Kosin Medical Journal

Original articles

Resurgence of multidrug-resistant tuberculosis during the COVID-19 pandemic in Korea: Tae Hoon Kim, I Re Heo, Ho Cheol Kim; Received March 3, 2025 Accepted April 16, 2025 Published online June 23, 2025; DOI: https://doi.org/10.7180/kmj.25.105 [Epub ahead of print]

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Abstract PDF PubReader ePub: Background
The coronavirus disease 2019 pandemic, which emerged in 2020, disrupted healthcare systems globally, affecting tuberculosis (TB) diagnosis and reporting. This study assessed the impact of the pandemic on the incidence of TB, multidrug-resistant TB (MDR-TB), and TB-related deaths in Korea between 2016 and 2023.
Methods
Data from annual reports from 2016 to 2023 were used to analyze the incidence of TB and MDR-TB, as well as TB-related deaths. Trends before and after the pandemic were compared to assess the pandemic’s impact on TB management. Key variables included age and sex-based TB incidence, MDR-TB incidence, and number of TB-related deaths.
Results
From 2016 to 2023, the total number of TB cases declined from 39,245 to 19,540, while new TB cases dropped from 30,892 to 15,640, representing reductions of 50.2% and 49.4%, respectively. The most pronounced decline occurred between 2020 and 2023. Individuals ≥65 years of age consistently had the highest TB burden, although the number of cases decreased by 28.6%. MDR-TB cases declined to 399 in 2020 but subsequently rose to 551 in 2023. TB-related deaths decreased from 2,186 in 2016 to 1,322 in 2022, with most deaths occurring in individuals ≥65 years of age.
Conclusions
While the incidence of TB and TB-related deaths decreased during the study period, MDR-TB exhibited an upward trend after 2020. Continued monitoring is needed to understand whether these changes were driven by pandemic-related disruptions or healthcare improvements.

Did the COVID-19 pandemic impact the surgical treatment of febrile acute appendicitis at a single center in Korea, a country not under lockdown? Observational cohort study: Youngil Choi, Youngsik Kim; Kosin Med J. 2025;40(1):55-65. Published online March 27, 2025; DOI: https://doi.org/10.7180/kmj.24.125

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Background
This study analyzed the impact of the coronavirus disease 2019 (COVID-19) pandemic on acute appendicitis (AA) treatment in Korea, a country that did not implement lockdown measures.
Methods
A retrospective analysis was conducted during two discretionary time periods: a pre COVID-19 period, and a COVID-19 period. This study included adult and pediatric patients diagnosed with AA who underwent surgical treatment. Clinical and laboratory parameters, changes in surgery timing, disease severity, and postoperative outcomes were compared between the pre and post pandemic periods.
Results
The study included a total of 221 patients, with 139 receiving appendectomy in the COVID-19 cohort and 82 in the control cohort. In patients without fever, operative time was significantly longer during the COVID-19 period (p<0.01). Among patients presenting with fever, the rate of complicated AA was higher during the COVID-19 period than in the control period (p<0.01). During the COVID-19 period, the diagnostic and preoperative delay times, as well as postoperative hospital stays, were longer (p<0.05), and the incidence of postoperative complications and other hospital diagnoses was higher (p<0.01) during the COVID-19 period than in the control period. Multivariate analysis showed that age (p=0.03) and the presence of fever (p<0.01) were independent risk factors for complicated AA.
Conclusions
Older patients and those with fever were at greater risk of severe AA. During outbreaks of infectious diseases like COVID-19, careful consideration is needed regarding surgical interventions in older patients with fever. Understanding vulnerabilities is crucial for disease management in the future.

Citations

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Acute appendicitis surgery in the COVID-19 era: delays without deterioration of outcomes
Sang-Yong Son
Kosin Medical Journal.2025; 40(1): 1. CrossRef

Case report

A fatal pediatric case of acute fulminant cerebral edema with COVID-19 in Korea: a case report: Minyoung Jung, Chi Eun Oh, Yujin Nam, Dalo Jung, Gyu Min Yeon; Kosin Med J. 2024;39(3):220-225. Published online September 10, 2024; DOI: https://doi.org/10.7180/kmj.24.102

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Abstract PDF PubReader ePub: Although most children with coronavirus disease 2019 (COVID-19) infection present with mild symptoms, a few pediatric patients develop severe neurological manifestations. Herein, we describe the case of a pediatric patient who presented with rapidly progressive diffuse and fatal cerebral edema associated with COVID-19. A previously healthy 6-year-old boy was diagnosed with acute fulminant cerebral edema (AFCE), which resulted in transtentorial downward herniation within 48 hours after the initial onset of fever. Detailed history-taking, close monitoring of the consciousness level with serial neurological examinations, and prompt diagnosis and treatment are required in patients suspected to have AFCE. Further research is needed to identify the pathogenesis of AFCE associated with COVID-19 and the related risk factors.

Original articles

Clinical features of coronavirus disease 2019 in Korean pediatric patients: a single-center retrospective study: Ji Eun Jeong, Hai Lee Chung, Young Hwan Kim, Nawon Lee, Younghyun Kim, Yoon Young Jang; Kosin Med J. 2024;39(2):99-111. Published online June 10, 2024; DOI: https://doi.org/10.7180/kmj.24.106

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Background
To address the public’s fear of coronavirus disease 2019 (COVID-19), understanding the clinical features of the disease is essential. However, research on the clinical features of COVID-19, including illness duration and post-acute COVID-19, in Korean pediatric patients has been limited. Therefore, this study investigated the clinical features of COVID-19 based on the medical records of pediatric patients with a history of COVID-19 who visited a single center.
Methods
In total, 311 patients were included in this study. The presence and duration of 19 symptoms were examined. Additionally, clinical features were investigated by dividing the patients into different age ranges. Patients aged 6 and above were further categorized according to the presence of asthma, while adolescent patients were divided into vaccinated and unvaccinated groups.
Results
Fever and cough were the most common symptoms. The mean illness duration was 2–4 days. Only 3.5% of the patients were asymptomatic. Post-acute COVID-19 was observed in 13.2% of the patients. The incidence of most symptoms tended to increase with age. Post-acute COVID-19 was observed more frequently in patients with asthma than in those without asthma. Vaccinated patients experienced less fever, vomiting, and fatigue than unvaccinated patients.
Conclusions
Our data suggest that most patients had mild disease lasting less than a week, and the clinical course may differ depending on the presence of asthma. The findings also indicate that vaccination may alleviate the symptoms of COVID-19 in breakthrough infections.

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Coronavirus disease 2019 infection in pediatric patients in Korea: insights and implications
Yu Jin Jung
Kosin Medical Journal.2024; 39(2): 81. CrossRef

Human resources and medical supplies consumption during the COVID-19 pandemic: a single-center study: Hye Jin Park, Yu Bin Seo, Jin Ju Park, Sun Hee Na, Jacob Lee; Kosin Med J. 2024;39(1):44-50. Published online September 14, 2023; DOI: https://doi.org/10.7180/kmj.23.126

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Abstract PDF PubReader ePub: Background
In the face of the unexpected coronavirus disease 2019 (COVID-19) pandemic, every country has struggled with insufficient human resources and medical supplies. This study aims to provide the statistical information necessary for discussing how to model stockpiles of medical resources.
Methods
This study was conducted at the Hallym University Kangnam Sacred Heart Hospital, in South Korea. The study duration was 2 weeks, centered on March 16, 2022, when the number of daily confirmed patients with COVID-19 in Korea peaked. The number of human resources was obtained by counting the number of healthcare workers using CCTV. Drug prescriptions and medical device usage were obtained from electronic medical records.
Results
In total, 117 inpatients and 26,485 outpatients were managed at this hospital during the 2-week study period. Daily visits were highest among nurses in all units, followed by doctors and radiology technicians. The mean daily consumption of personal protective equipment (PPE) per bed was 4.3 sets in the intensive care unit (ICU), 1.8 in the semi-ICU, and 1.4 in the ward. Despite the four-fold difference in the number of patients, there was no statistically significant difference between the two wards in the number of daily visits. Drug prescription rates were higher among inpatients than at-home patients.
Conclusions
The higher the COVID-19 severity, the higher the consumption of PPE per patient. Among healthcare workers, nurses had the highest number of inpatient treatment visits for COVID-19. To efficiently utilize, PPE, structures containing more isolation beds in a single negative pressure isolation system would be preferred.

The COVID-19 pandemic's impact on prostate cancer screening and diagnosis in Korea: Byeong Jin Kang, Kyung Hwan Kim, Hong Koo Ha; Kosin Med J. 2023;38(3):193-200. Published online August 16, 2023; DOI: https://doi.org/10.7180/kmj.23.116

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Background
The global coronavirus disease 2019 (COVID-19) pandemic, which started in early 2020, has had multiple impacts on cancer care. This study assessed how the COVID-19 pandemic influenced prostate cancer (PCa) screening and diagnosis in South Korea.
Methods
Patients who visited the outpatient clinic at a single institution for PCa evaluation were included in this study and divided into a pre-COVID-19 group and a COVID-19 pandemic group, based on the start of the COVID-19 pandemic and social distancing policies on March 1, 2020. The number of prostate-specific antigen (PSA) tests, patients with elevated PSA levels, and prostate biopsy results were analyzed.
Results
In total, 8,926 PSA tests were administered during the COVID-19 pandemic, compared to 15,654 before the pandemic (p<0.05). Of 2,132 patients with high PSA levels, 1,055 (49.5%) received prostate biopsies before the pandemic and 1,077 (50.5%) did so during the COVID-19 pandemic. The COVID-19 pandemic group had a higher detection rate of PC, and increased rates of Gleason scores (GS) 7 and 9–10, while the rate of GS 6 decreased compared to the pre-COVID-19 group (p<0.05). The rate of clinically significant PCa (csPCa) was also higher during the pandemic (p<0.05). In both magnetic resonance imaging-guided and standard biopsies, the GS 6 rate decreased, and the csPCa rate increased during the COVID-19 pandemic (each, p<0.05).
Conclusions
During the COVID-19 pandemic, the detection rate of prostate biopsies and the rate of csPCa increased significantly. Thus, PCa was diagnosed at a more advanced state in Korea during the COVID-19 pandemic.

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The Incidence of Extreme Serum Prostate Specific Antigen Levels During the COVID-19 Pandemic
Amanda E. Hird, Rano Matta, Refik Saskin, Erind Dvorani, Sarah Neu, Sender Herschorn, Robert K. Nam
Clinical Genitourinary Cancer.2024; 22(5): 102194. CrossRef

Performance comparison between Elecsys Anti-SARS-CoV-2 and Anti-SARS-CoV-2 S and Atellica IM SARS-CoV-2 Total and SARS-CoV-2 IgG assays: Seri Jeong, Yoo Rha Hong, Hyunyong Hwang; Kosin Med J. 2022;37(2):154-162. Published online June 27, 2022; DOI: https://doi.org/10.7180/kmj.22.114

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Background
Although serological severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) tests from several manufacturers have been introduced in South Korea and some are commercially available, the performance of these test kits has not yet been sufficiently validated. Therefore, we compared the performance of Elecsys Anti-SARS-CoV-2 (ACOV2) and Anti-SARS-CoV-2 S (ACOV2S) and Atellica IM SARS-CoV-2 Total (COV2T) and SARS-CoV-2 IgG (sCOVG) serological tests in this study.
Methods
A total of 186 patient samples were used. For each test, we analyzed the positive rate of serological antibody tests, precision, linearity, and agreement among the four assays.
Results
The positive rates of COV2T, sCOVG, and ACOV2S were high (81.7%–89.2%) in total, with those for ACOV2S being the highest, while those of ACOV2 were as low as 44.6%. This may be related to the high completion rate of vaccination in Korea. The repeatability and within-laboratory coefficients of variation were within the claimed allowable imprecision; however, further research is needed to establish an allowable imprecision at low concentrations. COV2T showed a linear fit, whereas sCOVG and ACOV2S were appropriately modeled with a nonlinear fit. Good agreement was found among COV2T, sCOVG, and ACOV2S; however, the agreement between ACOV2 and any one of the other methods was poor.
Conclusions
Considering the different antigens used in serological SARS-CoV-2 antibody assays, the performance of the tested assays is thought to show no significant difference for the qualitative detection of antibodies to SARS-CoV-2.

Citations

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Comparative evaluation of in-house ELISA and two commercial serological assays for the detection of antibodies against SARS-CoV-2
Dabesa Gobena, Esayas Kebede Gudina, Tizta Tilahun Degfie, Tsinuel Girma, Getu Gebre, Alemseged Abdissa, Fikadu G. Tafesse, Tesfaye Gelanew, Zeleke Mekonnen
Scientific Reports.2025;[Epub] CrossRef
Comparative analysis of Access PCT and Elecsys BRAHMS PCT assays for procalcitonin measurements
Hyunji Choi, Sang-Shin Lee, Hyunyong Hwang
Kosin Medical Journal.2024; 39(4): 272. CrossRef
Evaluation of automated calibration and quality control processes using the Aptio total laboratory automation system
Namhee Kim, Yein Kim, Jeongeun Park, Jungsoo Choi, Hyunyong Hwang
Kosin Medical Journal.2022; 37(4): 342. CrossRef

Review article

Adverse events following vaccination against coronavirus disease 2019: Minji Jeon, Sol Jin, Jin-Young Lee; Kosin Med J. 2022;37(1):18-26. Published online March 28, 2022; DOI: https://doi.org/10.7180/kmj.22.017

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To overcome the coronavirus disease 2019 (COVID-19) pandemic, large-scale vaccination is proceeding worldwide. As of December 23, 2021, 10 novel vaccines against COVID-19 had been validated for use by the World Health Organization (WHO), including BNT162b2 (Pfizer/BioNTech), mRNA-1273 (Moderna), AZD1222 (AstraZeneca), and Ad26.COV2.S (Janssen). These novel vaccines against COVID-19 showed acceptable safety profiles in randomized clinical trials. Most adverse events following immunization (AEFIs) associated with these novel vaccines ranged from mild to moderate and improved within a few days after administration. However, serious adverse events associated with vaccines that were not observed in the clinical trials were reported in real-world data. Adverse events of special interest include not only anaphylaxis or neurologic disorders (such as Guillain-Barré syndrome, transverse myelitis, or seizure) but also myocarditis or pericarditis associated with the messenger RNA (mRNA) vaccines and thrombosis with thrombocytopenia syndrome associated with the adenovirus-vector vaccines. Although several fatal cases of serious AEFIs that may have been related to vaccination have been reported, it is recommended to continue vaccination because the benefits of vaccines’ preventive effects against COVID-19 outweigh the risks of rare serious adverse events. Long-term monitoring of various AEFIs and sharing of clinical experiences are necessary for safe and efficient large-scale vaccination.

Citations

Citations to this article as recorded by

Events supposedly attributable to vaccination or immunization of COVID-19 vaccines in Brazil: a cross-sectional study
Poliana do Carmo Pimenta, Vitoria Gabriele Souza Geraldine, Thais Cristina de Aquino Lima, Fillipe Silva Tourinho, Denis de Oliveira Rodrigues, Murilo César do Nascimento, Lívia Máris Ribeiro Paranaiba Dias
Discover Public Health.2025;[Epub] CrossRef

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