Decision letter for "A comparison of epidemiology and clinical outcomes between influenza A H1N1pdm09 and H3N2 based on multicenter surveillance from 2014 to 2018 in South Korea"

Abstract Background It is well established that single pill combination (SPC) therapies have the potential to improve patient adherence versus multi-pill regimens, thereby improving blood pressure control and clinical outcomes in populations with hypertension. Purpose To develop a microsimulation model, capturing different treatment pathways, to project the impact on clinical outcomes of using single pill combination therapies for the management of hypertension in five countries (Italy, Russia, China, South Korea and Mexico). Methods The model was designed to project health outcomes between 2020 and 2030 for populations with hypertension managed according to four different treatment pathways: current treatment practices [CTP], single drug with dosage titration first then sequential addition of other agents [start low and go slow, SLGS], free choice combination with multiple pills [FCC] and combination therapy in the form of a single pill [SPC]. Model inputs were derived from Global Burden of Disease 2017 dataset, including demographics, health status/risk factors, transition probabilities and treatment attributes/healthcare utilization, and the model incorporated real-world challenges to healthcare delivery such as access to care, SBP measurement error, adherence and therapeutic inertia. Simulated outcomes of mortality, incidence of chronic kidney disease (CKD), stroke and ischemic heart disease (IHD), and disability-adjusted life years (DALYs) due to these conditions were estimated for population of 1,000,000 simulated patients for each treatment pathway and country. Results SPC therapy was projected to improve health outcomes over SLGS, FCC and CTP over 10 years in all five countries. SPC was forecast to reduce mortality by 5.4% (Italy), 4.9% (Russia), 4.5% (China), 2.3% (South Korea) and 3.6% (Mexico) versus CTP and showed greater projected reductions in mortality than SLGS and FCC. DALYs were projected to be reduced with SPC therapy by between 5.7% (Italy) and 2.2% (South Korea) compared with CTP and reductions in the incidence of clinical events were also projected with SPC therapy, with decreases in the range of 11.5% (Italy) to 4.9% (South Korea) versus CTP. Conclusions Ten-year projections of clinical outcomes associated with different anti-hypertensive treatment pathways in five countries indicated that both combination therapies (FCC and SPC) are likely to reduce the disease burden of hypertension compared with conventional management approaches, with SPC showing the greatest overall benefits due to improved adherence. Funding Acknowledgement Type of funding source: Private company. Main funding source(s): Sanofi, Gentilly, France

Download Full-text

Clinical outcomes and healthcare costs of inpatients with tetanus in Korea, 2011–2019

BMC Infectious Diseases ◽

10.1186/s12879-021-05935-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Sohyun Bae ◽

Minsik Go ◽

Yoonjung Kim ◽

Soyoon Hwang ◽

Shin-Woo Kim ◽

...

Keyword(s):

South Korea ◽

Clinical Outcomes ◽

Medical Costs ◽

Common Symptom ◽

University Hospitals ◽

South Korean ◽

National University ◽

Hospital Stays ◽

Serious Disease ◽

Vaccination Completion

Abstract Background Tetanus is a rare, vaccine-preventable but extremely serious disease. We investigated the recent trend of the clinical outcomes and medical costs for inpatients with tetanus in South Korea over 10 years. Methods We conducted a retrospective review to determine the clinical factors and medical costs associated with tetanus at two national university hospitals in South Korea between January 2011 and October 2019. Results Forty-nine patients were admitted for tetanus (mean age, 67.0 years [range, 53.0–80.0 years]; 32 women [57.1%]). All the patients had generalized tetanus, and 5 (10.2%) died during hospitalization. The median duration from symptom onset to hospital admission was 4 days. Trismus (85.7%) was the most common symptom, and the median hospital stay was 39 days. Thirty-two patients (65.3%) required mechanical ventilation, and 20 (40.8%) developed aspiration pneumonia. The median total healthcare cost per patient was US $18,011. After discharge, 35 patients (71.4%) recovered sufficiently to walk without disability. Conclusions Tetanus requires long hospital stays and high medical expenditures in South Korea; however, the vaccination completion rate is low. Medical staff should therefore promote medical advice and policies on the management of tetanus to the general South Korean population.

Download Full-text

Epidemiological analysis of critically ill adult patients with pandemic influenza A(H1N1) in South Korea

Epidemiology and Infection ◽

10.1017/s0950268812001604 ◽

2012 ◽

Vol 141 (5) ◽

pp. 1070-1079 ◽

Cited By ~ 7

Author(s):

S. B. HONG ◽

E. Y. CHOI ◽

S. H. KIM ◽

G. Y. SUH ◽

M. S. PARK ◽

...

Keyword(s):

South Korea ◽

Influenza A ◽

Multivariate Logistic Regression Analysis ◽

H1n1 Influenza ◽

Epidemiological Analysis ◽

Influenza A H1n1 ◽

Failure Assessment ◽

2009 H1n1 ◽

Independent Risk Factors ◽

Chronic Comorbidities

SUMMARYA total of 245 patients with confirmed 2009 H1N1 influenza were admitted to the intensive-care units of 28 hospitals (South Korea). Their mean age was 55·3 years with 68·6% aged >50 years, and 54·7% male. Nine were obese and three were pregnant. One or more comorbidities were present in 83·7%, and nosocomial acquisition occurred in 14·3%. In total, 107 (43·7%) patients received corticosteroids and 66·1% required mechanical ventilation. Eighty (32·7%) patients died within 30 days after onset of symptoms and 99 (40·4%) within 90 days. Multivariate logistic regression analysis showed that the clinician's decision to prescribe corticosteroids, older age, Sequential Organ Failure Assessment score and nosocomial bacterial pneumonia were independent risk factors for 90-day mortality. In contrast with Western countries, critical illness in Korea in relation to 2009 H1N1 was most common in older patients with chronic comorbidities; nosocomial acquisition occurred occasionally but disease in obese or pregnant patients was uncommon.

Download Full-text

Pathologic Changes in Wild Birds Infected with Highly Pathogenic Avian Influenza A(H5N8) Viruses, South Korea, 2014

Emerging Infectious Diseases ◽

10.3201/eid2105.141967 ◽

2015 ◽

Vol 21 (5) ◽

pp. 775-780 ◽

Cited By ~ 26

Author(s):

Hye-Ryoung Kim ◽

Yong-Kuk Kwon ◽

Il Jang ◽

Youn-Jeong Lee ◽

Hyun-Mi Kang ◽

...

Keyword(s):

Avian Influenza ◽

South Korea ◽

Influenza A ◽

Highly Pathogenic Avian Influenza ◽

Wild Birds ◽

Highly Pathogenic ◽

Pathogenic Avian Influenza

Download Full-text

Comparative Risk of Incidence and Clinical Outcomes of COVID-19 among Proton Pump Inhibitor and Histamine-2 Receptor Antagonist Users: A Nationwide Retrospective Cohort Study

10.21203/rs.3.rs-882550/v1 ◽

2021 ◽

Author(s):

Jimyung Park ◽

Seng Chan You ◽

Jaehyeong Cho ◽

Chan Hyuk Park ◽

Woon Shin ◽

...

Keyword(s):

Cohort Study ◽

South Korea ◽

Receptor Antagonist ◽

Clinical Outcomes ◽

Respiratory Disease ◽

Proton Pump ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Large Scale ◽

All Cause Mortality

Abstract Background: This study aimed to evaluate incidence risk and severe clinical outcomes in COVID-19 disease among short-term users of acid-suppressants in South Korea.Methods: This retrospective cohort study, conducted using a nationwide claims database for South Korea, used data from patients with COVID-19 tested between January 1 and May 15, 2020. Patients aged over 18 years and prescribed proton pump inhibitors (PPI) or histamine-2 receptor antagonist (H2RA) for more than 7 days were identified. Primary outcome was COVID-19 while secondary outcomes were all-cause mortality, hospitalization with respiratory disease, or intensive respiratory intervention. Large-scale propensity scores were used to match patients, while the Cox proportional hazard model was utilized to evaluate any association between exposure and outcome(s). The risk estimates were calibrated by using 123 falsification endpoints.Results: We identified 26,166 PPI users and 62,117 H2RA users. After propensity score matching, compared to H2RA use, PPI use was not significantly associated with lower risk of COVID-19 (calibrated hazard ratio [HR], 0.81 [95% confidence interval (CI), 0.30–2.19]); moreover, PPI use was not associated with adverse clinical outcomes in COVID-19, namely, hospitalization with respiratory disease (calibrated HR, 0.88 [95% CI, 0.72–1.08]), intensive respiratory interventions (calibrated HR, 0.92 [95% CI, 0.46–1.82]), except for all-cause mortality (calibrated HR, 0.54 [95% CI, 0.31–0.95]).Conclusions: In this study, we found that the PPI user was not associated with risk of COVID-19 compared to H2RA users. There was no significant relationship between severe clinical outcomes of COVID-19 and exposure to PPI compared with H2RA, except for all-cause mortality.

Download Full-text