 conditions following infection with the Omicron variant remained scarce. This prospective study was conducted to understand the prevalence, patterns, and duration of symptoms in patients who had recovered from COVID-19. Methods: A prospective study was conducted across 11 districts of Delhi, India, among individuals who had recovered from COVID-19. Study participants were enrolled, and then returned for post-recovery follow-up at 3 months and 6 months interval. Results: The mean age of study participants was 42.07 years, with a standard deviation of 14.89 years. The majority of the participants (79.7%) reported experiencing post-COVID-19 symptoms. The most common symptoms included joint pain (36.0%), persistent dry cough (35.7%), anxiety (28.4%), and shortness of breath (27.1%). Other symptoms were persistent fatigue (21.6%), persistent headache (20.0%), forgetfulness (19.7%), and limb weakness (18.6%). The longest duration of symptom was observed to be anxiety (138.75±54.14 days), followed by fatigue (137.57±48.33 days), shortness of breath (131.89±60.21 days), and joint pain/swelling (131.59±58.76 days). At the first follow-up visit, 2.2% of participants presented with abnormal electrocardiogram readings, but no abnormalities were noticed during the second follow-up. Additionally, 4.06% of participants exhibited abnormal chest X-ray findings at the first followup, which decreased to 2.16% by the second visit. Conclusion: The most frequently reported post-COVID-19 symptoms were joint pain, dry cough, anxiety and shortness of breath. These clinical symptoms persisted for up to 6 months, with evidence of multi-system involvement. Consequently, findings highlighted the need for long-term follow-up during the post-COVID-19 period.

Citations

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  • Quality of life post-COVID recovery: A prospective observational study, North India
    Amod Laxmikant Borle, Mongjam Meghachandra Singh, Gurmeet Singh, Nidhi Bhatnagar, Shivani Rao, Tanya Singh, Binita Goswami, Sarika Singh, Sumeet Singla, Tanu Anand
    The Indian Journal of Medical Research.2025; 161: 722.     CrossRef
  • Prevalence and pattern of post COVID-19 health problems among adults attending post COVID-19 clinics of selected tertiary care centres in Kolkata
    Uma Rani Adhikari, Manju Patra
    International Journal Of Community Medicine And Pu.2025; 12(10): 4443.     CrossRef
  • 5,135 View
  • 177 Download
  • 1 Web of Science
  • Crossref
Genetic diversity and evolutionary patterns of SARS-CoV-2 among the Bhutanese population during the pandemic
Tshering Dorji, Kunzang Dorji, Tandin Wangchuk, Tshering Pelki, Sonam Gyeltshen
Osong Public Health Res Perspect 2023;14(6):494-507.
Published online December 14, 2023
DOI: https://doi.org/10.24171/j.phrp.2023.0209
Genetic diversity and evolutionary patterns of SARS-CoV-2 among the Bhutanese population during the pandemic
Objectives
The coronavirus disease 2019 (COVID-19) pandemic, caused by a dynamic virus, has had a profound global impact. Despite declining global COVID-19 cases and mortality rates, the emergence of new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants remains a major concern. This study provides a comprehensive analysis of the genomic sequences of SARS-CoV-2 within the Bhutanese population during the pandemic. The primary aim was to elucidate the molecular epidemiology and evolutionary patterns of SARS-CoV-2 in Bhutan, with a particular focus on genetic variations and lineage dynamics. Methods: Whole-genome sequences of SARS-CoV-2 collected from Bhutan between May 2020 and February 2023 (n=135) were retrieved from the Global Initiative on Sharing All Influenza Database. Results: The SARS-CoV-2 variants in Bhutan were predominantly classified within the Nextstrain clade 20A (31.1%), followed by clade 21L (20%) and clade 22D (15.6%). We identified 26 Pangolin lineages with variations in their spatial and temporal distribution. Bayesian time-scaled phylogenetic analysis estimated the time to the most recent common ancestor as February 15, 2020, with a substitution rate of 0.97×10–3 substitutions per site per year. Notably, the spike glycoprotein displayed the highest mutation frequency among major viral proteins, with 116 distinct mutations, including D614G. The Bhutanese isolates also featured mutations such as E484K, K417N, and S477N in the spike protein, which have implications for altered viral properties. Conclusion: This is the first study to describe the genetic diversity of SARS-CoV-2 circulating in Bhutan during the pandemic, and this data can inform public health policies and strategies for preventing future outbreaks in Bhutan.

Citations

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  • Integration of multi-omics and machine learning strategies identifies immune related candidate biomarkers in inflammation-associated hypertrophic cardiomyopathy
    Qingzhu Liang, Jin Wang, Qingxiao Nong, Shouwen Tao, Dalang Fang
    Frontiers in Immunology.2025;[Epub]     CrossRef
  • Investigation of SARS-CoV-2 Genomic Variants in Two Patients: Insights into Initial Isolates from West Kalimantan, Indonesia
    Puji Astuti, Mahyarudin Mahyarudin, Delima Fajar Liana, Virhan Novianry, Sofi Siti Shofiyah, Puspa Amalia, Muhammad Faisal, Marinus Andre Reynaldi
    Infection Epidemiology and Microbiology.2025; 11(3): 285.     CrossRef
  • 4,557 View
  • 103 Download
  • 1 Web of Science
  • Crossref
Vaccine hesitancy in patients with COVID-19 who have back pain
Askeri Türken, Haşim Çapar
Osong Public Health Res Perspect 2023;14(2):100-109.
Published online March 24, 2023
DOI: https://doi.org/10.24171/j.phrp.2023.0003
Vaccine hesitancy in patients with COVID-19 who have back pain
Objectives
Musculoskeletal pain is among the most common symptoms in patients diagnosed with coronavirus disease 2019 (COVID-19), and it has placed a significant burden on health worldwide during the pandemic. This study explored vaccine hesitancy and associated factors in patients with positive COVID-19 polymerase chain reaction test results who were hospitalized and had back pain.
Methods
A cross-sectional study was conducted among 170 hospitalized COVID-19 patients over 18 years of age. Data were analyzed using descriptive statistics with IBM SPSS ver. 25.0.
Results
COVID-19 patients who were married considered COVID-19 vaccinations riskier than unmarried COVID-19 patients. Patients who had not been vaccinated expressed higher levels of distrust towards COVID-19 vaccines than patients who had been vaccinated. Participants had relatively little hesitation toward the Sinovac vaccine. High vaccine confidence was found in all participants regardless of vaccination status. Those who had not received the COVID-19 vaccine reported higher risk perceptions than those who had received at least 1 dose of any COVID-19 vaccine.
Conclusion
Measurements of the hesitancy of vaccinated and non-vaccinated patients or members of society towards vaccines can be an important parameter for health authorities to find solutions.

Citations

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  • COVID-19 VE DAVRANIŞSAL İKTİSAT: KÜRESEL BİR PANDEMİ SIRASINDA İNSAN DAVRANIŞINI ANLAMAK
    İlknur ARSLAN ARAS
    Sağlık ve Sosyal Refah Araştırmaları Dergisi.2024; 6(1): 97.     CrossRef
  • 7,382 View
  • 104 Download
  • Crossref

Review Article

SARS-CoV-2 in brief: from virus to prevention
Hassan Karami, Zeinab Karimi, Negin Karami
Osong Public Health Res Perspect 2022;13(6):394-406.
Published online November 28, 2022
DOI: https://doi.org/10.24171/j.phrp.2022.0155
The recent outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), ahighly transmissible virus with a likely animal origin, has posed major and unprecedentedchallenges to millions of lives across the affected nations of the world. This outbreak firstoccurred in China, and despite massive regional and global attempts shortly thereafter, itspread to other countries and caused millions of deaths worldwide. This review presents keyinformation about the characteristics of SARS-CoV-2 and its associated disease (namely,coronavirus disease 2019) and briefly discusses the origin of the virus. Herein, we also brieflysummarize the strategies used against viral spread and transmission.

Citations

Citations to this article as recorded by  Crossref logo
  • Cytomegalovirus and pneumocystis jirovecii co-infection pneumonia as an initial presentation of HIV infection
    Sharare Noruzi, Sobhan Mehdipourrabori, Zeynab Yassin
    Journal of Medicine, Surgery, and Public Health.2025; 5: 100174.     CrossRef
  • Mpox virus (MPXV): comprehensive analysis of pandemic risks, pathophysiology, treatments, and mRNA vaccine development
    Sajjad Eslamkhah, Elif Sibel Aslan, Cuneyd Yavas, Nermin Akcalı, Lutfiye Karcıoglu Batur, Asmaa Abuaisha, Erva Esma Yildirim, Mustafa Solak, Kenneth N. White
    Naunyn-Schmiedeberg's Archives of Pharmacology.2025; 398(6): 6143.     CrossRef
  • Monkeypox: a re-emergent virus with global health implications – a comprehensive review
    Nourhan G. Naga, Enas A. Nawar, A’laa A. Mobarak, Aya G. Faramawy, Hend M. H. Al-Kordy
    Tropical Diseases, Travel Medicine and Vaccines.2025;[Epub]     CrossRef
  • Marburg Virus Disease: A Narrative Review
    Arash Letafati, Somayeh Sadat Hosseini Fakhr, Ali Qaraee Najafabadi, Negin Karami, Hassan Karami
    Health Science Reports.2025;[Epub]     CrossRef
  • Exploring monkeypox virus antibody levels: insights from human immunological research
    Jing Wu, Xiaomin Zhang
    Virology Journal.2025;[Epub]     CrossRef
  • Novel agents inhibiting the Marburg nucleoprotein using molecular docking, ADMET, MD, and quantum DFT methods
    Haiwang Djefoulna Victorien Hermann, Fifen Jean Jules, Conradie Jeanet
    Discover Applied Sciences.2025;[Epub]     CrossRef
  • Investigating the impact of the number of COVID-19 reinfections, vaccination status, risk factors, and reinfection interval on long COVID symptomatology
    Björn Nicolay, Raquel Gómez Bravo, Djenna Hutmacher, Charles Benoy, Claus Vögele
    Discover Public Health.2025;[Epub]     CrossRef
  • Polysaccharides and Lectins: A Natural Complementary Approach against the SARS-CoV-2 Pandemic
    Radu Lefter, Prairna Balyan, Ioana-Miruna Balmus, Abdellah Ech-Chahad, Ahmad Ali, Alin Ciobica, Antoneta Dacia Petroaie, Gabriela Halitchi, Bogdan Novac, Catalina Ionescu, Fatima Zahra Kamal
    Microbiology Research.2024; 15(2): 525.     CrossRef
  • Risk of COVID-19 transmission on long-haul flights: During the COVID-19 pandemic
    Jiyun Park, Gye jeong Yeom, Poowin Bunyavejchewin
    PLOS ONE.2024; 19(8): e0309044.     CrossRef
  • Effectiveness of donning and doffing personal protective equipment education using video debriefing among Korean undergraduate nursing students
    GyeJeong Yeom, Jiyun Park
    BMC Nursing.2024;[Epub]     CrossRef
  • A Narrative Review on the Pandemic Zoonotic RNA Virus Infections Occurred During the Last 25 Years
    Gobena Ameni, Aboma Zewude, Begna Tulu, Milky Derara, Berecha Bayissa, Temesgen Mohammed, Berhanu Adenew Degefa, Mohamed Elfatih Hamad, Markos Tibbo, Robert Barigye
    Journal of Epidemiology and Global Health.2024; 14(4): 1397.     CrossRef
  • The next viral pandemic: A call for global preparedness
    Hassan Karami, Mina Soleimani, Negar Nayerain Jazi, Kiana Navi, Rojina Sajadi, Mohammad Mehdi Fazeli, Golara Pagheh, Samane Ostadhadi Dehkordi
    Journal of Medicine, Surgery, and Public Health.2024; 4: 100150.     CrossRef
  • Surveillance of endemic coronaviruses during the COVID‐19 pandemic in Iran, 2021–2022
    Hassan Karami, Kaveh Sadeghi, Sevrin Zadheidar, Fatemeh Saadatmand, Negar Mirsalehi, Nima Hoveidi Ardestani, Shirin Kalantari, Mohammad Farahmand, Jila Yavarian, Talat Mokhtari‐Azad
    Influenza and Other Respiratory Viruses.2023;[Epub]     CrossRef
  • 7,893 View
  • 133 Download
  • 11 Web of Science
  • Crossref

Short Communication

COVID-19 outbreak and risk factors for infection in a taekwondo gym in the Republic of Korea
Seung Hwan Shin, Eonjoo Park, Sookhyun Kim, Minji Jang, Subin Park, Dong-Hwi Kim, Tae Jong Son, Ji-Hyuk Park
Osong Public Health Res Perspect 2022;13(2):162-170.
Published online March 31, 2022
DOI: https://doi.org/10.24171/j.phrp.2021.0295
Objectives
Relatively few studies have assessed risk factors for coronavirus disease 2019 (COVID-19) in public facilities used by children and adolescents. This study presents an analysis of a COVID-19 outbreak that occurred in a taekwondo gym in Korea, predominantly among children and adolescents, with the aim of providing insights on managing COVID-19 outbreaks in similar facilities. Methods: All 108 taekwondo gym students and staff received COVID-19 tests. A survey and closed-circuit television analyses were used to identify risk factors. A univariate analysis was conducted, followed by multivariate logistic regression analysis with backward elimination for variables with a significance level <0.10 in the univariate analysis. Results: COVID-19 was confirmed in 30 of 108 subjects at the taekwondo gym (attack rate, 27.8%). The outbreak started in an adult class student. This student transmitted the virus to the staff, who consequently transmitted the virus to adolescent students. In the univariate analysis, the relative risk for younger age (≤9 years) was 2.14 (95% confidence interval [CI], 1.01–4.54; p=0.054), and that for food consumption inside the gym was 2.12 (95% CI, 1.04–4.30; p=0.048). In the multivariate logistic regression analysis, the odds ratio for younger age was 2.96 (95% CI, 1.07–8.20; p=0.036), and that for food consumption inside the gym was 3.00 (95% CI, 1.10–8.17; p=0.032). Conclusion: Food consumption inside the facility and young age were significant risk factors for COVID-19 transmission in this taekwondo gym. Food consumption should be prohibited in sports facilities, and infection prevention education for young students is also required.

Citations

Citations to this article as recorded by  Crossref logo
  • Causes of COVID-19 Outbreaks During Sports and Exercise: A Systematic Review
    Masaki Machida, Koichi Dai, Itaru Nakamura, Shigeru Inoue
    Sports Medicine.2025; 55(3): 713.     CrossRef
  • The First Outbreak of Novel Coronavirus Disease 2019 (COVID-19) at an Outdoor Camping Site in South Korea, 2020
    Na-Young Kim, Seonhee Ahn, GwangJin Kim, Donghyok Kwon, Young-Joon Park, Sang-Eun Lee
    Journal of Epidemiology.2024; 34(4): 203.     CrossRef
  • Risk evaluation of venue types and human behaviors of COVID-19 outbreaks in public indoor environments: A systematic review and meta-analysis
    Weiwei Huang, Caroline X. Gao, Danting Luo, Yong Wang, Xiaohong Zheng, Cong Liu, Ying Wang, Yuguo Li, Hua Qian
    Environmental Pollution.2024; 341: 122970.     CrossRef
  • Investigating Factors Contributing to the Occurrence of COVID-19 Outbreaks in Athletes in a Scoping Review
    Shuichi KASAMA, Haruyo SAKAKI, Eiko ENDO
    Taiikugaku kenkyu (Japan Journal of Physical Educa.2024; 69: 151.     CrossRef
  • The Risk of SARS-CoV-2 Transmission in Community Indoor Settings: A Systematic Review and Meta-analysis
    Mark Rohit Francis, Saheed Gidado, J Pekka Nuorti
    The Journal of Infectious Diseases.2024;[Epub]     CrossRef
  • Identifying risk factors for COVID-19 cluster infections in schools in the Republic of Korea: a case-control study
    Jihyun Choi, Seongju Choi, Baigu Lee, Young-Joon Park, Sang Eun Lee
    Osong Public Health and Research Perspectives.2024; 15(4): 375.     CrossRef
  • SARS-CoV-2 transmission modes: Why and how contamination occurs around shared meals and drinks?
    Aure Saulnier, Jean-Michel Wendling, Benoit Hermant, Didier Lepelletier
    Food Microbiology.2023; 114: 104297.     CrossRef
  • Risk factors for COVID-19 outbreaks in livestock slaughtering and processing facilities in Republic of Korea
    Seongju Choi, Tae Jong Son, Yeon-Kyung Lee
    Osong Public Health and Research Perspectives.2023; 14(3): 207.     CrossRef
  • Protective facemask-induced facial thermal stress and breathing burden during exercise in gyms
    Qilong Zhong, Jiyun Song, Dachuan Shi, Chung-Hin Dung
    Building and Environment.2023; 244: 110840.     CrossRef
  • 7,983 View
  • 138 Download
  • 10 Web of Science
  • Crossref

Review Articles

Worldwide prevalence of fungal coinfections among COVID-19 patients: a comprehensive systematic review and meta-analysis
Saber Soltani, Milad Zandi, Samireh Faramarzi, Ramin Shahbahrami, Mohebat Vali, Sara Akhavan Rezayat, Reza Pakzad, Pooneh Malekifar, Iraj Pakzad, Neda Jahandoost, Jalal Moludi
Osong Public Health Res Perspect 2022;13(1):15-23.
Published online February 8, 2022
DOI: https://doi.org/10.24171/j.phrp.2021.0293
Microbial coinfections can increase the morbidity and mortality rates of viral respiratory diseases. Therefore, this study aimed to determine the pooled prevalence of fungal coinfections in coronavirus disease 2019 (COVID-19) patients. Web of Science, Medline, Scopus, and Embase were searched without language restrictions to identify the related research on COVID-19 patients with fungal coinfections from December 1, 2019, to December 30, 2020. A random-effects model was used for analysis. The sample size included 2,246 patients from 8 studies. The pooled prevalence of fungal coinfections was 12.60%. The frequency of fungal subtype coinfections was 3.71% for Aspergillus, 2.39% for Candida, and 0.39% for other. The World Health Organization’s Regional Office for Europe and Regional Office for Southeast Asia had the highest (23.28%) and lowest (4.53%) estimated prevalence of fungal coinfection, respectively. Our findings showed a high prevalence of fungal coinfections in COVID-19 cases, which is a likely contributor to mortality in COVID-19 patients. Early identification of fungal pathogens in the laboratory for COVID-19 patients can lead to timely treatment and prevention of further damage by this hidden infection.
  • 11,291 View
  • 154 Download
  • 13 Web of Science
The role of lipids in the pathophysiology of coronavirus infections
Milad Zandi, Parastoo Hosseini, Saber Soltani, Azadeh Rasooli, Mona Moghadami, Sepideh Nasimzadeh, Farzane Behnezhad
Osong Public Health Res Perspect 2021;12(5):278-285.
Published online October 15, 2021
DOI: https://doi.org/10.24171/j.phrp.2021.0153
The role of lipids in the pathophysiology of coronavirus infections
Coronaviruses, which have been known to cause diseases in animals since the 1930s, utilize cellular components during their replication cycle. Lipids play important roles in viral infection, as coronaviruses target cellular lipids and lipid metabolism to modify their host cells to become an optimal environment for viral replication. Therefore, lipids can be considered as potential targets for the development of antiviral agents. This review provides an overview of the roles of cellular lipids in different stages of the life cycle of coronaviruses.

Citations

Citations to this article as recorded by  Crossref logo
  • The Enigmatic Conserved Q134-F135-N137 Triad in SARS-CoV-2 Spike Protein: A Conformational Transducer?
    Marine Lefebvre, Henri Chahinian, Nouara Yahi, Jacques Fantini
    Biomolecules.2026; 16(1): 111.     CrossRef
  • Homeostasis of Calnexin Is Essential for the Growth, Virulence, and Hypovirus RNA Accumulation in the Chestnut Blight Fungus
    Tao Huang, Xiaoling Ma, Ziqi Zhao, Danna Qin, Weiye Qin, Jinzi Wang, Baoshan Chen, Xipu He
    Molecular Microbiology.2025; 123(5): 393.     CrossRef
  • PEDV inhibits HNRNPA3 expression by miR-218-5p to enhance cellular lipid accumulation and promote viral replication
    Xiaojie Shi, Qi Zhang, Naling Yang, Quanqiong Wang, Yanxia Zhang, Xingang Xu, Xiang-Jin Meng, Ying Fang
    mBio.2024;[Epub]     CrossRef
  • Understanding the Molecular Actions of Spike Glycoprotein in SARS-CoV-2 and Issues of a Novel Therapeutic Strategy for the COVID-19 Vaccine
    Yasunari Matsuzaka, Ryu Yashiro
    BioMedInformatics.2024; 4(2): 1531.     CrossRef
  • Orsay Virus Infection of Caenorhabditis elegans Is Modulated by Zinc and Dependent on Lipids
    Luis Alberto Casorla-Perez, Ranya Guennoun, Ciro Cubillas, Bo Peng, Kerry Kornfeld, David Wang, Rebecca Ellis Dutch
    Journal of Virology.2022;[Epub]     CrossRef
  • 10,673 View
  • 200 Download
  • 5 Web of Science
  • Crossref
Scrutiny of COVID-19 response strategies among severely affected European nations
Shine Stephen, Alwin Issac, Rakesh Vadakkethil Radhakrishnan, Jaison Jacob, VR Vijay, Sam Jose, SM Azhar, Anoop S. Nair, Nadiya Krishnan, Rakesh Sharma, Manju Dhandapani
Osong Public Health Res Perspect 2021;12(4):203-214.
Published online July 29, 2021
DOI: https://doi.org/10.24171/j.phrp.2021.0068
Scrutiny of COVID-19 response strategies among severely affected European nations
Although the health care systems in Europe are considered the global benchmark, European nations were severely affected by the coronavirus disease 2019 (COVID-19) pandemic. This manuscript aimed to examine the strategies implemented to combat the COVID-19 pandemic by France, the United Kingdom, Spain, Italy, Germany, and Russia and their outcomes in terms of the number of cases, testing, and deaths. This is the first review of its kind that extensively analyzes the preparedness, mitigation, and response strategies against the COVID-19 pandemic adopted by these nations. This paper further suggests a strategic preparedness model for future pandemics. From the analysis, we found that a decentralized approach, prompt decision-making and timely execution, coordination between local health authorities, and public participation in the implementation of strategies could substantially reduce the case fatality rate. Nations with a high percentage of gross domestic product invested in the health sector, as well as more nurses, physicians, hospital beds, intensive care unit beds, and ventilators, better managed the pandemic. Instead, nations that postponed their pandemic response by delaying tracking, tracing, testing, quarantine, and lockdown were badly affected. The lessons learned from the present pandemic could be used as a guide to prepare for further pandemics.

Citations

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  • Facteurs protecteurs de la qualité de vie d’infirmières françaises durant la pandémie de COVID-19 : un devis descriptif-corrélationnel
    Emilie KORT, Philippe DELMAS, Jonathan JUBIN, Annie OULEVEY BACHMANN, Claudia ORTOLEVA BUCHER
    Recherche et Avancées en Sciences Infirmières.2025;[Epub]     CrossRef
  • Psychological impact and development of autistic traits in children during the COVID 19 Pandemic: A study through Guardian
    Waseem Iqbal, Mudassir Hassan, Parveez Ahmed Mir, Syed Kaiser
    IP International Journal of Medical Paediatrics an.2024; 9(4): 135.     CrossRef
  • The Safety of Covishield (ChAdOx1 nCoV-19) Vaccine after Three Doses Vaccination under Mass Vaccination Program of Government of India
    Narinder Singh, Jaswinder Singh, Vikram Bhandari, Rahat Kumar
    AMEI's Current Trends in Diagnosis & Treatment.2024; 7(2): 36.     CrossRef
  • A phenomenological experience of trainers in preparedness training during COVID-19 pandemic: Trainers perspective from tertiary care institute
    Rakesh Sharma, Prasuna Jelly, Kusum Kumari, Arun Varghese, K. Hemanthkumar, C. Vasantha Kalyani, Neha Singh, Shalinee Rao
    International Journal of Africa Nursing Sciences.2024; 20: 100711.     CrossRef
  • Antibody titre in infants of covid-19 infected mothers
    Shivani Sharma, Pushkar Lal Meena, Rameshwar Lal Suman, Jaya Ninama
    IP International Journal of Medical Paediatrics an.2023; 9(2): 68.     CrossRef
  • A study to assess the level of stress among nursing students of IUST during COVID-19 pandemic
    Javaid Ahmad Mir, Asmat Parveen, Suheel Rashid Wani, Tayyibah Nisar, Sakeena Majeed, Wahida Kausar, Basit Ul Islam
    IP International Journal of Medical Paediatrics an.2022; 8(1): 15.     CrossRef
  • Strategy to prevent infection from Covid-19 among security officers of tertiary care centre: A preexperimental study
    Rakesh Sharma, KusumK Rohilla, Lisa Chadha, Priyanka Malhotra, S Sharmila, Prasuna Jelly
    Journal of Family Medicine and Primary Care.2021; 10(9): 3257.     CrossRef
  • Post COVID-19 changes in the perception of the parents towards dentistry for their child
    Nahid Iftikhar, Shalini Dixit, Aditi Yadav
    IP International Journal of Medical Paediatrics an.2021; 7(3): 155.     CrossRef
  • A comparative study of attitudes towards COVID-19 vaccination in the rural and urban population of Uttarakhand, India
    Rakesh Sharma, Prasuna Jelly, Vishwas AS, Lisa Chadha, Vartika Saxena, Latika Mohan
    Journal of Global Health Economics and Policy.2021;[Epub]     CrossRef
  • A comparative study of attitudes towards COVID-19 vaccination in the rural and urban population of Uttarakhand, India
    Rakesh Sharma, Prasuna Jelly, Vishwas AS, Lisa Chadha, Vartika Saxena, Latika Mohan
    Journal of Global Health Economics and Policy.2021;[Epub]     CrossRef
  • 16,983 View
  • 164 Download
  • 2 Web of Science
  • Crossref

Original Article

Global variation of COVID-19 mortality rates in the initial phase
Saman Hasan Siddiqui, Azza Sarfraz, Arjumand Rizvi, Fariha Shaheen, Mohammad Tahir Yousafzai, Syed Asad Ali
Osong Public Health Res Perspect 2021;12(2):64-72.
Published online April 29, 2021
DOI: https://doi.org/10.24171/j.phrp.2021.12.2.03
Objectives
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused devastation in over 200 countries. Italy, Spain, and the United States (US) were most severely affected by the first wave of the pandemic. The reasons why some countries were more strongly affected than others remain unknown. We identified the most-affected and less-affected countries and states and explored environmental, host, and infrastructure risk factors that may explain differences in the SARS-CoV-2 mortality burden.
Methods
We identified the top 10 countries/US states with the highest deaths per population until May 2020. For each of these 10 case countries/states, we identified 6 control countries/states with a similar population size and at least 3 times fewer deaths per population. We extracted data for 30 risk factors from publicly available, trusted sources. We compared case and control countries/states using the non-parametric Wilcoxon rank-sum test, and conducted a secondary cluster analysis to explore the relationship between the number of cases per population and the number of deaths per population using a scalable EM (expectation–maximization) clustering algorithm.
Results
Statistically significant differences were found in 16 of 30 investigated risk factors, the most important of which were temperature, neonatal and under-5 mortality rates, the percentage of under-5 deaths due to acute respiratory infections (ARIs) and diarrhea, and tuberculosis incidence (<italic>p</italic><0.05)
Conclusion
Countries with a higher burden of baseline pediatric mortality rates, higher pediatric mortality from preventable diseases like diarrhea and ARI, and higher tuberculosis incidence had lower rates of coronavirus disease 2019-associated mortality, supporting the hygiene hypothesis.

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Brief Reports

Operating a National Hotline in Korea During the COVID-19 Pandemic
Rok Song, Yuh Seog Choi, Jae Young Ko
Osong Public Health Res Perspect 2020;11(6):380-382.
Published online December 22, 2020
DOI: https://doi.org/10.24171/j.phrp.2020.11.6.06
<p>The importance of effective communication cannot be overestimated during a pandemic. The Korea Disease Control and Prevention Agency national 1339 hotline has been in operation since the Middle East respiratory syndrome coronavirus outbreak in 2016. The hotline is open 24 hours a day, 7 days a week, 365 days a year, and provides accurate, reliable information based upon the Korea Disease Control and Prevention Agency guidelines in response to queries. During the coronavirus disease 2019 (COVID-19) pandemic, the 1339 hotline received callers’ questions about symptoms and the implications of their actions regarding the epidemic. Through the 1339 hotline, callers received the up-to-date information that enabled them to protect themselves as well as others from COVID-19. This public service may have influenced on reduced risk of virus transmission in Korea.</p>

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A Public-Private Partnership Model to Build a Triage System in Response to a COVID-19 Outbreak in Hanam City, South Korea
Seong Su Ku, Young June Choe
Osong Public Health Res Perspect 2020;11(5):339-342.
Published online October 22, 2020
DOI: https://doi.org/10.24171/j.phrp.2020.11.5.11
<p>A substantial, immediate healthcare burden for screening of Coronavirus disease 2019 (COVID-19) is created when large-scale outbreaks occur. There have been a series of measures to strengthen the screening process through robust public-private partnerships between Hanam City Public Health Center (PHC), the local medical association, and central/provincial government. A partnership between PHC and the local physician’s group in Hanam City established the Respiratory Clinic. The PHC provided the infrastructure for the Respiratory Clinic including medical facilities, supplies (i.e. personal protective equipment), and administrative support. A total of 11 registered physicians from the local physicians group agreed to participate in clinical service provided at the Respiratory Clinic. Any citizens with COVID-19 suspected respiratory symptoms call the COVID-19 hotline and visit the Respiratory Clinic if required. Responding to COVID-19 outbreaks will be a continual process, and the screening system is essential support to public health interventions, and crucial in the response to a surge in COVID-19 cases.</p>

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Original Article

COVID-19 in Nursing Facilities: Experience in Republic of Korea
Rok Song, Hee-Sook Kim, Seok-Ju Yoo, Kwan Lee, Ji-Hyuk Park, Joon Ho Jang, Gyoung-Sook Ahn, Jun-Nyun Kim
Osong Public Health Res Perspect 2020;11(4):164-169.
Published online August 31, 2020
DOI: https://doi.org/10.24171/j.phrp.2020.11.4.04
<sec> <title>Objectives</title> <p>Coronavirus disease 2019 (COVID-19) outbreaks in nursing facilities can easily lead to a high rate of infection and fatality. A surge in newly infected cases in the first quarter of 2020 in Gyeongsan-si, in the Republic of Korea, was followed by several outbreaks in nursing facilities in the same area. The aim of this study is to report on the epidemiological investigation and the management to reduce the infection rate in nursing facilities for older adults.</p></sec> <sec> <title>Methods</title> <p>The municipal government and the Korea Centers for Disease Control and Prevention performed an epidemiological investigation into 5 nursing facilities that reported a high number of COVID-19 infection cases from February to May 2020. COVID-19 infected cases in the facilities were investigated to identify the infection routes, and the fatality rate of the 5 facilities.</p></sec> <sec> <title>Results</title> <p>The 5 facilities had a combined fatality rate of 12.2% (9 deceased among the 74 infected cases). The median age of the deceased was 87 years old (range: 82–91). The infection was first identified on February 27<sup>th</sup>, 2020, peaked on March 6<sup>th</sup>, and was last detected on March 24<sup>th</sup>, 2020.</p></sec> <sec> <title>Conclusion</title> <p>Difficulties specific to such facilities included the delay in the recognition of symptoms and limitation in distancing. Tailored strategies such as daily monitoring of symptoms and proactive COVID-19 screening of quarantined residents, contributed to a decline in the infections in the facilities.</p></sec>

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Review Article

COVID-19: Weighing the Endeavors of Nations, with Time to Event Analysis
Shine Stephen, Alwin Issac, Jaison Jacob, VR Vijay, Rakesh Vadakkethil Radhakrishnan, Nadiya Krishnan
Osong Public Health Res Perspect 2020;11(4):149-157.
Published online August 31, 2020
DOI: https://doi.org/10.24171/j.phrp.2020.11.4.02
<p>The cataclysmic COVID-19 pandemic erupted silently causing colossal impact worldwide, the repercussions of which indicated a lackadaisical vigilance in preparation for such a pandemic. This review assessed the measures taken by nations to contain this pandemic. A literature review was conducted using Medline, Google Scholar, Science Direct, Scopus, and WHO website. There were 8 nations (selected from the GHS index list) appraised for containment strategies. This was achieved by using mortality rate (per million) as the primary endpoint. The nations which were proactive, initiated scientific strategies earlier with rigor, appeared to have succeeded in containing the pandemic, although it is still too early to arbitrate a verdict. The so called “pandemic war” mandates international, interdisciplinary, and interdepartmental collaboration. Furthermore, building trust and confidence between the government and the public, having transparent communication, information sharing, use of advanced research-technology, and plentiful resources are required in the fight against COVID-19.</p>

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    Alwin Issac, Rakesh Vadakkethil Radhakrishnan, VR Vijay, Shine Stephen, Nadiya Krishnan, Jaison Jacob, Sam Jose, SM Azhar, Anoop S Nair
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Editorial

The Impact of Social Distancing on the Transmission of Influenza Virus, South Korea, 2020
Young June Choe, Jong-Koo Lee
Osong Public Health Res Perspect 2020;11(3):91-92.
Published online June 1, 2020
DOI: https://doi.org/10.24171/j.phrp.2020.11.3.07

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Original Article

Cross-Country Comparison of Case Fatality Rates of COVID-19/SARS-COV-2
Morteza Abdullatif Khafaie, Fakher Rahim
Osong Public Health Res Perspect 2020;11(2):74-80.
Published online April 30, 2020
DOI: https://doi.org/10.24171/j.phrp.2020.11.2.03
<sec> <title>Objectives</title> <p>Case fatality rates (CFR) and recovery rates are important readouts during epidemics and pandemics. In this article, an international analysis was performed on the ongoing coronavirus disease 2019 (COVID-19) pandemic.</p></sec> <sec> <title>Methods</title> <p>Data were retrieved from accurate databases according to the user’s guide of data sources for patient registries, CFR and recovery rates were calculated for each country. A comparison of CFR between countries with total cases ≥ 1,000 was observed for 12<sup>th</sup> and 23<sup>rd</sup> March.</p></sec> <sec> <title>Results</title> <p>Italy’s CFR was the highest of all countries studied for both time points (12<sup>th</sup> March, 6.22% versus 23<sup>rd</sup> March, 9.26%). The data showed that even though Italy was the only European country reported on 12<sup>rd</sup> March, Spain and France had the highest CFR of 6.16 and 4.21%, respectively, on 23<sup>rd</sup> March, which was strikingly higher than the overall CFR of 3.61%.</p></sec> <sec> <title>Conclusion</title> <p>Obtaining detailed and accurate medical history from COVID-19 patients, and analyzing CFR alongside the recovery rate, may enable the identification of the highest risk areas so that efficient medical care may be provided. This may lead to the development of point-of-care tools to help clinicians in stratifying patients based on possible requirements in the level of care, to increase the probabilities of survival from COVID-19 disease.</p></sec>

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Short Communication

Contact Transmission of COVID-19 in South Korea: Novel Investigation Techniques for Tracing Contacts
COVID-19 National Emergency Response Center, Epidemiology & Case Management Team, Korea Centers for Disease Control & Prevention
Osong Public Health Res Perspect 2020;11(1):60-63.
Published online February 28, 2020
DOI: https://doi.org/10.24171/j.phrp.2020.11.1.09
<p>In the epidemiological investigation of an infectious disease, investigating, classifying, tracking, and managing contacts by identifying the patient’s route are important for preventing further transmission of the disease. However, omissions and errors in previous activities can occur when the investigation is performed through only a proxy interview with the patient. To overcome these limitations, methods that can objectively verify the patient’s claims (medical facility records, Global Positioning System, card transactions, and closed-circuit television) were used for the recent ongoing coronavirus disease 2019 contact investigations in South Korea.</p>

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Original Articles
Identification of Coronavirus Isolated from a Patient in Korea with COVID-19
Jeong-Min Kim, Yoon-Seok Chung, Hye Jun Jo, Nam-Joo Lee, Mi Seon Kim, Sang Hee Woo, Sehee Park, Jee Woong Kim, Heui Man Kim, Myung-Guk Han
Osong Public Health Res Perspect 2020;11(1):3-7.
Published online February 28, 2020
DOI: https://doi.org/10.24171/j.phrp.2020.11.1.02
<sec> <title>Objectives</title> <p>Following reports of patients with unexplained pneumonia at the end of December 2019 in Wuhan, China, the causative agent was identified as coronavirus (SARS-CoV-2), and the 2019 novel coronavirus disease was named COVID-19 by the World Health Organization. Putative patients with COVID-19 have been identified in South Korea, and attempts have been made to isolate the pathogen from these patients.</p></sec> <sec> <title>Methods</title> <p>Upper and lower respiratory tract secretion samples from putative patients with COVID-19 were inoculated onto cells to isolate the virus. Full genome sequencing and electron microscopy were used to identify the virus.</p></sec> <sec> <title>Results</title> <p>The virus replicated in Vero cells and cytopathic effects were observed. Full genome sequencing showed that the virus genome exhibited sequence homology of more than 99.9% with SARS-CoV-2 which was isolated from patients from other countries, for instance China. Sequence homology of SARS-CoV-2 with SARS-CoV, and MERS-CoV was 77.5% and 50%, respectively. Coronavirus-specific morphology was observed by electron microscopy in virus-infected Vero cells.</p></sec> <sec> <title>Conclusion</title> <p>SARS-CoV-2 was isolated from putative patients with unexplained pneumonia and intermittent coughing and fever. The isolated virus was named BetaCoV/Korea/KCDC03/2020.</p></sec>

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Effects of Timely Control Intervention on the Spread of Middle East Respiratory Syndrome Coronavirus Infection
Ilsu Choi, Dong Ho Lee, Yongkuk Kim
Osong Public Health Res Perspect 2017;8(6):373-376.
Published online December 31, 2017
DOI: https://doi.org/10.24171/j.phrp.2017.8.6.03
<sec><title>Objectives</title><p>The 2015 Middle East Respiratory Syndrome Coronavirus (MERS-CoV) outbreak in Korea caused major economic and social problems. The control intervention was conducted during the MERS-CoV outbreak in Korea immediately after the confirmation of the index case. This study investigates whether the early risk communication with the general public and mass media is an effective preventive strategy.</p></sec><sec><title>Methods</title><p>The SEIR (Susceptible, Exposed, Infectious, Recovered) model with estimated parameters for the time series data of the daily MERS-CoV incidence in Korea was considered from May to December 2015. For 10,000 stochastic simulations, the SEIR model was computed using the Gillespie algorithm. Depending on the time of control intervention on the 20th, 40th, and 60th days after the identification of the index case, the box plots of MERS-CoV incidences in Korea were computed, and the results were analyzed via ANOVA.</p></sec><sec><title>Results</title><p>The box plots showed that there was a significant difference between the non-intervention and intervention groups (the 20th day, 40th day, and 60th day groups) and seemed to show no significant difference based on the time of intervention. However, the ANOVA revealed that early intervention was a good strategy to control the disease.</p></sec><sec><title>Conclusion</title><p>Appropriate risk communication can secure the confidence of the general public in the public health authorities.</p></sec>

Citations

Citations to this article as recorded by  Crossref logo
  • Healthcare-associated infections: the hallmark of Middle East respiratory syndrome coronavirus with review of the literature
    J.A. Al-Tawfiq, P.G. Auwaerter
    Journal of Hospital Infection.2019; 101(1): 20.     CrossRef
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The Characteristics of Middle Eastern Respiratory Syndrome Coronavirus Transmission Dynamics in South Korea
Yunhwan Kim, Sunmi Lee, Chaeshin Chu, Seoyun Choe, Saeme Hong, Youngseo Shin
Osong Public Health Res Perspect 2016;7(1):49-55.
Published online February 28, 2016
DOI: https://doi.org/10.1016/j.phrp.2016.01.001
Objectives
The outbreak of Middle Eastern respiratory syndrome coronavirus (MERS-CoV) was one of the major events in South Korea in 2015. In particular, this study pays attention to formulating a mathematical model for MERS transmission dynamics and estimating transmission rates.
Methods
Incidence data of MERS-CoV from the government authority was analyzed for the first aim and a mathematical model was built and analyzed for the second aim of the study. A mathematical model for MERS-CoV transmission dynamics is used to estimate the transmission rates in two periods due to the implementation of intensive interventions.
Results
Using the estimates of the transmission rates, the basic reproduction number was estimated in two periods. Due to the superspreader, the basic reproduction number was very large in the first period; however, the basic reproduction number of the second period has reduced significantly after intensive interventions.
Conclusion
It turned out to be the intensive isolation and quarantine interventions that were the most critical factors that prevented the spread of the MERS outbreak. The results are expected to be useful to devise more efficient intervention strategies in the future.

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Middle East Respiratory Syndrome Coronavirus Outbreak in the Republic of Korea, 2015
Osong Public Health Res Perspect 2015;6(4):269-278.
Published online August 31, 2015
DOI: https://doi.org/10.1016/j.phrp.2015.08.006
Objectives
The outbreak of Middle East respiratory syndrome coronavirus (MERS-CoV) infection in the Republic of Korea started from the index case who developed fever after returning from the Middle East. He infected 26 cases in Hospital C, and consecutive nosocomial transmission proceeded throughout the nation. We provide an epidemiologic description of the outbreak, as of July 2015.
Methods
Epidemiological research was performed by direct interview of the confirmed patients and reviewing medical records. We also analyzed the incubation period, serial interval, the characteristics of superspreaders, and factors associated with mortality. Full genome sequence was obtained from sputum specimens of the index patient.
Results
A total of 186 confirmed patients with MERS-CoV infection across 16 hospitals were identified in the Republic of Korea. Some 44.1% of the cases were patients exposed in hospitals, 32.8% were caregivers, and 13.4% were healthcare personnel. The most common presenting symptom was fever and chills. The estimated incubation period was 6.83 days and the serial interval was 12.5 days. A total of 83.2% of the transmission events were epidemiologically linked to five superspreaders, all of whom had pneumonia at presentation and contacted hundreds of people. Older age [odds ratio (OR) = 4.86, 95% confidence interval (CI) 1.90–12.45] and underlying respiratory disease (OR = 4.90, 95% CI 1.64–14.65) were significantly associated with mortality. Phylogenetic analysis showed that the MERS-CoV of the index case clustered closest with a recent virus from Riyadh, Saudi Arabia.
Conclusion
A single imported MERS-CoV infection case imposed a huge threat to public health and safety. This highlights the importance of robust preparedness and optimal infection prevention control. The lessons learned from the current outbreak will contribute to more up-to-date guidelines and global health security.

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