Clinical Characteristics and Risk Factors for Mortality in Critical COVID-19 Patients Aged 50 Years or Younger During Omicron Wave in Korea: Comparison With Patients Older Than 50 Years of Age

Shi Hye Jin,Yang Jinyoung,Eom Joong Sik,Ko Jae-Hoon,Peck Kyong Ran,Kim Uh Jin,Jung Sook In,Kim Seulki,Seok Hyeri,Hyun Miri,Kim Hyun Ah,Kim Bomi,Joo Eun-Jeong,Cheong Hae Suk,Jun Cheon Hoo,Wi Yu Mi,Kim 대한의학회 2023 Journal of Korean medical science Vol.38 No.28

Background: The coronavirus disease 2019 (COVID-19) pandemic has caused the death of thousands of patients worldwide. Although age is known to be a risk factor for morbidity and mortality in COVID-19 patients, critical illness or death is occurring even in the younger age group as the epidemic spreads. In early 2022, omicron became the dominant variant of the COVID-19 virus in South Korea, and the epidemic proceeded on a large scale. Accordingly, this study aimed to determine whether young adults (aged ≤ 50 years) with critical COVID-19 infection during the omicron period had different characteristics from older patients and to determine the risk factors for mortality in this specific age group. Methods: We evaluated 213 critical adult patients (high flow nasal cannula or higher respiratory support) hospitalized for polymerase chain reaction-confirmed COVID-19 in nine hospitals in South Korea between February 1, 2022 and April 30, 2022. Demographic characteristics, including body mass index (BMI) and vaccination status; underlying diseases; clinical features and laboratory findings; clinical course; treatment received; and outcomes were collected from electronic medical records (EMRs) and analyzed according to age and mortality. Results: Overall, 71 critically ill patients aged ≤ 50 years were enrolled, and 142 critically ill patients aged over 50 years were selected through 1:2 matching based on the date of diagnosis. The most frequent underlying diseases among those aged ≤ 50 years were diabetes and hypertension, and all 14 patients who died had either a BMI ≥ 25 kg/m2 or an underlying disease. The total case fatality rate among severe patients (S-CFR) was 31.0%, and the S-CFR differed according to age and was higher than that during the delta period. The S-CFR was 19.7% for those aged ≤ 50 years, 36.6% for those aged > 50 years, and 38.1% for those aged ≥ 65 years. In multivariate analysis, age (odds ratio [OR], 1.084; 95% confidence interval [CI], 1.043–1.127), initial low-density lipoprotein > 600 IU/L (OR, 4.782; 95% CI, 1.584–14.434), initial C-reactive protein > 8 mg/dL (OR, 2.940; 95% CI, 1.042–8.293), highest aspartate aminotransferase > 200 IU/L (OR, 12.931; 95% CI, 1.691–98.908), and mechanical ventilation implementation (OR, 3.671; 95% CI, 1.294–10.420) were significant independent predictors of mortality in critical COVID-19 patients during the omicron wave. A similar pattern was shown when analyzing the data by age group, but most had no statistical significance owing to the small number of deaths in the young critical group. Although the vaccination completion rate of all the patients (31.0%) was higher than that in the delta wave period (13.6%), it was still lower than that of the general population. Further, only 15 (21.1%) critically ill patients aged ≤ 50 years were fully vaccinated. Overall, the severity of hospitalized critical patients was significantly higher than that in the delta period, indicating that it was difficult to find common risk factors in the two periods only with a simple comparison. Conclusion: Overall, the S-CFR of critically ill COVID-19 patients in the omicron period was higher than that in the delta period, especially in those aged ≤ 50 years. All of the patients who died had an underlying disease or obesity. In the same population, the vaccination rate was very low compared to that in the delta wave, indicating that non-vaccination significantly affected the progression to critical illness. Notably, there was a lack of prescription for Paxlovid for these patients although they satisfied the prescription criteria. Early diagnosis and active initial treatment was necessary, along with the proven methods of vaccination and personal hygiene. Further studies are needed to determine how each variant affects critically ill patients.

Clinical Characteristics and Risk Factors for Mortality in Critical Coronavirus Disease 2019 Patients 50 Years of Age or Younger During the Delta Wave: Comparison With Patients > 50 Years in Korea

Shi Hye Jin,Nham Eliel,Kim Bomi,Joo Eun-Jeong,Cheong Hae Suk,Hong Shin Hee,Hyun Miri,Kim Hyun ah,Jang Sukbin,Rhee Ji-Young,Kim Jungok,Kim Sungmin,Cho Hyun Kyu,Wi Yu Mi,Cheon Shinhye,Kim Yeon-Sook,Lim 대한의학회 2022 Journal of Korean medical science Vol.37 No.22

Background: Numerous patients around the globe are dying from coronavirus disease 2019 (COVID-19). While age is a known risk factor, risk analysis in the young generation is lacking. The present study aimed to evaluate the clinical features and mortality risk factors in younger patients (≤ 50 years) with a critical case of COVID-19 in comparison with those among older patients (> 50 years) in Korea. Methods: We analyzed the data of adult patients only in critical condition (requiring high flow nasal cannula oxygen therapy or higher respiratory support) hospitalized with PCR confirmed COVID-19 at 11 hospitals in Korea from July 1, 2021 to November 30, 2021 when the delta variant was a dominant strain. Patients’ electronic medical records were reviewed to identify clinical characteristics. Results: During the study period, 448 patients were enrolled. One hundred and forty-two were aged 50 years or younger (the younger group), while 306 were above 50 years of age (the older group). The most common pre-existing conditions in the younger group were diabetes mellitus and hypertension, and 69.7% of the patients had a body mass index (BMI) > 25 kg/m2 . Of 142 younger patients, 31 of 142 patients (21.8%, 19 women) did not have these pre-existing conditions. The overall case fatality rate among severity cases was 21.0%, and it differed according to age: 5.6% (n = 8/142) in the younger group, 28.1% in the older group, and 38% in the ≥ 65 years group. Age (odds ratio [OR], 7.902; 95% confidence interval [CI], 2.754–18.181), mechanical ventilation therapy (OR, 17.233; 95% CI, 8.439–35.192), highest creatinine > 1.5 mg/dL (OR, 17.631; 95% CI, 8.321–37.357), and combined blood stream infection (OR, 7.092; 95% CI, 1.061–18.181) were identified as independent predictors of mortality in total patients. Similar patterns were observed in age-specific analyses, but most results were statistically insignificant in multivariate analysis due to the low number of deaths in the younger group. The full vaccination rate was very low among study population (13.6%), and only three patients were fully vaccinated, with none of the patients who died having been fully vaccinated in the younger group. Seven of eight patients who died had a pre-existing condition or were obese (BMI > 25 kg/m2 ), and the one remaining patient died from a secondary infection. Conclusion: About 22% of the patients in the young critical group did not have an underlying disease or obesity, but the rate of obesity (BMI > 25 kg/m2 ) was high, with a fatality rate of 5.6%. The full vaccination rate was extremely low compared to the general population of the same age group, showing that non-vaccination has a grave impact on the progression of COVID-19 to a critical condition. The findings of this study highlight the need for measures to prevent critical progression of COVID-19, such as vaccinations and targeting young adults especially having risk factors.

Effects of Non-Pharmacological Interventions on Respiratory Viruses Other Than SARS-CoV-2: Analysis of Laboratory Surveillance and Literature Review From 2018 to 2021

Shi Hye Jin,Kim Nam Yee,Eom Sun Ah,Kim-Jeon Myung Deok,Oh Sung Suck,Moon Bag Sou,Kwon Mun Ju,Eom Joong Sik 대한의학회 2022 Journal of Korean medical science Vol.37 No.21

Background: Since the global coronavirus disease 2019 (COVID-19) pandemic, nonpharmacological interventions (NPIs) such as extensive and comprehensive hand hygiene, mask-wearing, and social distancing have been implemented globally. This study aimed to investigate changes in respiratory viruses other than severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) that occurred following the implementation of these NPIs. Methods: From January 2018 to December 2021, influenza-like illness patient specimens and specimens from the Korea Influenza and Respiratory Viruses Surveillance System were analyzed at the Incheon Metropolitan City Institute of Public Health and Environment. Oropharyngeal or nasopharyngeal swab samples from respiratory infection patients were transferred in a virus transport medium at 4°C. After RNA or DNA extraction, respiratory virus-specific genes for human influenza virus (IFV), adenovirus (ADV), parainfluenza virus (PIV), respiratory syncytial virus (RSV), human rhinovirus (hRV), human coronavirus, human bocavirus, and human metapneumovirus were detected by individual real-time reverse transcription polymerase chain reaction. Results: A total 3,334 samples were collected. After NPI was implemented, the detection of respiratory viruses other than SARS-CoV-2 decreased overall. The yearly detection rate of respiratory viruses was decreased from 69.5% (399/574) in 2018 and 73.3% (505/689) in 2019 to 19.8% (206/1,043) in 2020 and 34.9% (365/1,028) in 2021. The epidemic was more prominent in respiratory viruses such as IFV and RSV, which were considered dominant viruses, especially those with viral envelopes. Among viruses that were not considered dominant, hRV showed no clear change before and after NPI, while PIV showed a rapid increase compared to the existing dominant viruses between October–December 2021, after the increase in the number of gatherings started at the end of September and the “Relaxing COVID19 and mitigation policy,” which was implemented on November 1. Conclusion: NPI seems to have influenced the isolation and transmission of respiratory viruses in South Korea. In the future, additional studies focusing on the isolation and transmission patterns of respiratory viruses following NPI are needed.

Identification of Porcine Follicular Fluid Proteins of Mature and Immature Follicles in Using Proteomics

Shi, Quan Van,Lee, Hye-Ran,Kim, Hong-Rye,Park, Chang-Sik,Jin, Dong-Il 한국수정란이식학회 2006 한국수정란이식학회 학술대회 Vol.2006 No.1

살인 행동을 보인 정신분열병 환자에서 MMPI와 SCL-90-R 검사의 특징

강시현(Shi Hyun Kang),정석훈(Seockhoon Chung),정재열(Jaeyeul Jung),정혜윤(Hye Yoon Chung),성명제(Myung-Jae Sung),김민후(Min Hoo Kim),송해철(Hae-Cheol Song),권수희(Soo Hie Kwon),진영식(Young Sik Jin),백상빈(Sang-Bin Baek) 대한사회정신의학회 2005 사회정신의학 Vol.10 No.2

목 적: 공격성은 정신분열병 환자에게 나타나는 심각한 문제 중 하나이다. 공격성의 가장 극단적 형태인 살인 행동을 보인 정신분열병 환자들이 경험하는 주관적인 정신 증상 및 심리 상태의 특성을 알아보고자 본 연구를 시행하였다. 방 법: 살인 행동이 있었던 정신분열병 입원 환자(n=64)를 연구대상으로 하였고 살인 행동은 없었으며 실험군과 나이, 교육 연한, 항정신병 약물 용량을 짝짓기하여 선정한 정신분열병 입원 환자를 대조군(n=75)으로 선정하여 두 군간의 주관적 정신 증상 및 심리상태를 비교 연구하였다. 주관적 상태는 Minnesota Multiphasic Personality Inventory(MMPI)와 Symptom checklist-90-R(SCL-90-R)로 평가하였다. 살인 행동 환자군은 살인 행동 후 정신감정 시점에 검사된 MMPI와 SCL-90-R결과를 얻었다. 결 과: 살인 행동을 보인 환자군은 대조군에 비하여 MMPI와 SCL-90-R검사 모두에서 전반적으로 더 높은 점수를 받았다. MMPI 검사에서 우울증, 히스테리, 반사회성, 편집증, 내향성 척도가 살인 행동군에서 대조군에 비해 유의하게 높았다. SCL-90-R 검사에 서는 강박증, 대인관계 예민성, 불안, 편집증, 정신증 항목에서 살인 행동군에서 통계적으로 유의하게 높은 점수를 보였다. 결 론: 살인 행동을 보인 정신분열병 환자군은 주관적으로 사회적 상황에서 정서적으로 불안정하여 피해의식을 쉽게 느끼고 분노와 정감 조절이 어려울 때 인지적 왜곡에 부합하여 공격적 행동이 유발될 가능성이 있다. Objectives:Violence is a serious problem in some patients with schizophrenia. Homicide is one of the most extreme aggressive behavior. The purpose of this study was to investigate the characteristics of subjective symptomatology and psychological state of schizophrenia with homicidal behavior. Methods:Subjects were schizophrenia patients hospitalized in a mental hospital due to their homicidal behavior (n=64, group 1). Control subjects were schizophrenia patients without homicide also hospitalized in another mental hospital(n=75, group 2). Subjects were matched by age, years of education and dosage of antipsychotics. Minnesota Multiphasic Personality Inventory(MMPI) and Symptom checklist-90-R(SCL-90-R) were used to evaluate the subjective symptomatology. In group 1, the results of MMPI and SCL-90-R had been acquired following the incident that led to hospitalization. Results:Schizophrenia patients with homicide showed overall elevated MMPI clinical scales and SCL-90-R scales. The group with homicidal behavior had significantly higher scores than patients without homicidal behavior on the subscales of depression, hysteria, psychopathic deviance, paranoid, social introversion as assessed by the MMPI. They also had significantly higher scores on the subscales of obsessive-compulsive, interpersonal sensitivity, anxiety, paranoid ideation, psychoticism as assessed by the SCL-90-R. Conclusion:Schizophrenia patients with homicidal behavior did present different clinical subjective pictures : unstable emotion, more paranoid tendency, difficulty with control of anger, more perceptual disturbance. Under those subjective states they had a risk of violent behavior.

Autophagy Negatively Regulates Keratinocyte Inflammatory Responses via Scaffolding Protein p62/SQSTM1.

Lee, Hye-Mi,Shin, Dong-Min,Yuk, Jae-Min,Shi, Ge,Choi, Dae-Kyoung,Lee, Sang-Hee,Huang, Song Mei,Kim, Jin-Man,Kim, Chang Deok,Lee, Jeung-Hoon,Jo, Eun-Kyeong Williams Wilkins 2011 JOURNAL OF IMMUNOLOGY Vol.186 No.2

<P>The scaffolding adaptor protein p62/SQSTM1 (p62) has been shown to be an autophagy receptor that acts as a link between the ubiquitination and autophagy machineries. However, the roles of autophagy and p62 in human keratinocytes are not well understood. In this study, we show that keratinocyte autophagy negatively regulates p62 expression, which is essential for the prevention of excessive inflammation and the induction of cathelicidin in human keratinocytes. Stimulation of TLR2/6 or TLR4 in primary human keratinocytes robustly activated autophagy pathways and up-regulated p62 expression through induction of NADPH oxidases 2 and 4 and the generation of reactive oxygen species. MyD88 and TNFR-associated factor 6, key signaling molecules that mediate TLR activation, played an essential role in the induction of autophagy and p62 expression. Additionally, blockade of autophagy significantly increased the generation of inflammatory cytokines and expression of p62 in primary human keratinocytes. Notably, silencing hp62 through RNA interference resulted in a significant decrease in NF-관B activation, inflammatory cytokine production, cathelicidin expression, and cell proliferation (as well as cyclin D1 expression) in keratinocytes. Epidermal expression of p62 was further found to be significantly higher in psoriatic skin than in skin affected by atopic dermatitis or from healthy controls. Collectively, our data provide new insights into the roles of autophagy and p62 in controlling cutaneous inflammation.</P>

Evaluation of combined skin equivalents with gelatin and fibrin

Hyo Jin Kim,Hye Na Kang,Ho Jung Oh,Soon Nam Kim,Pan Soon Kim,Young Lim Kim,Nae Ry Lee,Gwan Soo Kim,Min Joo Cho,Fu Shi Qaun,Jong Hwan Lee,Hong Ki Min,Seung Hwa Hong 한국생물공학회 2007 한국생물공학회 학술대회 Vol.2007 No.10

Efficient hysteresis-less bilayer type CH₃NH₃PbI₃ perovskite hybrid solar cells

Park, Jin Kyoung,Heo, Jin Hyuck,Han, Hye Ji,Lee, Min Ho,Song, Dae Ho,You, Myoung Sang,Sung, Shi-Joon,Kim, Dae-Hwan,Im, Sang Hyuk IOP 2016 Nanotechnology Vol.27 No.2

<P>Bilayer type CH<SUB>3</SUB>NH<SUB>3</SUB>PbI<SUB>3</SUB> (MAPbI<SUB>3</SUB>) perovskite hybrid solar cells were fabricated via a one-step spin-coating process by using solubility controlled MAPbI<SUB>3</SUB> solutions of MAPbI<SUB>3</SUB>–DMSO (dimethyl sulfoxide) and MAPbI<SUB>3</SUB>–DMF (N, N-dimethylformamide)–HI. The best DMSO-bilayer device showed 1.07?±?0.02 V <I>V</I> <SUB>oc</SUB> (open-circuit voltage), 20.2?±?0.1 mA cm<SUP>−2</SUP> <I>J</I> <SUB>sc</SUB> (short-circuit current density), 68?±?2% FF (fill factor), and 15.2?±?0.3% <I>η</I> (overall power conversion efficiency) under the forward scan direction and 1.07?±?0.02 V <I>V</I> <SUB>oc</SUB>, 20.4?±?0.1 mA cm<SUP>−2</SUP> <I>J</I> <SUB>sc</SUB>, 70?±?3% FF, and 15.9?±?0.4% <I>η</I> under the reverse scan direction. The best HI-bilayer device had 1.08?±?0.02 V <I>V</I> <SUB>oc</SUB>, 20.6?±?0.1 mA cm<SUP>−2</SUP> <I>J</I> <SUB>sc</SUB>, 75?±?1% FF, and 17.2?±?0.2% <I>η</I> under the forward scan direction and 1.08?±?0.02 V <I>V</I> <SUB>oc</SUB>, 20.6?±?0.1 mA cm<SUP>−2</SUP> <I>J</I> <SUB>sc</SUB>, 76?±?2% FF, and 17.4?±?0.3% <I>η</I> under the reverse scan direction. The deviation of average device efficiency (<img ALIGN='MIDDLE' ALT='${\eta }_{{\rm{avg}}})$' SRC='http://ej.iop.org/images/0957-4484/27/2/024004/nanoaa0741ieqn1.gif'/> of 20 DMSO samples and 20 HI samples was 14.2?±?0.95% and 16.2?±?0.85%, respectively. Therefore, the HI-bilayer devices exhibited better device efficiency and smaller <I>J</I>–<I>V</I> (current density–voltage) hysteresis with respect to the scan direction than the DMSO-bilayer devices due to the reduced recombination and traps by the formation of a purer and larger MAPbI<SUB>3</SUB> perovskite crystalline film.</P>

Effects of Ti addition on sol-gel derived InO and InZnO thin film transistors

Kim, Jung-Hye,Son, Dae-Ho,Park, Si-Nea,Kim, Dae-Hwan,Sung, Shi-Joon,Jung, Eun-Ae,Ha, KiRyong,Kang, Jin-Kyu Elsevier 2012 Current Applied Physics Vol.12 No.suppl1

<P><B>Abstract</B></P><P>In this study, we have newly developed titanium-indium oxide (TiInO) and titanium-indium zinc oxide (TiInZnO) thin films as the active channel layer in thin film transistors (TFTs) by the sol-gel process. The effects of adding Ti on TiInO and TiInZnO TFTs were investigated. The addition of Ti elements can suppress formation of oxygen vacancies because of the stronger oxidation tendency of Ti relative to that of Zn or In. TiInO and TiInZnO TFTs showed lower off currents and higher on/off current ratios than pure InO and InZnO TFTs. A TiInO TFT doped with 10.31 mol% Ti showed good performance with an on/off current ratio greater than 10<SUP>7</SUP>, and a field-effect mobility of 1.91 cm<SUP>2</SUP> V<SUP>−1</SUP> S<SUP>−1</SUP>. A TiInZnO TFT doped with 2.92 mol % Ti showed an on/off current ratio greater than 10<SUP>6</SUP>, and a field-effect mobility of 0.45 cm<SUP>2</SUP> V<SUP>−1</SUP> S<SUP>−1</SUP>.</P>

Clinical Characteristics of Nocardiosis: a Multicenter Retrospective Study in Korea

Kim Seulki,Shi Hye Jin,Jeon Cheon-Hoo,Kim Sun Bean,Yi Jongyoun,Kim A Reum,Kim Kye-Hyung,Lim Seungjin 대한감염학회 2023 Infection and Chemotherapy Vol.55 No.4

Background: Nocardiosis is a rare, but potentially life-threatening condition. It is difficult to diagnose, and bacterial culture identification can be time consuming. We investigated the characteristics of nocardiosis and the suitability of the treatment approach in Korea. Materials and Methods: This retrospective study was conducted at 5 medical institutions between 2011 and 2021. We reviewed the medical records of patients with microbiologically confirmed nocardiosis. Appropriate antibiotic selection was defined as follows: (1) selecting antibiotics according to the species, (2) if the species of Nocardia was unknown, trimethoprim-sulfamethoxazole-based therapy or linezolid-based therapy was administered, and (3) selection of antibiotics using the antibiotic susceptibility test. The appropriate treatment periods for antibiotics were defined as treatment maintained from 3 to 12 months, depending on involvement of the organs. Descriptive analysis and Fisher exact test were used. Statistical significance was set at P-values of <0.05. Results: Thirty patients were enrolled. Of these patients, 18 (60.0%) were male. The median age was 70.5 years. Among the diagnosed patients, 12 (40.0%) had an immunocompromised status. Eight (30.0%) patients received optimal treatment for the appropriate treatment period. Appropriate dosing duration was observed in 3 of the 12(25.0%) immunocompromised patients. There was no significant difference between the presence or absence of immunosuppression and the adequacy of treatment for nocardiosis (P = 1.000). Skin and soft tissue (14 patients) were most frequently involved in this study. Nocardia species (spp.) were isolated from culture at a median of 6.0 days. There were 7 cases with N. farcinica (23.3%). Conclusion: We found that 60.0% of the patients with nocardiosis did not have an immunocompromised status. Further, 26.7% of the total patients received adequate treatment for nocardiosis. The reasons for suboptimal management of nocardiosis in Korea are presumed to be diagnostic difficulties, lack of awareness about nocardiosis, and difficulties in selecting antibiotics for Nocardia spp. among clinicians. The lack of antibiotic susceptibility tests for Nocardia spp. could be the source of these problems. Nocardiosis should be suspected in cases of recurrent infections with skin and soft tissue, musculoskeletal, or respiratory system involvement with or without an immunocompromised status. Clinical microbiological support is required for the diagnosis and selection of antibiotics in Korea. High clinical index of suspicion and clinical microbiological support are required for the accurate diagnosis of nocardiosis in Korea.