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Early countermeasures to COVID-19 at long-term care facilities in Gwangju Metropolitan City, Republic of Korea. 韩国光州长期护理机构的COVID-19早期对策
IF 4.3 Q1 Medicine Pub Date : 2023-02-01 DOI: 10.24171/j.phrp.2022.0293
Hye-Jin Kim, Jieun Kim, Yoon Suk Jang, Hanul Park, Jong Mu Kim, Young Joon Park, So-Yeon Ryu, Jun Hwi Cho, So Yeong Park, Sang-Eun Lee

Objectives: The coronavirus disease 2019 (COVID-19) pandemic has continued since its first detection in the Republic of Korea on January 20, 2020. This study describes the early countermeasures used to minimize the risk of COVID-19 outbreaks during cohort quarantine and compares the epidemiological characteristics of 2 outbreaks in long-term care facilities (LTCFs) in Gwangju Metropolitan City in summer 2020.

Methods: An epidemiological investigation was conducted via direct visits. We investigated epidemiological characteristics, including incidence, morbidity, and mortality rates, for all residents and staff members. Demographic characteristics were analyzed using a statistical program. Additionally, the method of managing infection in LTCFs is described.

Results: Residents and caregivers had high incidence rates in LTCF-A and LTCF-B, respectively. LTCF-B had a longer quarantine period than LTCF-A. The attack rate was 20.02% in LTCF-A and 27.9% in LTCF-B. The mortality rate was 2.3% (1/43) in LTCF-B, the only facility in which a COVID-19 death occurred.

Conclusions: Extensive management requires contact minimization, which involves testing all contacts to mitigate further transmission in the early stages of LTCF outbreaks. The findings of this study can help inform and prepare public health authorities for COVID-19 outbreaks, particularly for early control in vulnerable facilities.

2019冠状病毒病(COVID-19)自2020年1月20日在韩国首次发现以来,大流行仍在继续。本研究描述了在队列隔离期间为尽量减少COVID-19爆发风险而采取的早期对策,并比较了2020年夏季在光州长期护理机构(ltcf)发生的两起疫情的流行病学特征。方法:采用直接访视的方法进行流行病学调查。我们调查了所有居民和工作人员的流行病学特征,包括发病率、发病率和死亡率。使用统计程序分析人口统计学特征。此外,还描述了ltcf中管理感染的方法。结果:居民和护理人员LTCF-A和LTCF-B的发病率分别较高。LTCF-B的隔离期比LTCF-A长。LTCF-A和LTCF-B的发病率分别为20.02%和27.9%。LTCF-B的死亡率为2.3%(1/43),这是唯一发生COVID-19死亡的设施。结论:广泛管理需要最大限度地减少接触,这包括对所有接触者进行检测,以在LTCF暴发的早期阶段减轻进一步传播。这项研究的结果可以帮助公共卫生当局为COVID-19疫情提供信息并做好准备,特别是在脆弱设施中进行早期控制。
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引用次数: 0
How we will reach a safer community. 我们将如何建立一个更安全的社区。
IF 4.3 Q1 Medicine Pub Date : 2023-02-01 DOI: 10.24171/j.phrp.2023.0057
Jong-Koo Lee
At the end of last year, the Republic of Korea, China, and Japan responded to concerns about the increase in new coronavirus disease 2019 (COVID-19) patients and the emergence of new variants by strengthening their surveillance and quarantine measures. However, contrary to these concerns, the number of new cases and deaths decreased globally, and some have expressed the opinion that the World Health Organization (WHO) should reevaluate the declaration of a global public health crisis. However, the decision has been made to maintain the crisis status for the time being [1]. Nevertheless, in the first week of January, when the Rt value dropped below 1, the Republic of Korea implemented an exit strategy and has enforced it since January 30 [2]. The use of masks in public health facilities where a large number of people gather is now at individuals’ discretion, while their use is mandatory in public transportation. And, it is necessary to transition to a long-term strategy based on the endemicity of COVID-19. In the United States, the BXX. 1.5 variant has become predominant, but it is expected to be resolved by May 11th [3]. Therefore, the search for an exit strategy should consider which measures should be prioritized to prepare for the next pandemic. Building public trust in the safety and efficacy of currently available COVID-19 vaccines is of the utmost importance. Nationwide vaccination and booster programs have been initiated to curb the ongoing pandemic. During the vaccination campaign over the past 3 years, reports of vaccine adverse events have led to the need for research on the epidemiological relationship between vaccination and serious illnesses. To ensure scientific and objective judgments regarding this issue, the government has entrusted research on the adverse effects of COVID-19 vaccinations to the National Academy of Medicine of Korea. The study by Jeong et al. [4] published in this issue summarizes the methods used to research important adverse events following immunization; the ultimate goal of this research program is to increase the reliability of vaccines and combat vaccine hesitancy among medical professionals and the public. The second measure that must be prioritized is the improvement of governance by amending laws and regulations related to infectious diseases. After the Middle East respiratory syndrome outbreak in 2015, the government introduced a legal system that classifies reporting and quarantine methods for disease management based on the severity of each disease group. However, the severity of COVID-19 can change depending on vaccination or mutations in the virus. Thus, the government has changed the classification of COVID-19 from a level 1 disease, which requires immediate reporting, isolation, and treatment cost support, to a level 4 disease, which requires self-payment of treatment and surveillance. This adjustment of the severity level has created confusion in its management and procedural problems related to
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引用次数: 0
The first reported hepatitis E outbreak in a food manufacturing factory: Korea, 2022. 首次报告的戊型肝炎疫情发生在食品制造厂:韩国,2022年。
IF 4.3 Q1 Medicine Pub Date : 2023-02-01 DOI: 10.24171/j.phrp.2022.0305
Hansol Yeom, Soonryu Seo, Youngsil Yoon, Jaeeun Lee, Myung-Guk Han, Deog-Yong Lee, Sun-Whan Park, Song A Park, Sook-Hyang Jeong, Jin Gwack

Objectives: On February 16, 2022, 12 cases of hepatitis E virus (HEV) infection were reported in a food manufacturing factory in Korea. The aim of this study was to identify additional cases and to determine the source of this HEV outbreak.

Methods: This study was an in-depth investigation of 12 HEV immunoglobulin M (IgM)-positive cases and their demographic, clinical, and epidemiological characteristics. On-site specimens were collected from the environment and from humans, and a follow-up investigation was conducted 2 to 3 months after the outbreak.

Results: Among 80 production workers in the factory, 12 (15.0%) had acute HEV infection, all of whom were asymptomatic. The follow-up investigation showed that 3 cases were HEV IgMpositive, while 6 were HEV IgG-positive. HEV genes were not detected in the HEV IgM-positive specimens. HEV genes were not detected in the food products or environmental specimens collected on-site. HEV was presumed to be the causative pathogen. However, it could not be confirmed that the source of infection was common consumption inside the factory.

Conclusions: This was the first domestic case of an HEV infection outbreak in a food manufacturing factory in Korea. Our results provide information for the future control of outbreaks and for the preparation of measures to prevent domestic outbreaks of HEV infection.

目的:2022年2月16日,韩国一家食品制造厂报告了12例戊型肝炎病毒(HEV)感染。这项研究的目的是确定其他病例并确定HEV暴发的来源。方法:本研究对12例HEV免疫球蛋白M (IgM)阳性病例及其人口学、临床和流行病学特征进行了深入调查。从环境和人类中收集了现场标本,并在疫情发生2至3个月后进行了后续调查。结果:该厂80名生产工人中有12人(15.0%)急性HEV感染,均无症状。随访结果:3例HEV igg阳性,6例HEV igg阳性。HEV igm阳性标本中未检出HEV基因。在现场采集的食品或环境标本中未检出HEV基因。推测HEV为致病病原体。但是,目前还不能确定传染源是工厂内的普通消费。结论:这是韩国国内食品制造厂暴发的首例戊肝病毒感染病例。本研究结果为今后控制暴发和制定预防国内HEV感染暴发的措施提供了信息。
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引用次数: 0
Evaluation and follow-up of pain, fatigue, and quality of life in COVID-19 patients. COVID-19患者疼痛、疲劳和生活质量的评估与随访。
IF 4.3 Q1 Medicine Pub Date : 2023-02-01 DOI: 10.24171/j.phrp.2022.0275
Sevda Adar, Petek Şarlak Konya, Ali İzzet Akçin, Ümit Dündar, Neşe Demirtürk

Objectives: We evaluated pain, fatigue, anxiety, depression, and quality of life in patients hospitalized for coronavirus disease 2019 (COVID-19) and observed them over a period of 3 months. We also investigated the relationship of these symptoms to age, sex, disease severity, and levels of anxiety and depression.

Methods: The study included 100 confirmed COVID-19 patients (i.e., positive on a polymerase chain reaction test) between the ages of 18 and 75 years. Pain (visual analog scale [VAS]), fatigue (fatigue severity scale), anxiety, and depression (hospital anxiety and depression scales) were evaluated on the first day of hospitalization and at 1-month and 3-month follow-ups. The short form-12 questionnaire was used to measure quality of life at the 1-month and 3-month followups.

Results: No differences were found in pain, fatigue, anxiety levels, depression levels, and quality of life according to disease severity. High VAS scores at hospital admission were related to continued pain at the 3-month follow-up (odds ratio [OR], 1.067; p<0.001). High VAS (OR, 1.072; p=0.003) and anxiety levels (OR, 1.360; p=0.007) were related to severe fatigue at the 3-month evaluation.

Conclusions: Pain, fatigue, anxiety, and depression appear to be long-term sequelae of COVID-19 and can affect quality of life. High VAS and anxiety levels were found to be associated with long-term fatigue.

目的:评估2019冠状病毒病(COVID-19)住院患者的疼痛、疲劳、焦虑、抑郁和生活质量,并对其进行为期3个月的观察。我们还调查了这些症状与年龄、性别、疾病严重程度以及焦虑和抑郁水平的关系。方法:本研究纳入100例确诊的COVID-19患者(即聚合酶链反应试验阳性),年龄在18至75岁之间。在入院第一天及随访1个月和3个月时评估疼痛(视觉模拟量表[VAS])、疲劳(疲劳严重程度量表)、焦虑和抑郁(医院焦虑和抑郁量表)。在1个月和3个月的随访中,使用简短的表格-12问卷来测量生活质量。结果:根据疾病严重程度,疼痛、疲劳、焦虑水平、抑郁水平和生活质量均无差异。入院时VAS评分高与随访3个月时疼痛持续相关(优势比[OR], 1.067;结论:疼痛、疲劳、焦虑和抑郁似乎是COVID-19的长期后遗症,并可能影响生活质量。高VAS和焦虑水平被发现与长期疲劳有关。
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引用次数: 1
Chronic kidney disease in Indonesia: evidence from a national health survey. 印度尼西亚的慢性肾病:来自全国健康调查的证据。
IF 4.3 Q1 Medicine Pub Date : 2023-02-01 DOI: 10.24171/j.phrp.2022.0290
Puti Sari Hidayangsih, Dwi Hapsari Tjandrarini, Noor Edi Widya Sukoco, Nikson Sitorus, Ika Dharmayanti, Feri Ahmadi

Objectives: Several previous studies have stated that consuming certain foods and beverages might increase the risk of chronic kidney disease (CKD). This study aimed to examine the relationships of food and beverage consumption with other risk factors for CKD.

Methods: Data sources included the 2018 Basic Health Research (Riskesdas) and the National Socio-Economic Survey (Susenas), which were analyzed using a cross-sectional design. The study samples were households from 34 provinces in Indonesia, and the analysis was performed with provincial aggregates. Data were analyzed using risk factor analysis followed by linear regression to identify relationships with CKD.

Results: The prevalence of CKD in Indonesia was 0.38%. The province with the highest prevalence was North Kalimantan (0.64%), while the lowest was found in West Sulawesi (0.18%). Five major groups were formed from 15 identified risk factors using factor analysis. A linear regression model presented 1 significant selected factor (p=0.006, R2 =31%). The final model of risk factors included water quality, consumption of fatty foods, and a history of diabetes.

Conclusions: Drinking water quality, fatty food consumption, and diabetes are associated with CKD. There is a need to monitor drinking water, as well as to promote health education and provide comprehensive services for people with diabetes, to prevent CKD.

目的:先前的几项研究表明,摄入某些食物和饮料可能会增加慢性肾脏疾病(CKD)的风险。本研究旨在探讨食品和饮料消费与CKD其他危险因素的关系。方法:数据来源包括2018年基础卫生研究(Riskesdas)和国家社会经济调查(Susenas),采用横断面设计进行分析。研究样本为印度尼西亚34个省的家庭,并采用省汇总进行分析。数据分析采用风险因素分析,然后进行线性回归,以确定与CKD的关系。结果:印尼CKD患病率为0.38%。患病率最高的是北加里曼丹省(0.64%),最低的是西苏拉威西省(0.18%)。通过因子分析,将15个确定的危险因素分为五大组。线性回归模型显示1个显著因素(p=0.006, R2 =31%)。最后的风险因素模型包括水质、高脂肪食物的摄入和糖尿病史。结论:饮用水质量、高脂肪食物的摄入和糖尿病与慢性肾病有关。有必要监测饮用水,并促进健康教育,为糖尿病患者提供全面的服务,以预防慢性肾病。
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引用次数: 0
Association between the empirical dietary inflammatory index and musculoskeletal pain in community-dwelling older adults: a cross-sectional study. 经验饮食炎症指数与社区老年人肌肉骨骼疼痛之间的关系:一项横断面研究。
IF 4.3 Q1 Medicine Pub Date : 2023-02-01 DOI: 10.24171/j.phrp.2022.0194
Mahshid Rezaei, Zahra Tajary, Zahra Esmaeily, Atefeh Eyvazkhani, Shahrzad Daei, Marjan Mansouri Dara, Mohaddeseh Rezaei, Abolghassem Djazayeri, Ahmadreza Dorosty Motlagh

Objectives: Inflammation has been proposed to be one of the main causes of musculoskeletal pain. Diet is a lifestyle factor that plays an important role in managing inflammation; thus, we assessed the inflammatory potential of diets using the empirical dietary inflammatory index (EDII) to investigate the relationship between diet and musculoskeletal pain.

Methods: This cross-sectional study included 212 elderly individuals who were selected from health centers in Tehran, Iran. Dietary intake was evaluated using a valid and reliable 147-item food frequency questionnaire. To measure the intensity of pain, a visual analogue scale was used. Multiple linear regression was applied to assess the association between the EDII and musculoskeletal pain.

Results: In total, 62.7% and 37.3% of participants had mild and severe pain, respectively. The EDII values were 0.97±0.72 and 1.10±0.66, respectively, in those with mild and severe pain. A higher EDII score was associated with more intense musculoskeletal pain after adjusting for age and sex (β=0.20; 95% confidence interval [CI], 0.06-0.26; p<0.001), but not after adjustment for other confounders (β=-0.13; 95% CI, -1.54 to 0.60; p=0.39).

Conclusions: Our findings indicated that higher dietary inflammation might not be associated with musculoskeletal pain in older adults. However, further investigations are required to confirm these findings.

目的:炎症被认为是肌肉骨骼疼痛的主要原因之一。饮食是一种生活方式,在控制炎症方面起着重要作用;因此,我们使用经验饮食炎症指数(EDII)来评估饮食的炎症潜力,以研究饮食与肌肉骨骼疼痛之间的关系。方法:这项横断面研究包括从伊朗德黑兰的卫生中心选择的212名老年人。膳食摄入量评估采用有效可靠的147项食物频率问卷。采用视觉模拟量表测量疼痛强度。应用多元线性回归来评估EDII与肌肉骨骼疼痛之间的关系。结果:62.7%和37.3%的参与者分别有轻度和重度疼痛。轻度疼痛组和重度疼痛组的EDII值分别为0.97±0.72和1.10±0.66。在调整年龄和性别后,较高的EDII评分与更强烈的肌肉骨骼疼痛相关(β=0.20;95%置信区间[CI], 0.06-0.26;结论:我们的研究结果表明,较高的饮食炎症可能与老年人的肌肉骨骼疼痛无关。然而,需要进一步的调查来证实这些发现。
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引用次数: 1
Association between face covering policies and the incidence of coronavirus disease 2019 in European countries. 欧洲国家口罩政策与2019冠状病毒病发病率之间的关系
IF 4.3 Q1 Medicine Pub Date : 2023-02-01 DOI: 10.24171/j.phrp.2022.0287
Sookhyun Kim, Jiyoung Oh, Sangwoo Tak

Objectives: This study was conducted to determine the impact of the strengthening or relaxation of face covering mandates on the subsequent national case incidence of coronavirus disease 2019 (COVID-19) in Europe as the full vaccination rate was increasing.

Methods: European countries in which case incidence increased for 3 consecutive weeks were monitored and analyzed using COVID-19 incidence data shared by the World Health Organization (WHO). The epidemic trend of COVID-19 in Europe was compared with that of countries elsewhere in the world based on WHO weekly epidemiological reports from June 20 to October 30, 2021. In addition, this study provided insight into the impact of government mask mandates on COVID-19 incidence in Europe by measuring the index scores of those facial covering policies before and after mandate relaxation or strengthening. The effects of the vaccination rate and the speed of vaccination on COVID-19 incidence were also analyzed.

Results: The incidence of COVID-19 after the relaxation of face covering mandates was significantly higher than before relaxation. However, no significant difference was observed in vaccination rate between countries with increased and decreased incidence. Instead, rapid vaccination delayed the resurgence in incidence.

Conclusions: The findings suggest that face covering policies in conjunction with rapid vaccination efforts are essential to help mitigate the spread of COVID-19.

目的:本研究旨在确定随着全面疫苗接种率的提高,加强或放松蒙面规定对随后欧洲冠状病毒病2019 (COVID-19)全国病例发病率的影响。方法:利用世界卫生组织(WHO)共享的COVID-19发病率数据,对病例连续3周增加的欧洲国家进行监测和分析。根据世卫组织2021年6月20日至10月30日的每周流行病学报告,将新冠肺炎在欧洲的流行趋势与世界其他国家的流行趋势进行了比较。此外,本研究还通过衡量这些口罩政策放松或加强前后的指数得分,深入了解了政府口罩规定对欧洲COVID-19发病率的影响。分析疫苗接种率和接种速度对新冠肺炎发病的影响。结果:放宽蒙面规定后,新冠肺炎的发病率明显高于放松前。然而,在疫苗接种率升高和降低的国家之间没有观察到显著差异。相反,快速接种疫苗延缓了发病率的回升。结论:研究结果表明,面罩政策与快速疫苗接种工作相结合,对于帮助缓解COVID-19的传播至关重要。
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引用次数: 0
A framework for nationwide COVID-19 vaccine safety research in the Republic of Korea: the COVID-19 Vaccine Safety Research Committee. 大韩民国全国COVID-19疫苗安全研究框架:COVID-19疫苗安全研究委员会。
IF 4.3 Q1 Medicine Pub Date : 2023-02-01 DOI: 10.24171/j.phrp.2023.0026
Na-Young Jeong, Hyesook Park, Sanghoon Oh, Seung Eun Jung, Dong-Hyun Kim, Hyoung-Shik Shin, Hee Chul Han, Jong-Koo Lee, Jun Hee Woo, Byung-Joo Park, Nam-Kyong Choi

With the introduction of coronavirus disease 2019 (COVID-19) vaccines, the Korea Disease Control and Prevention Agency (KDCA) commissioned the National Academy of Medicine of Korea to gather experts to independently assess post-vaccination adverse events. Accordingly, the COVID-19 Vaccine Safety Research Committee (CoVaSC) was launched in November 2021 to perform safety studies and establish evidence for policy guidance. The CoVaSC established 3 committees for epidemiology, clinical research, and communication. The CoVaSC mainly utilizes pseudonymized data linking KDCA's COVID-19 vaccination data and the National Health Insurance Service's claims data. The CoVaSC's 5-step research process involves defining the target diseases and organizing ad-hoc committees, developing research protocols, performing analyses, assessing causal relationships, and announcing research findings and utilizing them to guide compensation policies. As of 2022, the CoVaSC completed this research process for 15 adverse events. The CoVaSC launched the COVID-19 Vaccine Safety Research Center in September 2022 and has been reorganized into 4 divisions to promote research including international collaborative studies, long-/short-term follow-up studies, and education programs. Through these enhancements, the CoVaSC will continue to swiftly provide scientific evidence for COVID-19 vaccine research and compensation and may serve as a model for preparing for future epidemics of new diseases.

随着2019冠状病毒病(COVID-19)疫苗的推出,疾病管理本部委托国立医学科学院召集专家,对疫苗接种后的不良反应进行独立评估。因此,2021年11月成立了COVID-19疫苗安全性研究委员会(CoVaSC),开展安全性研究并为政策指导建立证据。CoVaSC设立了流行病学、临床研究和传播3个委员会。CoVaSC主要利用了将防疫厅的新冠疫苗接种数据和国民健康保险公团的理赔数据连接起来的假名数据。CoVaSC的5步研究过程包括确定目标疾病和组织特设委员会,制定研究方案,进行分析,评估因果关系,宣布研究结果并利用它们来指导补偿政策。截至2022年,CoVaSC完成了15个不良事件的研究过程。CoVaSC于2022年9月成立了COVID-19疫苗安全研究中心,并将其重组为4个部门,以推进国际合作研究、长期/短期随访研究和教育项目等研究。通过这些改进,CoVaSC将继续迅速为COVID-19疫苗研究和补偿提供科学证据,并可作为准备应对未来新疾病流行的模式。
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引用次数: 2
mRNA vaccine effectiveness against SARS-CoV-2 B.1.617.2 (Delta) and B.1.1.529 (Omicron) variant transmission from home care cases to household contacts in South Korea. 韩国SARS-CoV-2 B.1.617.2 (Delta)和B.1.1.529 (Omicron)变体从家庭护理病例到家庭接触者传播的mRNA疫苗有效性
IF 4.3 Q1 Medicine Pub Date : 2022-12-01 DOI: 10.24171/j.phrp.2022.0243
Hanul Park, Young Joon Park, Sang Eun Lee, Min Jei Lee, Hyungtae Ahn

Objectives: Household contacts of confirmed cases of coronavirus disease 2019 (COVID-19) areexposed to a high risk of viral transmission, and secondary incidence is an important indicatorof community transmission. This study analyzed the secondary attack rate and mRNA vaccineeffectiveness against transmission (VET) for index cases (patients treated at home) confirmedto be infected with the Delta and Omicron variants.

Methods: The subjects of the study were 4,450 index cases and 10,382 household contacts.Logistic regression analysis was performed to compare the secondary attack rate byvaccination status, and adjusted relative risk and 95% confidence intervals were identified.

Results: The secondary attack rate of the Delta variant was 27.3%, while the secondary attackrate of the Omicron variant was 29.8%. For the Delta variant, groups with less than 90 daysand more than 90 days after 2 doses of mRNA vaccination both showed a VET of 37%. For theOmicron variant, a 64% VET was found among those with less than 90 days after 2 doses ofmRNA vaccination.

Conclusion: This study provides useful data on the secondary attack rate and VET of mRNAvaccines for household contacts of COVID-19 cases in South Korea.

目的:2019冠状病毒病(COVID-19)确诊病例的家庭接触者是病毒传播的高危人群,继发发病率是社区传播的重要指标。本研究分析了确认感染Delta和Omicron变异的指示病例(在家治疗的患者)的二次发作率和mRNA疫苗抗传播(VET)的有效性。方法:选取4450例病例和10382例家庭接触者作为研究对象。采用Logistic回归分析比较疫苗接种状况对继发发病率的影响,确定调整后的相对危险度和95%置信区间。结果:Delta变异继发率为27.3%,Omicron变异继发率为29.8%。对于Delta变体,接种2剂mRNA疫苗后少于90天和超过90天的组的VET均为37%。对于omicron变体,在2剂mrna疫苗接种后不到90天的患者中发现了64%的VET。结论:本研究为韩国COVID-19家庭接触者mrnavv疫苗的二次发作率和VET提供了有用的数据。
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引用次数: 2
Time-series comparison of COVID-19 case fatality rates across 21 countries with adjustment for multiple covariates. 21个国家COVID-19病死率的时间序列比较,并对多个协变量进行调整。
IF 4.3 Q1 Medicine Pub Date : 2022-12-01 DOI: 10.24171/j.phrp.2022.0212
Yongmoon Kim, Bryan Inho Kim, Sangwoo Tak

Objectives: 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.

虽然它被广泛用作死亡率的衡量标准,但2019年冠状病毒病(COVID-19)的病死率(CFR)可能会随着时间的推移而变化,并且由于病毒特征以外的许多原因而波动。为了在同等程度上比较不同国家的CFRs,我们在调整多个协变量后估计了可比较的CFRs,并检查了21个国家中导致CFRs变异的主要因素。方法:采用OurWorld in data、CoVariants.org和GISAID的时间序列截面数据进行统计分析。通过面板数据的合并广义线性平方回归模型估计COVID-19的双周cfr。协变量包括主要病毒变异、繁殖率、疫苗接种、国民经济状况、医院床位、糖尿病患病率和65岁以上人口比例。总共有21个国家有资格进行分析。结果:协变量的调整减少了COVID-19在不同国家和不同时期的cfr差异。回归结果显示,Omicron变异的显性传播、繁殖率和疫苗接种与较低的国家级CFRs相关,而年龄、极端贫困率和糖尿病患病率与较高的国家级CFRs相关。结论:直接比较各国之间的粗cfr可能是错误的,特别是在横断面分析中。我们的研究提出了一种调整后的CFRs随时间的比较,以便进行更适当的比较。此外,我们的研究结果表明,应避免在不考虑其背景(如流行阶段、医疗能力、监测策略和社会人口特征)的情况下比较不同国家的CFRs。
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Osong Public Health and Research Perspectives
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