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Lim SY, Jung YM, Kim Y, Kim G, Jeon J, Chin B, Kim MK. Adverse Reactions After Intradermal Vaccination With JYNNEOS for Mpox in Korea. J Korean Med Sci 2024; 39:e100. [PMID: 38442725 PMCID: PMC10911936 DOI: 10.3346/jkms.2024.39.e100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 02/18/2024] [Indexed: 03/07/2024] Open
Abstract
In response to the Mpox domestic epidemic, South Korea initiated a nationwide vaccination program in May 2023, administering a 0.1 mL intradermal dose of JYNNEOS (Modified Vaccinia Ankara vaccine, Bavarian Nordic) to a high-risk group. To investigate the adverse reactions after intradermal JYNNEOS vaccination, an anonymous online survey was conducted at the National Medical Center from May 22 to July 31, 2023. Overall, 142 individuals responded. Over 80% of the respondents reported local reactions of predominantly mild severity. The predominant local reactions were pruritus, redness, and swelling; their incidence rates after the first dose were 66.2%, 48.1%, and 49.4%, respectively; the corresponding rates after the second dose were 69.2%, 60.6%, and 53.8%. Fewer respondents reported systemic symptoms. The most common systemic symptom was fatigue, the incidence rates of which after the first and second doses were 37.7% and 24.6%, respectively. Overall, the intradermally administered JYNNEOS vaccine appeared well tolerated.
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Affiliation(s)
- So Yun Lim
- Division of Infectious Diseases, Department of Internal Medicine, National Medical Center, Seoul, Korea
| | - Yu Mi Jung
- Infectious Diseases Response Team, National Medical Center, Seoul, Korea
| | - Yeonjae Kim
- Division of Infectious Diseases, Department of Internal Medicine, National Medical Center, Seoul, Korea
| | - Gayeon Kim
- Division of Infectious Diseases, Department of Internal Medicine, National Medical Center, Seoul, Korea
| | - Jaehyun Jeon
- Division of Infectious Diseases, Department of Internal Medicine, National Medical Center, Seoul, Korea
| | - BumSik Chin
- Division of Infectious Diseases, Department of Internal Medicine, National Medical Center, Seoul, Korea
| | - Min-Kyung Kim
- Division of Infectious Diseases, Department of Internal Medicine, National Medical Center, Seoul, Korea.
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Jang KI, Lim SY, Lee JM, Jeon EJ, Lee HJ. Double Primary Cancers of Earlobe Merkel Cell Carcinoma and Lung Adenocarcinoma. J Audiol Otol 2024:jao.2023.00479. [PMID: 38382516 DOI: 10.7874/jao.2023.00479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 12/18/2023] [Indexed: 02/23/2024] Open
Abstract
Merkel cell carcinoma (MCC) is an aggressive neuroendocrine carcinoma with a high rate of metastasis. MCC is rarely suspected during clinical examination, thus requiring biopsy to establish a pathologic diagnosis. In addition, MCC sometimes occurs in double primary cancers. Although there have been reviews on double primary cancers, only a few cases involving MCC have been described. Herein, we report a case of a 54-year-old female patient who presented to our clinic with a diagnosis of earlobe MCC following an excisional biopsy performed by another clinic. Further evaluation, including chest imaging, revealed a mass in the lung. The patient underwent a wide excision of the right earlobe, and video-assisted thoracic surgery on the lung. Pathology confirmed MCC in the right earlobe and adenocarcinoma in the lung. The patient underwent postoperative adjuvant chemotherapy followed by radiotherapy. Up to this point, 3 years after the surgery, there has been no evidence of recurrence.
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Affiliation(s)
- Kyung Il Jang
- Republic of Korea Air Force The 8145th Unit, Air Defense Control Command, Yangpyeong, Korea
| | - So Yun Lim
- Department of Otorhinolaryngology-Head and Neck Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jeon Mi Lee
- Department of Otorhinolaryngology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Eun-Ju Jeon
- Department of Otorhinolaryngology-Head and Neck Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyun Jin Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Lim SY, Jo HJ, Lee SY, Ahn M, Kim Y, Jeon J, Kim ES, Chin B, Choi JP, Kim NJ. Clinical Features of Mpox Patients in Korea: A Multicenter Retrospective Study. J Korean Med Sci 2024; 39:e19. [PMID: 38288533 PMCID: PMC10825456 DOI: 10.3346/jkms.2024.39.e19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 11/20/2023] [Indexed: 02/01/2024] Open
Abstract
BACKGROUND Mpox is a viral illness with a characteristic skin rash caused by the monkeypox virus. In 2022, Mpox spread throughout the world, and an epidemic through domestic transmission started in South Korea in early 2023. This study aimed to summarize the clinical features of Mpox patients in South Korea. METHODS This is a multicenter retrospective study conducted at four hospitals in South Korea. All adult patients diagnosed with Mpox who were admitted to the study hospitals between June 1, 2022 and May 26, 2023 and were discharged by June 30, 2023 were reviewed. RESULTS Sixty patients were included, accounting for 65.9% of Mpox cases reported in South Korea during the study period. Median age was 32 years and 97% (58/60) of patients were male. In total, 85% (51/60) of patients reported their sexual orientation as homosexual or bisexual. The most common route of transmission was sexual or close contact (55/60). Every patient had a skin rash and 88% (53/60) had constitutional symptoms. In total, 42% (25/60) of patients had human immunodeficiency virus and 25% (15/60) had concomitant sexually transmitted infections. Severe manifestations of Mpox were identified in only two patients. CONCLUSION Mpox patients in South Korea were mainly young adult males and were infected through sexual contact. The clinical outcomes were favorable.
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Affiliation(s)
- So Yun Lim
- Division of Infectious Diseases, Department of Internal Medicine, National Medical Center, Seoul, Korea
| | - Hyeon Jae Jo
- Department of Internal Medicine, Seoul National College of Medicine, Seoul, Korea
| | - Su-Yeon Lee
- Division of Emerging Infectious Disease Response, Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Miyoung Ahn
- Department of Internal Medicine, Seoul Medical Center, Seoul, Korea
| | - Yeonjae Kim
- Division of Infectious Diseases, Department of Internal Medicine, National Medical Center, Seoul, Korea
| | - Jaehyun Jeon
- Division of Infectious Diseases, Department of Internal Medicine, National Medical Center, Seoul, Korea
| | - Eu Suk Kim
- Department of Internal Medicine, Seoul National College of Medicine, Seoul, Korea
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - BumSik Chin
- Division of Infectious Diseases, Department of Internal Medicine, National Medical Center, Seoul, Korea.
| | - Jae-Phil Choi
- Department of Internal Medicine, Seoul Medical Center, Seoul, Korea.
| | - Nam Joong Kim
- Department of Internal Medicine, Seoul National College of Medicine, Seoul, Korea.
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Lim SY, Kim J, Kwon J, Kang S, Kim S, Kim W, Son JY, Jang CY, Park H, Kim J, Lee S, Kim KT, Choi J, Kim JY, Lim JS, Chang E, Bae S, Jung J, Kim MJ, Chong YP, Lee S, Choi S, Kim YS, Park M, Kim S. Letter to the Editor with # CTM2-2023-10-2488 entitled 'Antibody responses as correlates of protection against SARS-CoV-2 in the Omicron era: A 5-month prospective cohort study in Korean healthcare workers'. Clin Transl Med 2024; 14:e1551. [PMID: 38279897 PMCID: PMC10819075 DOI: 10.1002/ctm2.1551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/29/2023] [Accepted: 01/06/2024] [Indexed: 01/29/2024] Open
Affiliation(s)
- So Yun Lim
- Department of Infectious DiseasesAsan Medical CenterUniversity of Ulsan College of MedicineSeoulSouth Korea
- Division of Infectious Diseases, Department of Internal MedicineNational Medical CenterSeoulSouth Korea
| | - Jineui Kim
- Department of MicrobiologyInstitute for Viral Diseases, Vaccine Innovation CenterCollege of Medicine, Korea UniversitySeoulSouth Korea
| | - Ji‐Soo Kwon
- Department of Infectious DiseasesAsan Medical CenterUniversity of Ulsan College of MedicineSeoulSouth Korea
| | - Sung‐Woon Kang
- Department of Infectious DiseasesAsan Medical CenterUniversity of Ulsan College of MedicineSeoulSouth Korea
| | - Seung‐Beom Kim
- Department of Infectious DiseasesAsan Medical CenterUniversity of Ulsan College of MedicineSeoulSouth Korea
| | - Woori Kim
- Department of Infectious DiseasesAsan Medical CenterUniversity of Ulsan College of MedicineSeoulSouth Korea
| | - Ju Yeon Son
- Department of Infectious DiseasesAsan Medical CenterUniversity of Ulsan College of MedicineSeoulSouth Korea
| | - Choi Young Jang
- Department of Infectious DiseasesAsan Medical CenterUniversity of Ulsan College of MedicineSeoulSouth Korea
| | - Heedo Park
- Department of MicrobiologyInstitute for Viral Diseases, Vaccine Innovation CenterCollege of Medicine, Korea UniversitySeoulSouth Korea
| | - Jeonghun Kim
- Department of MicrobiologyInstitute for Viral Diseases, Vaccine Innovation CenterCollege of Medicine, Korea UniversitySeoulSouth Korea
| | - Sohyun Lee
- Department of MicrobiologyInstitute for Viral Diseases, Vaccine Innovation CenterCollege of Medicine, Korea UniversitySeoulSouth Korea
| | - Kyung Taek Kim
- Department of MicrobiologyInstitute for Viral Diseases, Vaccine Innovation CenterCollege of Medicine, Korea UniversitySeoulSouth Korea
| | - Jaeuk Choi
- Department of MicrobiologyInstitute for Viral Diseases, Vaccine Innovation CenterCollege of Medicine, Korea UniversitySeoulSouth Korea
| | - Ji Yeun Kim
- Department of Infectious DiseasesAsan Medical CenterUniversity of Ulsan College of MedicineSeoulSouth Korea
| | - Joon Seo Lim
- Clinical Research CenterAsan Institute for Life Sciences, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulSouth Korea
| | - Euijin Chang
- Department of Infectious DiseasesAsan Medical CenterUniversity of Ulsan College of MedicineSeoulSouth Korea
| | - Seongman Bae
- Department of Infectious DiseasesAsan Medical CenterUniversity of Ulsan College of MedicineSeoulSouth Korea
| | - Jiwon Jung
- Department of Infectious DiseasesAsan Medical CenterUniversity of Ulsan College of MedicineSeoulSouth Korea
| | - Min Jae Kim
- Department of Infectious DiseasesAsan Medical CenterUniversity of Ulsan College of MedicineSeoulSouth Korea
| | - Yong Pil Chong
- Department of Infectious DiseasesAsan Medical CenterUniversity of Ulsan College of MedicineSeoulSouth Korea
| | - Sang‐Oh Lee
- Department of Infectious DiseasesAsan Medical CenterUniversity of Ulsan College of MedicineSeoulSouth Korea
| | - Sang‐Ho Choi
- Department of Infectious DiseasesAsan Medical CenterUniversity of Ulsan College of MedicineSeoulSouth Korea
| | - Yang Soo Kim
- Department of Infectious DiseasesAsan Medical CenterUniversity of Ulsan College of MedicineSeoulSouth Korea
| | - Man‐Seong Park
- Department of MicrobiologyInstitute for Viral Diseases, Vaccine Innovation CenterCollege of Medicine, Korea UniversitySeoulSouth Korea
| | - Sung‐Han Kim
- Department of Infectious DiseasesAsan Medical CenterUniversity of Ulsan College of MedicineSeoulSouth Korea
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Lim SY, Kim JW, Kim JY, Kang SW, Jang CY, Chang E, Yang JS, Kim KC, Jang HC, Kim DS, Shin Y, Lee JY, Kim SH. The association between antibody responses and prolonged viable SARS-CoV-2 shedding in immunocompromised patients: a prospective cohort study. J Infect Dis 2023:jiad579. [PMID: 38114088 DOI: 10.1093/infdis/jiad579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 12/06/2023] [Accepted: 12/12/2023] [Indexed: 12/21/2023] Open
Abstract
Immunocompromised COVID-19 patients were prospectively enrolled from March to November 2022 to understand the association between antibody responses and SARS-CoV-2 shedding. A total of 62 patients were analyzed and the results indicated a faster decline in genomic and subgenomic viral RNA in patients with higher neutralizing and S1-specific IgG antibodies (both P < 0.001). Notably, high neutralizing antibody levels were associated with a significantly faster decrease in viable virus cultures (P = 0.04). Our observations suggest the role of neutralizing antibodies in prolonged virus shedding in immunocompromised patients, highlighting the potential benefits of enhancing their humoral immune response through vaccination or monoclonal antibody treatments.
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Affiliation(s)
- So Yun Lim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
- Division of Infectious Diseases, Department of Internal Medicine, National Medical Center, Seoul, Republic of Korea
| | - Jun-Won Kim
- National Institute of Infectious Diseases, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Ji Yeun Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sung-Woon Kang
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Choi-Young Jang
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Euijin Chang
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jeong-Sun Yang
- National Institute of Infectious Diseases, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Kyung-Chang Kim
- National Institute of Infectious Diseases, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Hee-Chang Jang
- National Institute of Infectious Diseases, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Da Sol Kim
- National Institute of Infectious Diseases, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Younmin Shin
- National Institute of Infectious Diseases, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Joo-Yeon Lee
- National Institute of Infectious Diseases, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Sung-Han Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
- Office for Infection Control, Asan Medical Center, Seoul, South Korea
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Lim SY, Kwon HJ, Lee YW, Sung H, Kim MN, Chang E, Bae S, Jung J, Kim MJ, Kim SH, Choi SH, Lee SO, Kim YS, Lee JY, Chong YP. Routine ophthalmologic examination in Klebsiella pneumoniae bacteremia is not necessary: incidence of and risk factors for ocular involvement. Antimicrob Agents Chemother 2023; 67:e0082223. [PMID: 37874294 PMCID: PMC10648850 DOI: 10.1128/aac.00822-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 09/12/2023] [Indexed: 10/25/2023] Open
Abstract
Klebsiella pneumoniae bacteremia is known to present a virulent clinical course, including multiple metastatic infections, which is not uncommon in Asia. However, there are limited data on the incidence and risk factors for ocular involvement in K. pneumoniae bacteremia. We retrospectively reviewed the medical records of all patients with K. pneumoniae bacteremia who underwent ophthalmologic examination in a tertiary center in Seoul, Korea, from February 2012 to December 2020. Two retinal specialists reviewed the findings of the ophthalmologic examinations and classified them as endophthalmitis, chorioretinitis, and no ocular involvement. Of 689 patients, 56 [8.1%; 95% confidence interval (CI) 6.2-10.4] had ocular involvement, and 9 (1.3%; 95% CI 0.6-2.5) were diagnosed with endophthalmitis. Of 47 patients with chorioretinitis, 45 (95.7%) improved with systemic antibiotic therapy alone. Community-onset bacteremia (100% vs 62.1% vs 57.4%, P = 0.04), cryptogenic liver abscess (55.6% vs 11.8% vs 8.5%, P = 0.003), and metastatic infection (66.7% vs 5.8% vs 10.6%, P < 0.001) were more common in endophthalmitis than in no ocular involvement or chorioretinitis. In the multivariable analysis, cryptogenic liver abscess [adjusted odds ratio (aOR), 6.63; 95% CI 1.44-35.20] and metastatic infection (aOR, 17.52; 95% CI 3.69-96.93) were independent risk factors for endophthalmitis. Endophthalmitis was not associated with 30-day mortality. Endophthalmitis is rare in Asian patients with K. pneumoniae bacteremia. Targeted ophthalmologic examination in those with cryptogenic liver abscess, metastatic infection, or ocular symptoms may be more appropriate than routine examination of all patients.
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Affiliation(s)
- So Yun Lim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Hye Ji Kwon
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Yun Woo Lee
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Heungsup Sung
- Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Mi-Na Kim
- Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Euijin Chang
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Seongman Bae
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Jiwon Jung
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Min Jae Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Sung-Han Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Sang-Ho Choi
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Sang-Oh Lee
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Yang Soo Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Joo Yong Lee
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Yong Pil Chong
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
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Chang E, Lee J, Kim J, Seok JH, Bae J, Kim J, Park H, Jang C, Kang S, Lim SY, Kim JY, Yang J, Kim K, Lee J, Park M, Kim S. Mutational analysis of severe acute respiratory syndrome coronavirus 2 in immunocompromised patients with persistent viral detection using whole genome sequencing. Clin Transl Med 2023; 13:e1462. [PMID: 37929659 PMCID: PMC10626488 DOI: 10.1002/ctm2.1462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 10/08/2023] [Accepted: 10/13/2023] [Indexed: 11/07/2023] Open
Affiliation(s)
- Euijin Chang
- Department of Infectious DiseasesAsan Medical Center, University of Ulsan College of MedicineSeoulRepublic of Korea
| | - Jungmin Lee
- Department of MicrobiologyInstitute for Viral Diseases, Vaccine Innovation Center, Korea University College of MedicineSeoulRepublic of Korea
| | - Jun‐Won Kim
- Division of Emerging Virus and Vector ResearchCenter for Emerging Virus Research, National Institute of Infectious Diseases, Korea Disease Control and Prevention AgencyCheongjuRepublic of Korea
| | - Jong Hyeon Seok
- Department of MicrobiologyInstitute for Viral Diseases, Vaccine Innovation Center, Korea University College of MedicineSeoulRepublic of Korea
| | - Joon‐Yong Bae
- Department of MicrobiologyInstitute for Viral Diseases, Vaccine Innovation Center, Korea University College of MedicineSeoulRepublic of Korea
| | - Jeonghun Kim
- Department of MicrobiologyInstitute for Viral Diseases, Vaccine Innovation Center, Korea University College of MedicineSeoulRepublic of Korea
| | - Heedo Park
- Department of MicrobiologyInstitute for Viral Diseases, Vaccine Innovation Center, Korea University College of MedicineSeoulRepublic of Korea
| | - Choi‐Young Jang
- Department of Infectious DiseasesAsan Medical Center, University of Ulsan College of MedicineSeoulRepublic of Korea
| | - Sung‐Woon Kang
- Department of Infectious DiseasesAsan Medical Center, University of Ulsan College of MedicineSeoulRepublic of Korea
| | - So Yun Lim
- Department of Infectious DiseasesAsan Medical Center, University of Ulsan College of MedicineSeoulRepublic of Korea
| | - Ji Yeun Kim
- Department of Infectious DiseasesAsan Medical Center, University of Ulsan College of MedicineSeoulRepublic of Korea
| | - Jeong‐Sun Yang
- Division of Emerging Virus and Vector ResearchCenter for Emerging Virus Research, National Institute of Infectious Diseases, Korea Disease Control and Prevention AgencyCheongjuRepublic of Korea
| | - Kyung‐Chang Kim
- Division of Emerging Virus and Vector ResearchCenter for Emerging Virus Research, National Institute of Infectious Diseases, Korea Disease Control and Prevention AgencyCheongjuRepublic of Korea
| | - Joo‐Yeon Lee
- Division of Emerging Virus and Vector ResearchCenter for Emerging Virus Research, National Institute of Infectious Diseases, Korea Disease Control and Prevention AgencyCheongjuRepublic of Korea
| | - Man‐Seong Park
- Department of MicrobiologyInstitute for Viral Diseases, Vaccine Innovation Center, Korea University College of MedicineSeoulRepublic of Korea
| | - Sung‐Han Kim
- Department of Infectious DiseasesAsan Medical Center, University of Ulsan College of MedicineSeoulRepublic of Korea
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Kang SW, Kim JW, Kim JY, Lim SY, Jang CY, Chang E, Yang JS, Kim KC, Jang HC, Kim D, Shin Y, Lee JY, Kim SH. Virological characteristics and the rapid antigen test as deisolation criteria in immunocompromised patients with COVID-19: A prospective cohort study. J Med Virol 2023; 95:e29228. [PMID: 38009999 DOI: 10.1002/jmv.29228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 10/27/2023] [Accepted: 10/31/2023] [Indexed: 11/29/2023]
Abstract
There are limited data supporting current Centers for Disease Control and Prevention guidelines for the isolation period in moderate to severely immunocompromised patients with coronavirus disease 2019 (COVID-19). Adult COVID-19 patients who underwent solid organ transplantation (SOT) or received active chemotherapy against hematologic malignancy were enrolled and weekly respiratory samples were collected. Samples with positive genomic real-time polymerase chain reaction results underwent virus culture and rapid antigen testing (RAT). A total of 65 patients (40 with hematologic malignancy and 25 SOT) were enrolled. The median duration of viable virus shedding was 4 weeks (interquartile range: 3-7). Multivariable analysis revealed that B-cell depletion (hazard ratio [HR]: 4.76) was associated with prolonged viral shedding, and COVID-19 vaccination (≥3 doses) was negatively associated with prolonged viral shedding (HR: 0.22). The sensitivity, specificity, positive predictive value, and negative predictive value of RAT for viable virus shedding were 79%, 76%, 74%, and 81%, respectively. The negative predictive value of RAT was only 48% (95% confidence interval [CI]: 33-65) in the samples from those with symptom onset ≤20 days, but it was as high as 92% (95% CI: 85-96) in the samples from those with symptom onset >20 days. About half of immunocompromised COVID-19 patients shed viable virus for ≥4 weeks from the diagnosis, and virus shedding was prolonged especially in unvaccinated patients with B-cell-depleting therapy treatment. RAT beyond 20 days in immunocompromised patients had a relatively high negative predictive value for viable virus shedding.
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Affiliation(s)
- Sung-Woon Kang
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jun-Won Kim
- Center for Emerging Virus Research, National Institute of Infectious Diseases, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Ji Yeun Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - So Yun Lim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Choi-Young Jang
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Euijin Chang
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jeong-Sun Yang
- Center for Emerging Virus Research, National Institute of Infectious Diseases, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Kyung-Chang Kim
- Center for Emerging Virus Research, National Institute of Infectious Diseases, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Hee-Chang Jang
- Center for Emerging Virus Research, National Institute of Infectious Diseases, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Dasol Kim
- Center for Emerging Virus Research, National Institute of Infectious Diseases, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Younmin Shin
- Center for Emerging Virus Research, National Institute of Infectious Diseases, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Joo-Yeon Lee
- Center for Emerging Virus Research, National Institute of Infectious Diseases, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Sung-Han Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Kim JY, Koo B, Lim SY, Cha HH, Kim MJ, Chong YP, Choi SH, Lee SO, Kim YS, Shin Y, Kim SH. A non-invasive, sensitive assay for active TB: combined cell-free DNA detection and FluoroSpot assays. Int J Tuberc Lung Dis 2023; 27:790-792. [PMID: 37749833 PMCID: PMC10519393 DOI: 10.5588/ijtld.23.0180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 06/18/2023] [Indexed: 09/27/2023] Open
Affiliation(s)
- J Y Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul
| | - B Koo
- Department of Biotechnology, Yonsei University, Seoul, Republic of Korea
| | - S Y Lim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul
| | - H H Cha
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul
| | - M J Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul
| | - Y P Chong
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul
| | - S-H Choi
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul
| | - S-O Lee
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul
| | - Y S Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul
| | - Y Shin
- Department of Biotechnology, Yonsei University, Seoul, Republic of Korea
| | - S-H Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul
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Lee YW, Lim SY, Jin S, Park HJ, Sung H, Kim MN, Bae S, Jung J, Kim MJ, Kim SH, Lee SO, Choi SH, Kim YS, Chong YP. Clinical Sensitivity of the (1-3)-β-D-glucan Test for Predicting Candidemia. Ann Lab Med 2023; 43:381-385. [PMID: 36843407 PMCID: PMC9989527 DOI: 10.3343/alm.2023.43.4.381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 11/08/2022] [Accepted: 12/28/2022] [Indexed: 02/28/2023] Open
Abstract
The sensitivity of the (1-3)-β-D-glucan (BDG) diagnostic test for candidemia varies in different clinical settings, and its usefulness in early diagnosis of candidemia is suboptimal. We evaluated the sensitivity of the test for early candidemia prediction. All adult patients with culture-proven candidemia who underwent a serum Goldstream Fungus (1-3)-β-D-Glucan Test within seven days prior to candidemia onset at a tertiary referral hospital between January 2017 and May 2021 were included. Any-positive BDG results within seven days prior to candidemia onset were obtained in 38 out of 93 (40.9%) patients. The positive rate increased when the test was performed near the day of candidemia onset (P=0.04) but reached only 52% on the day of candidemia onset. We observed no significant differences between BDG-positive and -negative groups in terms of underlying disease, risk factors for candidemia, clinical presentation, origin of candidemia, and 30-day mortality. Candida albicans was significantly associated with positive BDG results than with all-negative BDG results (P=0.04). The Goldstream BDG test is unreliable for candidemia prediction because of its low sensitivity. Negative BDG results in patients with a high risk of invasive candidiasis should be interpreted with caution.
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Affiliation(s)
- Yun Woo Lee
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - So Yun Lim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sol Jin
- Department of Infectious Diseases, Kosin University Gospel Hospital, Busan, Korea
| | - Hye Jin Park
- Department of Infectious Diseases, Bumin Hospital, Seoul, Korea
| | - Heungsup Sung
- Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Mi-Na Kim
- Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seongman Bae
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jiwon Jung
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Min Jae Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sung-Han Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sang-Oh Lee
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sang-Ho Choi
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yang Soo Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yong Pil Chong
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Kang SW, Kim JY, Park H, Lim SY, Kim J, Bae S, Jung J, Kim MJ, Chong YP, Lee SO, Choi SH, Kim YS, Park MS, Kim SH. Corrigendum to "Comparison of outward transmission potential between vaccinated and partially vaccinated or unvaccinated individuals with the SARS-CoV-2 delta variant infection" [J Infect 85 (2022) e69-e71]. J Infect 2023:S0163-4453(23)00294-3. [PMID: 37244782 DOI: 10.1016/j.jinf.2023.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Affiliation(s)
- Sung Woon Kang
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Ji Yeun Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Heedo Park
- BK21 Graduate Program, Department of Biomedical Sciences, Korea University College of Medicine, Seoul 02841, Republic of Korea; Department of Microbiology, Institute for Viral Diseases, Biosafety Center, College of Medicine, Korea University, Seoul, Republic of Korea
| | - So Yun Lim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jeonghun Kim
- BK21 Graduate Program, Department of Biomedical Sciences, Korea University College of Medicine, Seoul 02841, Republic of Korea; Department of Microbiology, Institute for Viral Diseases, Biosafety Center, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Seongman Bae
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jiwon Jung
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Min Jae Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Yong Pil Chong
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sang-Oh Lee
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sang-Ho Choi
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Yang Soo Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Man-Seong Park
- BK21 Graduate Program, Department of Biomedical Sciences, Korea University College of Medicine, Seoul 02841, Republic of Korea; Department of Microbiology, Institute for Viral Diseases, Biosafety Center, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Sung-Han Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
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12
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Kang SW, Park H, Kim JY, Lim SY, Lee S, Bae JY, Kim J, Chang E, Bae S, Jung J, Kim MJ, Chong YP, Lee SO, Choi SH, Kim YS, Park MS, Kim SH. Comparison of the clinical and virological characteristics of SARS-CoV-2 Omicron BA.1/BA.2 and omicron BA.5 variants: A prospective cohort study. J Infect 2023; 86:e148-e151. [PMID: 36669564 PMCID: PMC9846898 DOI: 10.1016/j.jinf.2023.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 01/12/2023] [Indexed: 01/19/2023]
Affiliation(s)
- Sung-Woon Kang
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Heedo Park
- Department of Microbiology, Vaccine Innovation Center, Biosafety Center, College of Medicine, Korea University, Seoul, Korea
| | - Ji Yeun Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - So Yun Lim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sohyun Lee
- Department of Microbiology, Vaccine Innovation Center, Biosafety Center, College of Medicine, Korea University, Seoul, Korea
| | - Joon-Yong Bae
- Department of Microbiology, Vaccine Innovation Center, Biosafety Center, College of Medicine, Korea University, Seoul, Korea
| | - Jeonghun Kim
- Department of Microbiology, Vaccine Innovation Center, Biosafety Center, College of Medicine, Korea University, Seoul, Korea
| | - Euijin Chang
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seongman Bae
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jiwon Jung
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Min Jae Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yong Pil Chong
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sang-Oh Lee
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sang-Ho Choi
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yang Soo Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Man-Seong Park
- Department of Microbiology, Vaccine Innovation Center, Biosafety Center, College of Medicine, Korea University, Seoul, Korea.
| | - Sung-Han Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
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Koh JY, Ko JH, Lim SY, Bae S, Huh K, Cho SY, Kang CI, Chung DR, Chung CR, Kim SH, Peck KR, Lee JS. Triple immune modulator therapy for aberrant hyperinflammatory responses in severe COVID-19. Clin Immunol 2023; 251:109628. [PMID: 37119951 PMCID: PMC10139747 DOI: 10.1016/j.clim.2023.109628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 04/11/2023] [Accepted: 04/26/2023] [Indexed: 05/01/2023]
Abstract
A dysregulated hyperinflammatory response is a key pathogenesis of severe COVID-19, but optimal immune modulator treatment has not been established. To evaluate the clinical effectiveness of double (glucocorticoids and tocilizumab) and triple (plus baricitinib) immune modulator therapy for severe COVID-19, a retrospective cohort study was conducted. For the immunologic investigation, a single-cell RNA sequencing analysis was performed in serially collected PBMCs and neutrophil specimens. Triple immune modulator therapy was a significant factor in a multivariable analysis for 30-day recovery. In the scRNA-seq analysis, type I and II IFN response-related pathways were suppressed by GC, and the IL-6-associated signature was additionally downregulated by TOC. Adding BAR to GC and TOC distinctly downregulated the ISGF3 cluster. Adding BAR also regulated the pathologically activated monocyte and neutrophil subpopulation induced by aberrant IFN signals. Triple immune modulator therapy in severe COVID-19 improved 30-day recovery through additional regulation of the aberrant hyperinflammatory immune response.
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Affiliation(s)
| | - Jae-Hoon Ko
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - So Yun Lim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Seongman Bae
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Kyungmin Huh
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Sun Young Cho
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Cheol-In Kang
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Doo Ryeon Chung
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Chi Ryang Chung
- Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Sung-Han Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
| | - Kyong Ran Peck
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
| | - Jeong Seok Lee
- Genome Insight, Inc., San Diego, La Jolla, CA, USA; Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Republic of Korea.
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Abstract
BACKGROUND There are limited data on the rates of the waning of antibody levels after two-dose and booster vaccination according to the different platforms of COVID-19 vaccines. METHODS We enrolled healthcare workers (HCWs) in a tertiary care hospital who received homologous two-dose vaccination, followed by a homologous or heterologous booster mRNA vaccine. SARS-CoV-2 S1-specific IgG was measured using ELISA. A linear mixed regression model was used to compare the slope from the peak antibody titre to the lowest antibody titres 3 months after vaccination. RESULTS A total of 113 HCWs (BNT162b2 (n = 48 [42%]), ChAdOx1 nCoV-19 (n = 52 [46%]) or mRNA-1273 (n = 13 [12%])) were enrolled in this prospective cohort study. More gradual antibody waning was observed over 3 months with the two-dose ChAdOx1 nCoV-19 (ChAdOx1) than with the two-dose BNT162b2 or mRNA-1273 (p < 0.001 and p = 0.001, respectively). In addition, homologous mRNA-1273 booster induced a more durable antibody response than homologous BNT162b2 booster (p < 0.001) or heterologous ChAdOx1-BNT162b2 booster (p < 0.001). CONCLUSIONS Two-dose homologous ChAdOx1 vaccination or homologous mRNA-1273 booster appears to induce more-durable antibody responses than 2-dose homologous mRNA vaccination, homologous BNT162b2 booster, or 2-dose ChAdOx1 followed by BNT62b2 booster, although our findings are based on the relatively short term (3-month) follow-up after the vaccinations and the evaluation of the slopes from different antibody peak levels. Further studies on long-term durability depending on the types of vaccines are needed.
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Affiliation(s)
- So Yun Lim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Ji Yeun Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jiwon Jung
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.,Office for Infection Control, Asan Medical Center, Seoul, South Korea
| | - Sung-Cheol Yun
- Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Sung-Han Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.,Office for Infection Control, Asan Medical Center, Seoul, South Korea
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Lim SY, Yoon YI, Kim JY, Tak E, Kwon H, Shin S, Kim YH, Song GW, Kim SH, Lee SG. Different antibody responses between liver and kidney transplant recipients elicited by third doses of COVID-19 mRNA vaccines. Korean J Transplant 2023; 37:49-56. [PMID: 37064770 PMCID: PMC10090824 DOI: 10.4285/kjt.22.0056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/05/2023] [Accepted: 01/07/2023] [Indexed: 02/22/2023] Open
Abstract
Background Solid organ transplant recipients exhibit decreased antibody responses, mainly due to their weakened immune systems. However, data are limited on antibody responses after the primary series of coronavirus disease 2019 (COVID-19) vaccines among recipients of various solid organ transplant types. Thus, we compared the antibody responses after three COVID-19 vaccine doses between liver transplant (LT) and kidney transplant (KT) recipients. Methods We prospectively enrolled solid organ transplant recipients who received three COVID-19 vaccine doses from June 2021 to February 2022 and measured S1-specific immunoglobulin G antibodies using an enzyme-linked immunosorbent assay. Results Seventy-six LT and 17 KT recipients were included in the final analysis. KT recipients showed consistently lower antibody responses even after the third vaccine dose (86.2% vs. 52.9%, P=0.008) and lower antibody titers (median, 423.0 IU/mL [interquartile range, 99.6-2,057 IU/mL] vs. 19.7 IU/mL [interquartile range, 6.9-339.4 IU/mL]; P=0.006) than were observed in LT recipients. Mycophenolic acid was a significant risk factor for a seropositive antibody response after the third vaccine dose in the multivariable analysis (odds ratio, 0.06; 95% confidence interval, 0.00-0.39; P=0.02). Conclusions We found a weaker antibody response despite the completion of the primary series of COVID-19 vaccines in KT recipients than in LT recipients. Mycophenolic acid use in KT recipients might be the main contributor to this observation.
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Affiliation(s)
- So Yun Lim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Young-In Yoon
- Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ji Yeun Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Eunyoung Tak
- Department of Convergence Medicine, Asan Medical Institute of Convergence Science and Technology (AMIST), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hyunwook Kwon
- Division of Kidney and Pancreas Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sung Shin
- Division of Kidney and Pancreas Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Young Hoon Kim
- Division of Kidney and Pancreas Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Gi-Won Song
- Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sung-Han Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sung-Gyu Lee
- Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Kang SW, Kim JW, Kim JY, Lim SY, Jang CY, Chang E, Yang JS, Kim KC, Jang HC, Kim D, Shin Y, Lee JY, Kim SH. Characteristics and risk factors of prolonged viable virus shedding in immunocompromised patients with COVID-19: a prospective cohort study. J Infect 2023; 86:412-414. [PMID: 36682630 PMCID: PMC9852259 DOI: 10.1016/j.jinf.2023.01.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 01/17/2023] [Indexed: 01/22/2023]
Affiliation(s)
- Sung-Woon Kang
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jun-Won Kim
- National Institute of Infectious Diseases, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Ji Yeun Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - So Yun Lim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Choi-Young Jang
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Euijin Chang
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jeong-Sun Yang
- National Institute of Infectious Diseases, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Kyung-Chang Kim
- National Institute of Infectious Diseases, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Hee-Chang Jang
- National Institute of Infectious Diseases, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Dasol Kim
- National Institute of Infectious Diseases, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Younmin Shin
- National Institute of Infectious Diseases, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Joo-Yeon Lee
- National Institute of Infectious Diseases, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea,Corresponding authors at: Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro-43-gil, Songpa-gu, Seoul, 05505, South Korea
| | - Sung-Han Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea,Corresponding authors at: Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro-43-gil, Songpa-gu, Seoul, 05505, South Korea
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17
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Kang S, Kim JY, Park H, Lim SY, Kim J, Chang E, Bae S, Jung J, Kim MJ, Chong YP, Lee S, Choi S, Kim YS, Park M, Kim S. Comparison of secondary attack rate and viable virus shedding between patients with SARS-CoV-2 Delta and Omicron variants: A prospective cohort study. J Med Virol 2023; 95:e28369. [PMID: 36458559 PMCID: PMC9877691 DOI: 10.1002/jmv.28369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 11/12/2022] [Accepted: 11/28/2022] [Indexed: 12/04/2022]
Abstract
There are limited data comparing the transmission rates and kinetics of viable virus shedding of the Omicron variant to those of the Delta variant. We compared these rates in hospitalized patients infected with Delta and Omicron variants. We prospectively enrolled adult patients with COVID-19 admitted to a tertiary care hospital in South Korea between September 2021 and May 2022. Secondary attack rates were calculated by epidemiologic investigation, and daily saliva samples were collected to evaluate viral shedding kinetics. Genomic and subgenomic SARS-CoV-2 RNA was measured by PCR, and virus culture was performed from daily saliva samples. A total of 88 patients with COVID-19 who agreed to daily sampling and were interviewed, were included. Of the 88 patients, 48 (59%) were infected with Delta, and 34 (41%) with Omicron; a further 5 patients gave undetectable or inconclusive RNA PCR results and 1 was suspected of being coinfected with both variants. Omicron group had a higher secondary attack rate (31% [38/124] vs. 7% [34/456], p < 0.001). Survival analysis revealed that shorter viable virus shedding period was observed in Omicron variant compared with Delta variant (median 4, IQR [1-7], vs. 8.5 days, IQR [5-12 days], p < 0.001). Multivariable analysis revealed that moderate-to-critical disease severity (HR: 1.96), and immunocompromised status (HR: 2.17) were independent predictors of prolonged viral shedding, whereas completion of initial vaccine series or first booster-vaccinated status (HR: 0.49), and Omicron infection (HR: 0.44) were independently associated with shorter viable virus shedding. Patients with Omicron infections had higher transmission rates but shorter periods of transmissible virus shedding than those with Delta infections.
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Affiliation(s)
- Sung‐Woon Kang
- Department of Infectious Diseases, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulRepublic of Korea
| | - Ji Yeun Kim
- Department of Infectious Diseases, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulRepublic of Korea
| | - Heedo Park
- Department of Biomedical Sciences, BK21 Graduate ProgramKorea University College of MedicineSeoulRepublic of Korea
- Department of Microbiology, Institute for Viral Diseases, Vaccine Innovation Center, College of MedicineKorea UniversitySeoulSouth Korea
| | - So Yun Lim
- Department of Infectious Diseases, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulRepublic of Korea
| | - Jeonghun Kim
- Department of Biomedical Sciences, BK21 Graduate ProgramKorea University College of MedicineSeoulRepublic of Korea
- Department of Microbiology, Institute for Viral Diseases, Vaccine Innovation Center, College of MedicineKorea UniversitySeoulSouth Korea
| | - Euijin Chang
- Department of Infectious Diseases, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulRepublic of Korea
| | - Seongman Bae
- Department of Infectious Diseases, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulRepublic of Korea
| | - Jiwon Jung
- Department of Infectious Diseases, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulRepublic of Korea
| | - Min Jae Kim
- Department of Infectious Diseases, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulRepublic of Korea
| | - Yong Pil Chong
- Department of Infectious Diseases, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulRepublic of Korea
| | - Sang‐Oh Lee
- Department of Infectious Diseases, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulRepublic of Korea
| | - Sang‐Ho Choi
- Department of Infectious Diseases, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulRepublic of Korea
| | - Yang Soo Kim
- Department of Infectious Diseases, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulRepublic of Korea
| | - Man‐Seong Park
- Department of Biomedical Sciences, BK21 Graduate ProgramKorea University College of MedicineSeoulRepublic of Korea
- Department of Microbiology, Institute for Viral Diseases, Vaccine Innovation Center, College of MedicineKorea UniversitySeoulSouth Korea
| | - Sung‐Han Kim
- Department of Infectious Diseases, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulRepublic of Korea
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18
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Kang SW, Kim JY, Park H, Park S, Lim SY, Bae S, Jung J, Kim MJ, Chong YP, Choi SH, Lee SO, Kim YS, Park MS, Yun SC, Kim SH. 305. Clinical scoring system to predict viable viral shedding in patients with COVID-19. Open Forum Infect Dis 2022. [DOI: 10.1093/ofid/ofac492.383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Abstract
Background
Centers for Disease Control and Prevention (CDC) recommends 5 to 20 days of isolation for COVID-19 patients depending on symptom duration and severity regardless of genomic PCR results or vaccination history. However, in real clinical practice, more individualized approach is required. We thus developed clinical scoring system to predict viable viral shedding in a given patient by using various factors affecting viable viral shedding.
Methods
We prospectively enrolled adult patients with SARS-CoV-2 infection admitted to tertiary hospital and day care center between February 2020 and January 2022. The daily dense respiratory sampling (i.e. saliva, sputum, or nasopharyngeal swabs) during the hospital and day care center stay were obtained. Genomic RNA viral load and viral culture were performed for these samples. Clinical predictors of negative viral culture results were identified using survival analysis and multivariable analysis.
Results
A total of 612 samples from 121 patients of varying degrees of severity were obtained. Of these, 494 (81%) samples were saliva, 63 (10%) were nasopharyngeal swab, and the remaining 55 (9%) were sputum. Of these 612 specimens, 154 (25%) samples revealed positive viral culture results. Univariate and multivariable Cox's time varying proportional hazard model revealed that symptom onset day, viral copy number, disease severity, organ transplant recipient, gender, and vaccination status were independently associated with viral culture results. We thus developed the 5-factor model from -3 to 3 points: viral copy number (-3 to 3 points depending on copy number), disease severity (1 point to moderate to critical diseases), organ transplant recipient (2 points), gender (-1 points to male), and vaccination status (-2 points to fully vaccinated status). The predictive culture-negative rates were calculated through the symptom onset day and the score of the day the sample was collected. Table 1.Prediction scores for negative viral culture resultsTable 2.Predicted Culture-negative Rates
Values in the table expressed as percentages.
Conclusion
Our clinical scoring system can provide objective probability of negative culture results in a given COVID-19 patient with genomic viral load, and appears to be useful to decide de-isolation policy depending on individualized factors associated with viable viral shedding beyond simple symptom-based isolation strategy by CDC.
Disclosures
All Authors: No reported disclosures.
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Affiliation(s)
- Sung Woon Kang
- Asan medical center , Seoul, Seoul-t'ukpyolsi , Republic of Korea
| | - Ji Yeon Kim
- Asan medical center , Seoul, Seoul-t'ukpyolsi , Republic of Korea
| | - Heedo Park
- Korea University , Seoul, Seoul-t'ukpyolsi , Republic of Korea
| | - Sunghee Park
- Soonchunhyang University Bucheon Hospital , Bucheon, Kyonggi-do , Republic of Korea
| | - So Yun Lim
- Asan medical center , Seoul, Seoul-t'ukpyolsi , Republic of Korea
| | - SeongMan Bae
- Asan medical center , Seoul, Seoul-t'ukpyolsi , Republic of Korea
| | - Jiwon Jung
- Asan Medical Center , Seoul, Seoul-t'ukpyolsi , Republic of Korea
| | - Min Jae Kim
- Asan Medical Center , Seoul, Seoul-t'ukpyolsi , Republic of Korea
| | - Yong Pil Chong
- Asan Medical Center , Seoul, Seoul-t'ukpyolsi , Republic of Korea
| | - Sang-Ho Choi
- Asan Medical Center , Seoul, Seoul-t'ukpyolsi , Republic of Korea
| | - Sang-Oh Lee
- Asan Medical Center , Seoul, Seoul-t'ukpyolsi , Republic of Korea
| | - Yang Soo Kim
- Asan Medical Center , Seoul, Seoul-t'ukpyolsi , Republic of Korea
| | - Man-Seong Park
- Korea University , Seoul, Seoul-t'ukpyolsi , Republic of Korea
| | - Sung-Cheol Yun
- Asan medical center , Seoul, Seoul-t'ukpyolsi , Republic of Korea
| | - Sung-Han Kim
- Asan medical center , Seoul, Seoul-t'ukpyolsi , Republic of Korea
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19
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Lim SY, Kim JY, Jung J, Yun SC, Kim SH. 1979. Waning of humoral immunity depending on the types of COVID-19 vaccine. Open Forum Infect Dis 2022. [PMCID: PMC9752443 DOI: 10.1093/ofid/ofac492.1604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background There are limited data on the rates of the waning of antibody levels after two-dose and booster vaccination according to the different platforms of COVID-19 vaccines. Methods We enrolled healthcare workers (HCWs) in a tertiary care hospital who received homologous two-dose vaccination, followed by a homologous or heterologous booster mRNA vaccine. SARS-CoV-2 S1-specific IgG was measured using ELISA. A linear mixed regression model was used to compare the slope from the peak antibody titer to the lowest antibody titers 3 months after vaccination. Results A total of 113 HCWs (BNT162b2 (n=48 [42%]), ChAdOx1 nCoV-19 (n=52 [46%]) or mRNA-1273 (n=13 [12%])) were enrolled in this prospective cohort study. More gradual antibody waning was observed over 3 months with the two-dose ChAdOx1 nCoV-19 (ChAdOx1) than with the two-dose BNT162b2 or mRNA-1273 (p< 0.001 and p=0.001, respectively). In addition, homologous mRNA-1273 booster induced a more durable antibody response than homologous BNT162b2 booster (p< 0.001) or heterologous ChAdOx1-BNT162b2 booster (p< 0.001).
![]() ![]() ![]() Conclusion 2-dose homologous ChAdOx1 vaccination or homologous mRNA-1273 booster appears to induce more-durable antibody responses than 2-dose homologous mRNA vaccination, homologous BNT162b2 booster, or 2-dose ChAdOx1 followed by BNT162b2 booster. Disclosures All Authors: No reported disclosures.
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Affiliation(s)
- So Yun Lim
- Asan medical center, Seoul, Seoul-t'ukpyolsi, Republic of Korea
| | - Ji Yeon Kim
- Asan medical center, Seoul, Seoul-t'ukpyolsi, Republic of Korea
| | - Jiwon Jung
- Asan Medical Center, Seoul, Seoul-t'ukpyolsi, Republic of Korea
| | - Sung-Cheol Yun
- Asan medical center, Seoul, Seoul-t'ukpyolsi, Republic of Korea
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20
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Reum Kim A, Lee J, Park S, Kang SW, Lee YW, Lim SY, Jang E, Bae S, Jung J, Kim MJ, Chong YP, Lee SO, Kim YS, Kim SH. 259. Comparison of the causes of death in patients with delta variant versus omicron variant infections. Open Forum Infect Dis 2022. [PMCID: PMC9752205 DOI: 10.1093/ofid/ofac492.337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) variant strain B.1.1.529 (omicron) has been less virulent than SARS-CoV-2 B.1.617.2 variant (delta), but there are limited data on the comparison of the cause of death between delta variant and omicron variant infections. We thus compared the causes of death in COVID-19 patients with the delta variant and omicron variant. Methods We retrospectively reviewed the medical records of adult patients with COVID-19 who were admitted at Asan Medical Center, Seoul, South Korea, between July 2021 and March 2022. We divided into delta-variant dominant period (from July 2021 to December 2021) and omicron-dominant period (from February 2022 to March 2022) with the exclusion of January 2022 because this period was overlapping of delta and omicron variant. The causes of death were classified into COVID-19-associated pneumonia, other causes, and indeterminate cause. Results A total of 654 patients with COVID-19 were admitted and 42 (6.4%) died during the omicron dominant period (between February and March 2022), while a total of 366 patients with COVID-19 were hospitalized and 42 (11.5%) died during the delta dominant period (between July and December 2021). The primary cause of death was COVID-19-associated pneumonia in 64% (27/42) during the omicron era whereas that was COVID-19-associated pneumonia in 88% (37/42) during the delta era (p value=0.01) (Table 1).
![]() Conclusion We found that about two thirds of patients with omicron variant infection died due to COVID-19, while the majority of patients with delta variant infection died due to COVID-19. Disclosures All Authors: No reported disclosures.
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Affiliation(s)
- A Reum Kim
- Department of Infectious Disease, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Seoul-t'ukpyolsi, Republic of Korea
| | - Jiyoung Lee
- Asan medical center, Seoul, Seoul-t'ukpyolsi, Republic of Korea
| | - Somi Park
- Asan medical center, Seoul, Seoul-t'ukpyolsi, Republic of Korea
| | - Sung Woon Kang
- Asan medical center, Seoul, Seoul-t'ukpyolsi, Republic of Korea
| | - Yun Woo Lee
- Asan Medical Center, Seoul, Seoul-t'ukpyolsi, Republic of Korea
| | - So Yun Lim
- Asan medical center, Seoul, Seoul-t'ukpyolsi, Republic of Korea
| | - Euijin Jang
- Asan medical center, Seoul, Seoul-t'ukpyolsi, Republic of Korea
| | - SeongMan Bae
- Asan medical center, Seoul, Seoul-t'ukpyolsi, Republic of Korea
| | - Jiwon Jung
- Asan Medical Center, Seoul, Seoul-t'ukpyolsi, Republic of Korea
| | - Min Jae Kim
- Asan Medical Center, Seoul, Seoul-t'ukpyolsi, Republic of Korea
| | - Yong Pil Chong
- Asan Medical Center, Seoul, Seoul-t'ukpyolsi, Republic of Korea
| | - Sang-Oh Lee
- Asan Medical Center, Seoul, Seoul-t'ukpyolsi, Republic of Korea
| | - Yang Soo Kim
- Asan Medical Center, Seoul, Seoul-t'ukpyolsi, Republic of Korea
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21
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Kim JY, Kwon JS, Cha HH, Lim SY, Bae S, Kim SH. Comparison of the rapidity of SARS-CoV-2 immune responses between primary and booster vaccination for COVID-19. Korean J Intern Med 2022; 37:1234-1240. [PMID: 36217813 PMCID: PMC9666257 DOI: 10.3904/kjim.2022.173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 06/15/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND/AIMS The rapidity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-specific memory B or T cell response in vaccinated individuals is important for our understanding of immunopathogenesis of coronavirus disease 2019 (COVID-19). We therefore compared the timing of adequate immune responses between the first and booster doses of COVID-19 vaccines in infection-naïve healthcare workers. METHODS We enrolled healthcare workers who received two doses of either the BNT162b2 vaccine or the ChAdOx1 vaccine, all of whom received the BNT162b2 vaccine as the booster (the third) dose. Spike 1 (S1)-immunoglobulin G (IgG) antibodies and interferon gamma producing T cell responses were measured at 0, 7, 14, and 21 days after the first dose, and at 0 and between 2 to 7 days after the booster dose. RESULTS After the first-dose vaccination, the S1-IgG antibody responses were elicited within 14 days in the BNT162b2 group and within 21 days in the ChAdOx1 group. After the booster dose, the S1-IgG antibody responses were elicited within 5 days in both groups. The SARS-CoV-2-specific T cell responses appeared at 7 days after the first dose and at 4 days after the booster dose. CONCLUSION SARS-CoV-2-specific immune responses by memory B cells and T cells may be expected to appear around 4 to 5 days after the booster dose.
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Affiliation(s)
- Ji Yeun Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ji-Soo Kwon
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hye Hee Cha
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - So Yun Lim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seongman Bae
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sung-Han Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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22
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Bae S, Park H, Kim JY, Park S, Lim SY, Bae JY, Kim J, Jung J, Kim MJ, Chong YP, Lee SO, Choi SH, Kim YS, Park MS, Kim SH. Daily, self-test rapid antigen test to assess SARS-CoV-2 viability in de-isolation of patients with COVID-19. Front Med (Lausanne) 2022; 9:922431. [DOI: 10.3389/fmed.2022.922431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 09/26/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundIsolation of COVID-19 patients is a crucial infection control measure to prevent further SARS-CoV-2 transmission, but determining an appropriate timing to end the COVID-19 isolation is a challenging. We evaluated the performance of the self-test rapid antigen test (RAT) as a potential proxy to terminate the isolation of COVID-19 patients.Materials and methodsSymptomatic COVID-19 patients were enrolled who were admitted to a regional community treatment center (CTC) in Seoul (South Korea). Self-test RAT and the collection of saliva samples were performed by the patients, on a daily basis, until patient discharge. Cell culture and subgenomic RNA detection were performed on saliva samples.ResultsA total of 138 pairs of saliva samples and corresponding RAT results were collected from 34 COVID-19 patients. Positivity of RAT and cell culture was 27% (37/138) and 12% (16/138), respectively. Of the 16 culture-positive saliva samples, seven (43.8%) corresponding RAT results were positive. Using cell culture as the reference standard, the overall percent agreement, percent positive agreement, and percent negative agreement of RAT were 71% (95% CI, 63–78), 26% (95% CI, 12–42), and 82% (95% CI, 76–87), respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of the RAT for predicting culture results were 44% (95% CI, 20–70), 75% (95% CI, 66–82), 18% (95% CI, 8–34), and 91% (95% CI, 84–96), respectively.ConclusionAbout half of the patients who were SARS-CoV-2 positive based upon cell culture results gave negative RAT results. However, the remaining positive culture cases were detected by RAT, and RAT showed relatively high negative predictive value for viable viral shedding.
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23
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Lee J, Park S, Kim JY, Lim SY, Chang E, Bae S, Jung J, Kim MJ, Chong YP, Lee SO, Choi SH, Kim YS, Lee N, Shum D, Kim S, Jee Y, Kim SH. No correlation of neutralizing antibody titers against the Omicron variant after a booster dose of COVID-19 vaccines with subsequent breakthrough Omicron infections among healthcare workers. J Infect 2022; 85:e177-e180. [PMID: 36223860 PMCID: PMC9548087 DOI: 10.1016/j.jinf.2022.10.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 09/19/2022] [Accepted: 10/03/2022] [Indexed: 11/06/2022]
Affiliation(s)
- Jeongjae Lee
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea,Department of Infectious Disease, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro-43-gil, Songpa-gu, Seoul 05505, South Korea
| | - Soonju Park
- Institut Pasteur Korea, 16, Daewangpangyo-ro 712 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do 13488, South Korea
| | - Ji Yeun Kim
- Department of Infectious Disease, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro-43-gil, Songpa-gu, Seoul 05505, South Korea
| | - So Yun Lim
- Department of Infectious Disease, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro-43-gil, Songpa-gu, Seoul 05505, South Korea
| | - Euijin Chang
- Department of Infectious Disease, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro-43-gil, Songpa-gu, Seoul 05505, South Korea
| | - Seongman Bae
- Department of Infectious Disease, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro-43-gil, Songpa-gu, Seoul 05505, South Korea
| | - Jiwon Jung
- Department of Infectious Disease, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro-43-gil, Songpa-gu, Seoul 05505, South Korea
| | - Min Jae Kim
- Department of Infectious Disease, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro-43-gil, Songpa-gu, Seoul 05505, South Korea
| | - Yong Pil Chong
- Department of Infectious Disease, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro-43-gil, Songpa-gu, Seoul 05505, South Korea
| | - Sang-Oh Lee
- Department of Infectious Disease, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro-43-gil, Songpa-gu, Seoul 05505, South Korea
| | - Sang-Ho Choi
- Department of Infectious Disease, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro-43-gil, Songpa-gu, Seoul 05505, South Korea
| | - Yang Soo Kim
- Department of Infectious Disease, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro-43-gil, Songpa-gu, Seoul 05505, South Korea
| | - Nakyung Lee
- Institut Pasteur Korea, 16, Daewangpangyo-ro 712 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do 13488, South Korea
| | - David Shum
- Institut Pasteur Korea, 16, Daewangpangyo-ro 712 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do 13488, South Korea
| | - Seungtaek Kim
- Institut Pasteur Korea, 16, Daewangpangyo-ro 712 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do 13488, South Korea
| | - Youngmee Jee
- Institut Pasteur Korea, 16, Daewangpangyo-ro 712 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do 13488, South Korea,Corresponding authors
| | - Sung-Han Kim
- Department of Infectious Disease, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro-43-gil, Songpa-gu, Seoul 05505, South Korea,Corresponding authors
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Chong SY, Wang X, Van Bloois L, Huang C, Yu X, Sayed N, Zhang S, Ting HJ, Thiam CH, Lim SY, Lim HY, Zharkova O, Angeli V, Storm G, Wang JW. Liposomal docosahexaenoic acid halts atherosclerosis progression. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Atherosclerosis is the main cause underlying cardiovascular disease (CVD). Docosahexaenoic acid (DHA, 22:6n-3) is a hydrophobic polyunsaturated fatty acid that exerts anti-inflammatory and antioxidant activities. However, the beneficial effects of DHA on CVD have been controversial likely due to variations in bioavailability after oral intake.
Purpose
In this study, we aim to investigate the potential inhibiting properties of liposomal DHA on atherosclerosis progression upon intravenous administration.
Methods
Four weeks old ApoE−/− and LDLr−/− mice were fed on athero-inducing high fat diet for 4 weeks and then randomly divided into two groups. The mice received either control liposomes (control group) or liposomes containing DHA (liposomal DHA treatment group) via intravenous injection, twice a week for 8 weeks while still being fed on high fat diet. At the experiment endpoint, whole aortas were collected for Oil Red O staining to quantify plaque area or for biochemical analysis. Plasma was collected for total cholesterol measurement and lipidomic analysis. Aortic roots were used for histological analysis.
Results
Upon intravenous injection, as shown by IVIS imaging, DHA-containing liposomes accumulated preferentially in the atherosclerotic plaques. Compared to control liposomes, liposomal DHA treatment reduced the atherosclerotic plaque area in both atherosclerosis animal models, with the total plaque area decreased by 35.8% in ApoE−/− mice, (p<0.001) and by 22.4% in LDLr−/− mice (p<0.05). Plaque composition analysis revealed that liposomal DHA treatment increased collagen content and reduced the number of macrophages and neutral lipid within the plaques, resulting in a lower plaque vulnerability index (1.095 for liposomal DHA treated group vs. 1.692 for control group, p<0.05). Among those plaque macrophages, as demonstrated by immunohistology, M2 (anti-inflammatory) macrophages accounted for 4.44% in liposomal DHA treated mice and 2.24% in control liposomes treated mice (p<0.05). In agreement with the histology results, higher mRNA expression levels of anti-inflammatory markers (IL-10, CD206 and CD163) and collagen type 1 were determined in aortic tissue after liposomal DHA treatment. Moreover, liposomal DHA did not change total cholesterol level in the blood but significantly lowered plasma levels of several species of triglycerides. In vitro experiment with bone marrow derived macrophages showed that liposomal DHA was able to suppress lipopolysaccharide-induced inflammatory response and oxidative stress.
Conclusions
Our findings demonstrate that incorporation of DHA in injectable liposomes is an effective way to increase the inhibitory effects of DHA on halting the progression of atherosclerosis via lowering circulating triglycerides, reducing plaque inflammation, and enhancing plaque stability. Intravenous administration of liposomal DHA may become an efficacious strategy for the treatment of atherosclerosis.
Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): NUSMed Seed Fund
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Affiliation(s)
- S Y Chong
- Yong Loo Lin School of Medicine, National University of Singapore, Department of Surgery , Singapore , Singapore
| | - X Wang
- Yong Loo Lin School of Medicine, National University of Singapore, Department of Surgery , Singapore , Singapore
| | - L Van Bloois
- Department of Pharmaceutics, Faculty of Science, Utrecht University , Utrecht , The Netherlands
| | - C Huang
- Yong Loo Lin School of Medicine, National University of Singapore, Department of Surgery , Singapore , Singapore
| | - X Yu
- Yong Loo Lin School of Medicine, National University of Singapore, Department of Surgery , Singapore , Singapore
| | - N Sayed
- Yong Loo Lin School of Medicine, National University of Singapore, Department of Surgery , Singapore , Singapore
| | - S Zhang
- Yong Loo Lin School of Medicine, National University of Singapore, Department of Surgery , Singapore , Singapore
| | - H J Ting
- Yong Loo Lin School of Medicine, National University of Singapore, Department of Surgery , Singapore , Singapore
| | - C H Thiam
- Immunology translational research program, Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore , Singapore , Singapore
| | - S Y Lim
- Immunology translational research program, Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore , Singapore , Singapore
| | - H Y Lim
- Immunology translational research program, Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore , Singapore , Singapore
| | - O Zharkova
- Yong Loo Lin School of Medicine, National University of Singapore, Department of Surgery , Singapore , Singapore
| | - V Angeli
- Immunology translational research program, Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore , Singapore , Singapore
| | - G Storm
- Yong Loo Lin School of Medicine, National University of Singapore, Department of Surgery , Singapore , Singapore
| | - J W Wang
- Yong Loo Lin School of Medicine, National University of Singapore, Department of Surgery , Singapore , Singapore
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Abstract
Since severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was noted to cause coronavirus disease 2019 (COVID-19) in 2019, there have been many trials to develop vaccines against the virus. Messenger ribonucleic acid (mRNA) vaccine as a type of the vaccine has been developed and commercialized rapidly, but there was not enough time to verify the long-term safety. An 82-year-old female patient was admitted to the emergency room with dyspnea accompanied by stridor three days after the 3rd COVID-19 mRNA vaccination (Comirnaty, Pfizer-BioNTech, USA). The patient was diagnosed with bilateral vocal fold paralysis (VFP) by laryngoscope. Respiratory distress was improved after the intubation and tracheostomy in sequence. The brain, chest, and neck imaging tests, serological tests, cardiological analysis, and immunological tests were performed to evaluate the cause of bilateral VFP. However, no definite cause was found except for the precedent vaccination. Because bilateral VFP can lead to a fatal condition, a quick evaluation is necessary in consideration of VFP when dyspnea with stridor occurs after vaccination.
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Affiliation(s)
- Soo Ah Son
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yeon Ji Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - So Yun Lim
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyun Bum Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea.
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26
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Kang SW, Kim JY, Park H, Lim SY, Kim J, Bae S, Jung J, Kim MJ, Chong YP, Lee SO, Choi SH, Kim YS, Park MS, Kim SH. Comparison of outward transmission potential between vaccinated and partially vaccinated or unvaccinated individuals with the SARS-CoV-2 delta variant infection. J Infect 2022; 85:e69-e71. [PMID: 35705135 PMCID: PMC9188485 DOI: 10.1016/j.jinf.2022.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 06/06/2022] [Indexed: 11/18/2022]
Affiliation(s)
- Sung Woon Kang
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Ji Yeun Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Heedo Park
- BK21 Graduate Program, Department of Biomedical Sciences, Korea University College of Medicine, Seoul 02841, Republic of Korea; Department of Microbiology, Institute for Viral Diseases, Biosafety Center, College of Medicine, Korea University, Seoul, South Korea
| | - So Yun Lim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jeonghun Kim
- BK21 Graduate Program, Department of Biomedical Sciences, Korea University College of Medicine, Seoul 02841, Republic of Korea; Department of Microbiology, Institute for Viral Diseases, Biosafety Center, College of Medicine, Korea University, Seoul, South Korea
| | - Seongman Bae
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jiwon Jung
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Min Jae Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Yong Pil Chong
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sang-Oh Lee
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sang-Ho Choi
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Yang Soo Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Man-Seong Park
- BK21 Graduate Program, Department of Biomedical Sciences, Korea University College of Medicine, Seoul 02841, Republic of Korea; Department of Microbiology, Institute for Viral Diseases, Biosafety Center, College of Medicine, Korea University, Seoul, South Korea.
| | - Sung-Han Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
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27
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Lim SY, Park S, Kim JY, Kim S, Jee Y, Kim SH. Comparison of Waning Neutralizing Antibody Responses Against the Omicron Variant 6 Months After Natural Severe Acute Respiratory Syndrome Coronavirus 2 Infection (With or Without Subsequent Coronavirus Disease 2019 [COVID-19] Vaccination) Versus 2-Dose COVID-19 Vaccination. Clin Infect Dis 2022; 75:2243-2246. [PMID: 35686300 PMCID: PMC9214150 DOI: 10.1093/cid/ciac435] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 05/16/2022] [Accepted: 05/26/2022] [Indexed: 01/19/2023] Open
Abstract
Following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, subsequent ChAdOx1 nCoV-19 vaccination induced similar neutralizing antibody levels against the original strain but significantly higher levels against the Omicron variant compared to those who were not vaccinated. Prior SARS-CoV-2 infection exhibited higher neutralization antibody titers than vaccination alone for both original strains and the Omicron variant.
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Affiliation(s)
- So Yun Lim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | | | | | - Seungtaek Kim
- Institut Pasteur Korea, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Youngmee Jee
- Institut Pasteur Korea, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Sung-Han Kim
- Corresponding authors: Sung-Han Kim, MD Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro-43-gil, Songpa-gu, Seoul, 05505, South Korea E-mail:
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28
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Lim SY, Jung J, Kim S. Preparedness for further boosting coronavirus disease 2019 vaccines. Clinical and Translational Dis 2022; 2:e55. [PMID: 35571516 PMCID: PMC9087125 DOI: 10.1002/ctd2.55] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 04/06/2022] [Indexed: 11/25/2022]
Affiliation(s)
- So Yun Lim
- Department of Infectious Diseases Asan Medical Center University of Ulsan College of Medicine Seoul South Korea
| | - Jiwon Jung
- Department of Infectious Diseases Asan Medical Center University of Ulsan College of Medicine Seoul South Korea
- Office for Infection Control Asan Medical Center Seoul South Korea
| | - Sung‐Han Kim
- Department of Infectious Diseases Asan Medical Center University of Ulsan College of Medicine Seoul South Korea
- Office for Infection Control Asan Medical Center Seoul South Korea
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Bae S, Ko JH, Choi JY, Park WJ, Lim SY, Ahn JY, Song KH, Lee KH, Song YG, Chan Kim Y, Park YS, Choi WS, Jeong HW, Kim SW, Kwon KT, Kang ES, Kim AR, Jang S, Kim B, Kim SS, Jang HC, Choi JY, Kim SH, Peck KR. Heterologous ChAdOx1 and BNT162b2 vaccination induces strong neutralizing antibody responses against SARS-CoV-2 including delta variant with tolerable reactogenicity. Clin Microbiol Infect 2022; 28:1390.e1-1390.e7. [PMID: 35598855 PMCID: PMC9117169 DOI: 10.1016/j.cmi.2022.04.019] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 03/11/2022] [Accepted: 04/20/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES We assessed humoral responses and reactogenicity following the heterologous vaccination compared to the homologous vaccination groups. METHODS We enrolled healthcare workers (HCWs) who were either vaccinated with ChAdOx1 followed by BNT162b2 (heterologous group) or two doses of ChAdOx1 (ChAdOx1 group) or BNT162b2 (BNT162b2 group). Immunogenicity was assessed by measuring antibody titers against receptor-binding domain (RBD) of SARS-CoV-2 spike protein in all participants and neutralizing antibody titer in 100 participants per group. Reactogenicity was evaluated by a questionnaire-based survey. RESULTS We enrolled 499 HCWs (ChAdOx1, n=199; BNT162b2, n=200; heterologous ChAdOx1/BNT162b2, n=100). The geometric mean titer of anti-RBD antibody at 14 days after the booster dose was significantly higher in the heterologous group (11780.55 BAU/mL [95% CI, 10891.52-12742.14]) than in the ChAdOx1 (1561.51 [1415.03-1723.15]) or BNT162b2 (2895.90 [2664.01-3147.98]) groups (both P value<.001). The neutralizing antibody titer of the heterologous group (geometric mean ND50, 2367.74 [1970.03-2845.74]) was comparable to that of the BNT162b2 group (2118.63 [1755.88-2556.32], P >.05) but higher than that of the ChAdOx1 group (391.77 [326.16-470.59], P value<.001). Compared with those against wild-type SARS-CoV-2, the geometric mean neutralizing antibody titers against the delta variant at 14 days after the boosting were reduced by 3.0-fold in the heterologous group (geometric mean ND50. 872.01 [95% CI, 685.33-1109.54]), 4.0-fold in the BNT162b2 group (337.93 [262.78-434.57]), and 3.2-fold in the ChAdOx1 group (206.61 [144.05-296.34]). The local or systemic reactogenicity after the booster dose in the heterologous group was higher than that of the ChAdOx1 group but comparable to that of the BNT162b2 group. CONCLUSIONS Heterologous ChAdOx1 followed by BNT162b2 vaccination with a 12-week interval induced a robust humoral immune response against SARS-CoV-2 including the delta variant that was comparable to the homologous BNT162b2 vaccination and stronger than the homologous ChAdOx1 vaccination, with a tolerable reactogenicity profile.
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Affiliation(s)
- Seongman Bae
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Jae-Hoon Ko
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Ju-Yeon Choi
- National Institute of Infectious Diseases, National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju-si, Chungcheongbuk-do, South Korea
| | - Woo-Jung Park
- National Institute of Infectious Diseases, National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju-si, Chungcheongbuk-do, South Korea
| | - So Yun Lim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Jin Young Ahn
- Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Kyoung-Ho Song
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea
| | - Kyoung Hwa Lee
- Division of Infectious Diseases, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Young Goo Song
- Division of Infectious Diseases, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Yong Chan Kim
- Division of Infectious Disease, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, South Korea
| | - Yoon Soo Park
- Division of Infectious Disease, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, South Korea
| | - Won Suk Choi
- Division of Infectious Diseases, Department of Internal Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, South Korea
| | - Hye Won Jeong
- Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, South Korea
| | - Shin-Woo Kim
- Department of Internal Medicine, Kyungpook National University, School of Medicine, Daegu, South Korea
| | - Ki Tae Kwon
- Division of Infectious Diseases, Department of Internal Medicine, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu, South Korea
| | - Eun-Suk Kang
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Ah-Ra Kim
- National Institute of Infectious Diseases, National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju-si, Chungcheongbuk-do, South Korea
| | - Sundong Jang
- National Institute of Infectious Diseases, National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju-si, Chungcheongbuk-do, South Korea
| | - Byoungguk Kim
- National Institute of Infectious Diseases, National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju-si, Chungcheongbuk-do, South Korea
| | - Sung Soon Kim
- National Institute of Infectious Diseases, National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju-si, Chungcheongbuk-do, South Korea
| | - Hee-Chang Jang
- National Institute of Infectious Diseases, National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju-si, Chungcheongbuk-do, South Korea
| | - Jun Yong Choi
- Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.
| | - Sung-Han Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
| | - Kyong Ran Peck
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
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Jung J, Kim JY, Park H, Park S, Lim JS, Lim SY, Bae S, Lim YJ, Kim EO, Kim J, Park MS, Kim SH. Transmission and Infectious SARS-CoV-2 Shedding Kinetics in Vaccinated and Unvaccinated Individuals. JAMA Netw Open 2022; 5:e2213606. [PMID: 35608859 PMCID: PMC9131744 DOI: 10.1001/jamanetworkopen.2022.13606] [Citation(s) in RCA: 51] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
IMPORTANCE Data are limited on whether patients with breakthrough COVID-19 infection have the potential to significantly contribute to the spread of SARS-CoV-2. OBJECTIVE To compare the secondary attack rate and infectious viral shedding kinetics of SARS-CoV-2 between fully vaccinated individuals (breakthrough infection group) and partially or unvaccinated individuals (nonbreakthrough infection group). DESIGN, SETTING, AND PARTICIPANTS This cohort study assessed secondary transmission by analyzing the epidemiologic data of health care workers, inpatients, and caregivers diagnosed with COVID-19 during hospitalization or residence in a tertiary care hospital between March 1, 2020, and November 6, 2021. To evaluate viral shedding kinetics, the genomic RNA of SARS-CoV-2 was measured using polymerase chain reaction and performed virus culture from daily saliva samples of individuals with mild COVID-19 infected with the Delta variant who were isolated in a community facility in Seoul, South Korea, between July 20 and August 20, 2021. EXPOSURES COVID-19 vaccination. MAIN OUTCOMES AND MEASURES The secondary attack rate and infectious viral shedding kinetics according to COVID-19 vaccination status. RESULTS A total of 173 individuals (median [IQR] age, 47 [32-59] years; 100 female [58%]) with COVID-19 were included in the secondary transmission study, of whom 50 (29%) had a breakthrough infection. Secondary transmission was significantly less common in the breakthrough infection group than in the nonbreakthrough infection group (3 of 43 [7%] vs 29 of 110 [26%]; P = .008). In the viral shedding kinetics study, 45 patients (median age, 37 years [IQR, 25-49 years]; 14 female [31%]) infected with the Delta variant were included, of whom 6 (13%) were fully vaccinated and 39 (87%) were partially or unvaccinated. Although the initial genomic viral load was comparable between the 2 groups, viable virus in cell culture was detected for a notably longer duration in partially vaccinated (8 days after symptom onset) or unvaccinated (10 days after symptom onset) individuals compared with fully vaccinated individuals (4 days after symptom onset). CONCLUSIONS AND RELEVANCE In this cohort study, although the initial genomic viral load was similar between vaccinated and unvaccinated individuals, fully vaccinated individuals had a shorter duration of viable viral shedding and a lower secondary attack rate than partially vaccinated or unvaccinated individuals. Data from this study provide important evidence that despite the possibility of breakthrough infections, COVID-19 vaccinations remain critically useful for controlling the spread of SARS-CoV-2.
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Affiliation(s)
- Jiwon Jung
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
- Office for Infection Control, Asan Medical Center, Seoul, South Korea
| | - Ji Yeun Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Heedo Park
- Department of Microbiology, Institute for Viral Diseases, Biosafety Center, College of Medicine, Korea University, Seoul, South Korea
| | - Sunghee Park
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Joon Seo Lim
- Clinical Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, South Korea
| | - So Yun Lim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Seongman Bae
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Young-Ju Lim
- Office for Infection Control, Asan Medical Center, Seoul, South Korea
| | - Eun Ok Kim
- Office for Infection Control, Asan Medical Center, Seoul, South Korea
| | - Jineui Kim
- Department of Microbiology, Institute for Viral Diseases, Biosafety Center, College of Medicine, Korea University, Seoul, South Korea
| | - Man-Seong Park
- Department of Microbiology, Institute for Viral Diseases, Biosafety Center, College of Medicine, Korea University, Seoul, South Korea
| | - Sung-Han Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
- Office for Infection Control, Asan Medical Center, Seoul, South Korea
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Park S, Lim SY, Kim JY, Park H, Lim JS, Bae S, Kim J, Jung J, Kim MJ, Chong YP, Choi SH, Lee SO, Kim YS, Park MS, Kim SH. Clinical and virological characteristics of SARS-CoV-2 B.1.617.2 (Delta) variant: a prospective cohort study. Clin Infect Dis 2022; 75:e27-e34. [PMID: 35362530 PMCID: PMC9047158 DOI: 10.1093/cid/ciac239] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Indexed: 12/19/2022] Open
Abstract
Background Data on the clinical and virological characteristics of the Delta variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are limited. This prospective cohort study compared the characteristics of the Delta variant to other variants. Methods Adult patients with mild coronavirus disease 2019 (COVID-19) who agreed to daily saliva sampling at a community isolation facility in South Korea between July and August 2021 were enrolled. Scores of 28 COVID-19-related symptoms were recorded daily. The genomic RNA and subgenomic RNA from saliva samples were measured by real-time reverse-transcription polymerase chain reaction (PCR). Cell cultures were performed on saliva samples with positive genomic RNA results. Results A total of 141 patients (Delta group, n = 108 [77%]; non-Delta group, n = 33 [23%]) were enrolled. Myalgia was more common in the Delta group than in the non-Delta group (52% vs 27%, P = .03). Total symptom scores were significantly higher in the Delta group between days 3 and 10 after symptom onset. Initial genomic RNA titers were similar between the 2 groups; however, during the late course of disease, genomic RNA titers were higher in the Delta group. Negative conversion of subgenomic RNA was slower in the Delta group (median 9 vs 5 days; P < .001). The duration of viral shedding in terms of positive viral culture was also longer in the Delta group (median 5 vs 3 days; P = .002). Conclusions COVID-19 patients infected with the Delta variant exhibited prolonged viable viral shedding with more severe symptoms than those infected with non-Delta variants.
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Affiliation(s)
| | | | | | | | - Joon Seo Lim
- Clinical Research Center, Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Seongman Bae
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Jeonghun Kim
- BK21 Graduate Program, Department of Biomedical Sciences, Korea University College of Medicine, Seoul, Republic of Korea
- Department of Microbiology, Institute for Viral Diseases, Biosafety Center, College of Medicine, Korea University, Seoul, South Korea
| | - Jiwon Jung
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Min Jae Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Yong Pil Chong
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Sang-Ho Choi
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Sang-Oh Lee
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Yang Soo Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | | | - Sung-Han Kim
- Correspondence: S.-H. Kim, Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro-43-gil, Songpa-gu, Seoul, 05505, South Korea ()
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Lim SY, Jung J, Kim JY, Park S, Kwon J, Park SY, Kim S, Lim Y, Kim EO, Bae S, Kim MJ, Chong YP, Lee S, Choi S, Kim YS, Lee N, Kim K, Shum D, Jee Y, Kim S. Breakthrough infections and waning immune responses with ChAdOx1 nCoV-19 or mRNA vaccine in healthcare workers. Clin Transl Med 2022; 12:e804. [PMID: 35452187 PMCID: PMC9029012 DOI: 10.1002/ctm2.804] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 03/19/2022] [Accepted: 03/23/2022] [Indexed: 11/29/2022] Open
Affiliation(s)
- So Yun Lim
- Department of Infectious DiseasesAsan Medical CenterUniversity of Ulsan College of MedicineSeoulRepublic of Korea
| | - Jiwon Jung
- Department of Infectious DiseasesAsan Medical CenterUniversity of Ulsan College of MedicineSeoulRepublic of Korea
- Office for Infection ControlAsan Medical CenterUniversity of Ulsan College of MedicineSeoulSouth Korea
| | - Ji Yeun Kim
- Department of Infectious DiseasesAsan Medical CenterUniversity of Ulsan College of MedicineSeoulRepublic of Korea
| | - Soonju Park
- Institut Pasteur KoreaSeongnam‐siRepublic of Korea
| | - Ji‐Soo Kwon
- Department of Infectious DiseasesAsan Medical CenterUniversity of Ulsan College of MedicineSeoulRepublic of Korea
| | - So Yeon Park
- Office for Infection ControlAsan Medical CenterUniversity of Ulsan College of MedicineSeoulSouth Korea
| | - Sun‐Kyung Kim
- Office for Infection ControlAsan Medical CenterUniversity of Ulsan College of MedicineSeoulSouth Korea
| | - Young‐Ju Lim
- Office for Infection ControlAsan Medical CenterUniversity of Ulsan College of MedicineSeoulSouth Korea
| | - Eun Ok Kim
- Office for Infection ControlAsan Medical CenterUniversity of Ulsan College of MedicineSeoulSouth Korea
| | - Seongman Bae
- Department of Infectious DiseasesAsan Medical CenterUniversity of Ulsan College of MedicineSeoulRepublic of Korea
| | - Min Jae Kim
- Department of Infectious DiseasesAsan Medical CenterUniversity of Ulsan College of MedicineSeoulRepublic of Korea
| | - Yong Pil Chong
- Department of Infectious DiseasesAsan Medical CenterUniversity of Ulsan College of MedicineSeoulRepublic of Korea
| | - Sang‐Oh Lee
- Department of Infectious DiseasesAsan Medical CenterUniversity of Ulsan College of MedicineSeoulRepublic of Korea
| | - Sang‐Ho Choi
- Department of Infectious DiseasesAsan Medical CenterUniversity of Ulsan College of MedicineSeoulRepublic of Korea
| | - Yang Soo Kim
- Department of Infectious DiseasesAsan Medical CenterUniversity of Ulsan College of MedicineSeoulRepublic of Korea
| | - Nakyung Lee
- Institut Pasteur KoreaSeongnam‐siRepublic of Korea
| | - Kideok Kim
- Institut Pasteur KoreaSeongnam‐siRepublic of Korea
| | - David Shum
- Institut Pasteur KoreaSeongnam‐siRepublic of Korea
| | - Youngmee Jee
- Institut Pasteur KoreaSeongnam‐siRepublic of Korea
| | - Sung‐Han Kim
- Department of Infectious DiseasesAsan Medical CenterUniversity of Ulsan College of MedicineSeoulRepublic of Korea
- Office for Infection ControlAsan Medical CenterUniversity of Ulsan College of MedicineSeoulSouth Korea
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Cha HH, Lim SY, Kwon JS, Kim JY, Bae S, Jung J, Kim SH. Comparison of antibody responses after the 1st and 2nd doses of COVID-19 vaccine with those of patients with mild or severe COVID-19. Korean J Intern Med 2022; 37:455-459. [PMID: 35272444 PMCID: PMC8925962 DOI: 10.3904/kjim.2021.409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 12/07/2021] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND/AIMS Data comparing the antibody responses of different coronavirus disease 2019 (COVID-19) vaccine platforms according to dose with natural severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection-induced antibody responses are limited. METHODS Blood samples from adult patients with mild and severe COVID-19 and healthcare workers who received ChAdOx1 nCoV-19 vaccine (2nd dose at 12-week intervals) and BNT162b2 vaccine (2nd dose at 3-week intervals) were collected and compared by immunoglobulin G immune responses to SARS-CoV-2 specific spike protein using an in-house-developed enzyme-linked immunosorbent assay. RESULTS A total of 53 patients, including 12 and 41 with mild and severe COVID-19, respectively, were analyzed. In addition, a total of 73 healthcare workers, including 37 who received ChAdOx1 nCoV-19 and 36 who received BNT162b2, were enrolled. Antibody responses after the first and second doses of the ChAdOx1 nCoV-19 vaccine or the first dose of the BNT162b2 vaccine were similar to those in convalescent patients with mild COVID-19, but lower than those in convalescent patients with severe COVID-19, respectively. However, after the second dose of the BNT162b2 vaccine, the antibody response was comparable to that in convalescent patients with severe COVID-19. CONCLUSION Our data suggest that the second dose of mRNA vaccination may be more beneficial in terms of long-term immunity and prevention of SARS-CoV-2 variant infection than a single dose of COVID-19 vaccination or homologous second challenge ChAdOx1 nCoV-19.
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Affiliation(s)
- Hye Hee Cha
- Asan Medical Institute of Convergence Science and Technology (AMIST), University of Ulsan College of Medicine, Seoul,
Korea
| | - So Yun Lim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul,
Korea
| | - Ji-Soo Kwon
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul,
Korea
| | - Ji Yeun Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul,
Korea
| | - Seongman Bae
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul,
Korea
| | - Jiwon Jung
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul,
Korea
| | - Sung-Han Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul,
Korea
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Lim SY, Kim JY, Park S, Kwon JS, Park JY, Cha HH, Suh MH, Lee HJ, Lim JS, Bae S, Jung J, Lee N, Kim K, Shum D, Jee Y, Kim SH. Correlation between Reactogenicity and Immunogenicity after the ChAdOx1 nCoV-19 and BNT162b2 mRNA Vaccination. Immune Netw 2022; 21:e41. [PMID: 35036028 PMCID: PMC8733188 DOI: 10.4110/in.2021.21.e41] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 11/25/2021] [Accepted: 11/25/2021] [Indexed: 01/15/2023] Open
Abstract
Correlation between vaccine reactogenicity and immunogenicity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is unclear. Thus, we investigated to determine whether the reactogenicity after coronavirus disease 2019 vaccination is associated with antibody (Ab) titers and T cell responses. This study was prospective cohort study done with 131 healthcare workers at tertiary center in Seoul, South Korea. The degrees of the local reactions after the 1st and 2nd doses of ChAdOx1 nCov-19 (ChAdOx1) vaccination were significantly associated with the S1-specific IgG Ab titers (p=0.003 and 0.01, respectively) and neutralizing Ab (p=0.04 and 0.10, respectively) in age- and sex-adjusted multivariate analysis, whereas those after the BNT162b2 vaccination did not show significant associations. T cell responses did not show significant associations with the degree of reactogenicity after the ChAdOx1 vaccination or the BNT162b2 vaccination. Thus, high degree of local reactogenicity after the ChAdOx1 vaccine may be used as an indicator of strong humoral immune responses against SARS-CoV-2.
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Affiliation(s)
- So Yun Lim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
| | - Ji Yeun Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
| | - Soonju Park
- Institut Pasteur Korea, Seongnam 13488, Korea
| | - Ji-Soo Kwon
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
| | - Ji Young Park
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
| | - Hye Hee Cha
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
| | - Mi Hyun Suh
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
| | - Hyun Jung Lee
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
| | - Joon Seo Lim
- Clinical Research Center, Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
| | - Seongman Bae
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
| | - Jiwon Jung
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
| | - Nakyung Lee
- Institut Pasteur Korea, Seongnam 13488, Korea
| | - Kideok Kim
- Institut Pasteur Korea, Seongnam 13488, Korea
| | - David Shum
- Institut Pasteur Korea, Seongnam 13488, Korea
| | | | - Sung-Han Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
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Affiliation(s)
- P Bhardwaj
- Department of Ophthalmology, 9820Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - S Y Lim
- Department of Neurology, 9820Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - A M Gruener
- Department of Ophthalmology, 9820Nottingham University Hospitals NHS Trust, Nottingham, UK.,School of Medicine, 6123University of Nottingham, Nottingham, UK
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Lim SY, Yoon YI, Kim JY, Tak E, Song GW, Kim SH, Lee SG. Antibody Response Induced by Two Doses of ChAdOx1 nCoV-19, mRNA-1273, or BNT162b2 in Liver Transplant Recipients. Immune Netw 2022; 22:e24. [PMID: 35799703 PMCID: PMC9250869 DOI: 10.4110/in.2022.22.e24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 04/26/2022] [Accepted: 05/04/2022] [Indexed: 12/01/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) vaccination in immunocompromised, especially transplant recipients, may induce a weaker immune response. But there are limited data on the immune response after COVID-19 vaccination in liver transplant (LT) recipients, especially on the comparison of Ab responses after different vaccine platforms between mRNA and adenoviral vector vaccines. Thus, we conducted a prospective study on LT recipients who received two doses of the ChAdOx1 nCoV-19 (ChAdOx1), mRNA-1273, or BNT162b2 vaccines compared with healthy healthcare workers (HCWs). SARS-CoV-2 S1-specific IgG Ab titers were measured using ELISA. Overall, 89 LT recipients (ChAdOx1, n=16 [18%]) or mRNA vaccines (mRNA-1273 vaccine, n=23 [26%]; BNT162b2 vaccine, n=50 [56%]) received 3 different vaccines. Of them, 16 (18%) had a positive Ab response after one dose of COVID-19 vaccine and 62 (73%) after 2 doses. However, the median Ab titer after two doses of mRNA vaccines was significantly higher (44.6 IU/ml) than after two doses of ChAdOx1 (19.2 IU/ml, p=0.04). The longer time interval from transplantation was significantly associated with high Ab titers after two doses of vaccine (p=0.003). However, mycophenolic acid use was not associated with Ab titers (p=0.53). In conclusion, about 3-quarters of LT recipients had a positive Ab response after 2 doses of vaccine, and the mRNA vaccines induced higher Ab responses than the ChAdOx1 vaccine.
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Affiliation(s)
- So Yun Lim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
| | - Young-In Yoon
- Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
| | - Ji Yeun Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
| | - Eunyoung Tak
- Department of Convergence Medicine, Asan Medical Institute of Convergence Science and Technology (AMIST), Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
| | - Gi-Won Song
- Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
| | - Sung-Han Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
| | - Sung-Gyu Lee
- Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
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Kim J, Lim SY. Compound heterozygosity for a variably penetrant variant and a variant of unknown significance in FLT4 causes fully penetrant Milroy's lymphedema. Lymphology 2022; 55:41-46. [PMID: 36170577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Milroy disease, known as primary congenital lymphedema, is characterized by chronic tissue swelling due to impaired lymphatic drainage and is inherited in an autosomal dominant manner. This study reports a rare case of Milroy disease affecting siblings from unaffected parents. A one-month-old female infant presented with swelling of the bilateral calf and the dorsum of the feet which had been present since birth. Her 14-month-old brother had a similar presentation since birth with swelling of the bilateral calf and the dorsum of the feet. Milroy disease was diagnosed based on the clinical findings of bilateral lower limb swelling and confirmed by molecular genetic testing. The patient and her family, including her brother, parents, and maternal grandfather, were genetically tested, and two novel missense mutations (NM_182925.4: c.2534T>C; p.Leu845Pro, c.4006G>A; p.Glu1336Lys) were found in the Fms-related tyrosine kinase (FLT4) gene. Mutations segregated by the parents who carried each mutation in the heterozygous state were identified in the patient and her brother. The present case report in which Milroy disease developed in all offspring of parents with a normal phenotype suggests the possibility of a compound heterozygous mutation or non-penetrance during the process of inheritance of Milroy disease.
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Affiliation(s)
- J Kim
- Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, South Korea
| | - S Y Lim
- Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, South Korea
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Kim JY, Lim SY, Park S, Kwon JS, Bae S, Park JY, Cha HH, Seo MH, Lee HJ, Lee N, Kim K, Shum D, Jee Y, Kim SH. Immune responses to the ChAdOx1 nCoV-19 and BNT162b2 vaccines and to natural COVID-19 infections over a three-month period. J Infect Dis 2021; 225:777-784. [PMID: 34850034 PMCID: PMC8767884 DOI: 10.1093/infdis/jiab579] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 11/23/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND There are limited data directly comparing immune responses to vaccines and to natural infections with COVID-19. This study assessed the immunogenicity of the BNT162b2 and ChAdOx1 nCoV-19 vaccines over a 3-month period and compared the immune responses with those to natural infections. METHOD We enrolled healthcare workers (HCWs) who received BNT162b2 or ChAdOx1 nCoV-19 vaccines and COVID-19-confirmed patients, and then S1-IgG and neutralizing antibodies and T cell responses were measured. RESULTS A total of 121 vaccinees and 26 patients with confirmed COVID-19 were analyzed. After the 2 nd dose, the BNT162b2 vaccine yielded S1-IgG antibody responses similar to natural infections (2241 ± 899 vs. 2601 ± 5039, p=0.676), but significantly stronger than the ChAdOx1 vaccine (174 ± 96, p <0.0001). The neutralizing antibody titer generated by BNT162b2 was 6-fold higher than that generated by ChAdOx1, but lower than that by natural infection. T cell responses persisted for the 3 months in the BNT162b2 and natural infection but decreased in the ChAdOx1. CONCLUSIONS Antibody responses after the 2 nd dose of BNT162b2 are higher than after the 2 nd dose of ChAdOx1 and like those occurring after natural infection. T cell responses are maintained longer in BNT162b2 vaccinees than in ChAdOx1 vaccinees.
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Affiliation(s)
- Ji Yeun Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - So Yun Lim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Soonju Park
- Institut Pasteur Korea, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Ji-Soo Kwon
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Seongman Bae
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Ji Young Park
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Hye Hee Cha
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Mi Hyun Seo
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Hyun Jung Lee
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Nakyung Lee
- Institut Pasteur Korea, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Kideok Kim
- Institut Pasteur Korea, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - David Shum
- Institut Pasteur Korea, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Youngmee Jee
- Institut Pasteur Korea, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Sung-Han Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Park C, Choi I, Roh J, Lim SY, Kim SH, Lee J, Yang S. Evaluation of Applied Force During Nasopharyngeal Swab Sampling Using Handheld Sensorized Instrument. Annu Int Conf IEEE Eng Med Biol Soc 2021; 2021:2207-2210. [PMID: 34891725 DOI: 10.1109/embc46164.2021.9629916] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Nasopharyngeal swab is the most widely used diagnostic test for COVID-19 detection. However, enormous tests have posed a high risk of infection to medical professionals due to close contact with patients and substantial health burden. While automation of the nasopharyngeal swab is regarded as a potential solution to address these problems, the quantitative study of force for safe and effective control has not been widely performed yet. Hence, this study presents applied force during the standard nasopharyngeal swab sampling procedure using a handheld sensorized instrument. The sensorized instrument can simultaneously measure multi-axis forces and 6-DOF hand motion while allowing natural hand motion as is used in the standard swab sampling. To accurately measure force from the handheld instrument, the compensation of gravity bias is accomplished online while estimating the orientation of the hand with an embedded IMU sensor. As a result, the instrument can measure all three-axes forces by an error below 5 mN. A simulated test on a phantom model using the sensorized instrument shows that how the forces vary during the sampling sequences.
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Bae S, Kim JY, Lim SY, Park H, Cha HH, Kwon JS, Suh MH, Lee HJ, Lim JS, Jung J, Kim MJ, Chong YP, Lee SO, Choi SH, Kim YS, Lee HY, Lee S, Park MS, Kim SH. Dynamics of Viral Shedding and Symptoms in Patients with Asymptomatic or Mild COVID-19. Viruses 2021; 13:v13112133. [PMID: 34834940 PMCID: PMC8625453 DOI: 10.3390/v13112133] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 10/13/2021] [Accepted: 10/18/2021] [Indexed: 12/03/2022] Open
Abstract
We conducted a prospective cohort study at a community facility designated for the isolation of individuals with asymptomatic or mild COVID-19 between 10 January and 22 February 2021 to investigate the relationship of viral shedding with symptom changes of COVID-19. In total, 89 COVID-19 adult patients (12 asymptomatic, 16 presymptomatic, 61 symptomatic) were enrolled. Symptom scores, the genomic RNA and subgenomic RNA of SARS-CoV-2 from saliva samples with a cell culture were measured. Asymptomatic COVID-19 patients had a similar viral load to symptomatic patients during the early course of the disease, but exhibited a rapid decrease in viral load with the loss of infectivity. Subgenomic RNA and viable virus by cell culture in asymptomatic patients were detected only until 3 days after diagnosis, and the positivity of the subgenomic RNA and cell culture in symptomatic patients gradually decreased in both from 40% in the early disease course to 13% at 10 days and 4% at 8 days after the symptom onset, respectively. In conclusion, symptomatic patients have a high infectivity with high symptom scores during the early disease course and gradually lose infectivity depending on the symptom. Conversely, asymptomatic patients exhibit a rapid decrease in viral load with the loss of infectivity, despite a similar viral load during the early disease course.
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Affiliation(s)
- Seongman Bae
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (S.B.); (J.Y.K.); (S.Y.L.); (H.H.C.); (J.-S.K.); (M.H.S.); (H.J.L.); (J.J.); (M.J.K.); (Y.P.C.); (S.-O.L.); (S.-H.C.); (Y.S.K.)
| | - Ji Yeun Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (S.B.); (J.Y.K.); (S.Y.L.); (H.H.C.); (J.-S.K.); (M.H.S.); (H.J.L.); (J.J.); (M.J.K.); (Y.P.C.); (S.-O.L.); (S.-H.C.); (Y.S.K.)
| | - So Yun Lim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (S.B.); (J.Y.K.); (S.Y.L.); (H.H.C.); (J.-S.K.); (M.H.S.); (H.J.L.); (J.J.); (M.J.K.); (Y.P.C.); (S.-O.L.); (S.-H.C.); (Y.S.K.)
| | - Heedo Park
- BK21 Graduate Program, Department of Biomedical Sciences, Korea University College of Medicine, Seoul 02841, Korea; (H.P.); (H.Y.L.); (S.L.)
- Department of Microbiology, Institute for Viral Diseases, Biosafety Center, College of Medicine, Korea University, Seoul 02841, Korea
| | - Hye Hee Cha
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (S.B.); (J.Y.K.); (S.Y.L.); (H.H.C.); (J.-S.K.); (M.H.S.); (H.J.L.); (J.J.); (M.J.K.); (Y.P.C.); (S.-O.L.); (S.-H.C.); (Y.S.K.)
| | - Ji-Soo Kwon
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (S.B.); (J.Y.K.); (S.Y.L.); (H.H.C.); (J.-S.K.); (M.H.S.); (H.J.L.); (J.J.); (M.J.K.); (Y.P.C.); (S.-O.L.); (S.-H.C.); (Y.S.K.)
| | - Mi Hyun Suh
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (S.B.); (J.Y.K.); (S.Y.L.); (H.H.C.); (J.-S.K.); (M.H.S.); (H.J.L.); (J.J.); (M.J.K.); (Y.P.C.); (S.-O.L.); (S.-H.C.); (Y.S.K.)
| | - Hyun Jung Lee
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (S.B.); (J.Y.K.); (S.Y.L.); (H.H.C.); (J.-S.K.); (M.H.S.); (H.J.L.); (J.J.); (M.J.K.); (Y.P.C.); (S.-O.L.); (S.-H.C.); (Y.S.K.)
| | - Joon Seo Lim
- Clinical Research Center, Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea;
| | - Jiwon Jung
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (S.B.); (J.Y.K.); (S.Y.L.); (H.H.C.); (J.-S.K.); (M.H.S.); (H.J.L.); (J.J.); (M.J.K.); (Y.P.C.); (S.-O.L.); (S.-H.C.); (Y.S.K.)
| | - Min Jae Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (S.B.); (J.Y.K.); (S.Y.L.); (H.H.C.); (J.-S.K.); (M.H.S.); (H.J.L.); (J.J.); (M.J.K.); (Y.P.C.); (S.-O.L.); (S.-H.C.); (Y.S.K.)
| | - Yong Pil Chong
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (S.B.); (J.Y.K.); (S.Y.L.); (H.H.C.); (J.-S.K.); (M.H.S.); (H.J.L.); (J.J.); (M.J.K.); (Y.P.C.); (S.-O.L.); (S.-H.C.); (Y.S.K.)
| | - Sang-Oh Lee
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (S.B.); (J.Y.K.); (S.Y.L.); (H.H.C.); (J.-S.K.); (M.H.S.); (H.J.L.); (J.J.); (M.J.K.); (Y.P.C.); (S.-O.L.); (S.-H.C.); (Y.S.K.)
| | - Sang-Ho Choi
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (S.B.); (J.Y.K.); (S.Y.L.); (H.H.C.); (J.-S.K.); (M.H.S.); (H.J.L.); (J.J.); (M.J.K.); (Y.P.C.); (S.-O.L.); (S.-H.C.); (Y.S.K.)
| | - Yang Soo Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (S.B.); (J.Y.K.); (S.Y.L.); (H.H.C.); (J.-S.K.); (M.H.S.); (H.J.L.); (J.J.); (M.J.K.); (Y.P.C.); (S.-O.L.); (S.-H.C.); (Y.S.K.)
| | - Ho Young Lee
- BK21 Graduate Program, Department of Biomedical Sciences, Korea University College of Medicine, Seoul 02841, Korea; (H.P.); (H.Y.L.); (S.L.)
- Department of Microbiology, Institute for Viral Diseases, Biosafety Center, College of Medicine, Korea University, Seoul 02841, Korea
| | - Sohyun Lee
- BK21 Graduate Program, Department of Biomedical Sciences, Korea University College of Medicine, Seoul 02841, Korea; (H.P.); (H.Y.L.); (S.L.)
- Department of Microbiology, Institute for Viral Diseases, Biosafety Center, College of Medicine, Korea University, Seoul 02841, Korea
| | - Man-Seong Park
- BK21 Graduate Program, Department of Biomedical Sciences, Korea University College of Medicine, Seoul 02841, Korea; (H.P.); (H.Y.L.); (S.L.)
- Department of Microbiology, Institute for Viral Diseases, Biosafety Center, College of Medicine, Korea University, Seoul 02841, Korea
- Correspondence: (M.-S.P.); (S.-H.K.); Tel.: +82-2-2286-1312 (M.-S.P.); +82-2-3010-3305 (S.-H.K.)
| | - Sung-Han Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (S.B.); (J.Y.K.); (S.Y.L.); (H.H.C.); (J.-S.K.); (M.H.S.); (H.J.L.); (J.J.); (M.J.K.); (Y.P.C.); (S.-O.L.); (S.-H.C.); (Y.S.K.)
- Correspondence: (M.-S.P.); (S.-H.K.); Tel.: +82-2-2286-1312 (M.-S.P.); +82-2-3010-3305 (S.-H.K.)
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Kim JY, Bae S, Park S, Kwon JS, Lim SY, Park JY, Cha HH, Seo MH, Lee HJ, Lee N, Heo J, Shum D, Jee Y, Kim SH. Comparison of Antibody and T Cell Responses Induced by Single Doses of ChAdOx1 nCoV-19 and BNT162b2 Vaccines. Immune Netw 2021; 21:e29. [PMID: 34522442 PMCID: PMC8410992 DOI: 10.4110/in.2021.21.e29] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 08/11/2021] [Accepted: 08/13/2021] [Indexed: 12/31/2022] Open
Abstract
There are limited data directly comparing humoral and T cell responses to the ChAdOx1 nCoV-19 and BNT162b2 vaccines. We compared Ab and T cell responses after first doses of ChAdOx1 nCoV-19 vs. BNT162b2 vaccines. We enrolled healthcare workers who received ChAdOx1 nCoV-19 or BNT162b2 vaccine in Seoul, Korea. Anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) S1 protein-specific IgG Abs (S1-IgG), neutralizing Abs (NT Abs), and SARS-CoV-2-specific T cell response were evaluated before vaccination and at 1-wk intervals for 3 wks after vaccination. A total of 76 persons, comprising 40 injected with the ChAdOx1 vaccine and 36 injected with the BNT162b2 vaccine, participated in this study. At 3 wks after vaccination, the mean levels (±SD) of S1-IgG and NT Abs in the BNT162b2 participants were significantly higher than in the ChAdOx1 participants (S1-IgG, 14.03±7.20 vs. 6.28±8.87, p<0.0001; NT Ab, 183.1±155.6 vs. 116.6±116.2, p=0.035), respectively. However, the mean values of the T cell responses in the 2 groups were comparable after 2 wks. The humoral immune response after the 1st dose of BNT162b2 developed faster and was stronger than after the 1st dose of ChAdOx1. However, the T cell responses to BNT162b2 and ChAdOx1 were similar.
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Affiliation(s)
- Ji Yeun Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
| | - Seongman Bae
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
| | - Soonju Park
- Institut Pasteur Korea, Seongnam 13488, Korea
| | - Ji-Soo Kwon
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
| | - So Yun Lim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
| | - Ji Young Park
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
| | - Hye Hee Cha
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
| | - Mi Hyun Seo
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
| | - Hyun Jung Lee
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
| | - Nakyung Lee
- Institut Pasteur Korea, Seongnam 13488, Korea
| | | | - David Shum
- Institut Pasteur Korea, Seongnam 13488, Korea
| | | | - Sung-Han Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
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Jung J, Lim SY, Lee J, Bae S, Lim YJ, Hong MJ, Kwak SH, Kim EO, Sung H, Kim MN, Bae JY, Park MS, Kim SH. Clustering and multiple-spreading events of nosocomial severe acute respiratory syndrome coronavirus 2 infection. J Hosp Infect 2021; 117:28-36. [PMID: 34453983 PMCID: PMC8384763 DOI: 10.1016/j.jhin.2021.06.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 06/06/2021] [Accepted: 06/07/2021] [Indexed: 11/04/2022]
Abstract
Background There is growing evidence that super-spreading events (SSEs) and multiple-spreading events (MSEs) are a characteristic feature of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. However, data regarding the possibility of SSEs or MSEs in healthcare settings are limited. Methods This study was performed at a tertiary-care hospital in Korea. We analysed the nosocomial COVID-19 cases that occurred in healthcare workers and inpatients and their caregivers between January and 20th December 2020. Cases with two to four secondary cases were defined as MSEs and those with five or more secondary cases as SSEs. Findings We identified 21 nosocomial events (single-case events, N = 12 (57%); MSE + SSE, N = 9 (43%)) involving 65 individuals with COVID-19. Of these 65 individuals, 21 (32%) were infectors. The infectors tended to have a longer duration between symptom onset and diagnostic confirmation than did the non-infectors (median two days vs zero days, P=0.08). Importantly, 12 (18%) individuals were responsible for MSEs and one (2%) for an SSE, which collectively generated 35 (54%) secondary cases. Conclusion In a hospital with thorough infection-control measures, approximately 70% of the nosocomial cases of COVID-19 did not generate secondary cases, and one-fifth of the infectors were responsible for SSEs and MSEs, which accounted for approximately half of the total cases. Early case identification, isolation, and extensive contact tracing are important for the prevention of transmission and SSEs.
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Affiliation(s)
- J Jung
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Office for Infection Control, Asan Medical Center, Seoul, Republic of Korea
| | - S Y Lim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - J Lee
- Department of Microbiology, Institute for Viral Diseases, Biosafety Center, College of Medicine, Korea University, Seoul, Republic of Korea
| | - S Bae
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Y-J Lim
- Office for Infection Control, Asan Medical Center, Seoul, Republic of Korea
| | - M J Hong
- Office for Infection Control, Asan Medical Center, Seoul, Republic of Korea
| | - S H Kwak
- Office for Infection Control, Asan Medical Center, Seoul, Republic of Korea
| | - E O Kim
- Office for Infection Control, Asan Medical Center, Seoul, Republic of Korea
| | - H Sung
- Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - M-N Kim
- Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - J-Y Bae
- Department of Microbiology, Institute for Viral Diseases, Biosafety Center, College of Medicine, Korea University, Seoul, Republic of Korea
| | - M-S Park
- Department of Microbiology, Institute for Viral Diseases, Biosafety Center, College of Medicine, Korea University, Seoul, Republic of Korea.
| | - S-H Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Office for Infection Control, Asan Medical Center, Seoul, Republic of Korea.
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Kim DH, Kim SW, Stybayeva G, Lim SY, Hwang SH. Predictive Value of Olfactory and Taste Symptoms in the Diagnosis of COVID-19: A Systematic Review and Meta-Analysis. Clin Exp Otorhinolaryngol 2021; 14:312-320. [PMID: 33541033 PMCID: PMC8373831 DOI: 10.21053/ceo.2020.02369] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 01/18/2021] [Accepted: 01/24/2021] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES This study evaluated the diagnostic value of various symptoms of coronavirus disease 2019 (COVID-19) in screening for this disease. METHODS Two authors (working independently) comprehensively reviewed six databases (PubMed, Cochrane Database, Embase, Web of Science, Scopus, and Google Scholar) from their dates of inception until November 2020. The predictive value of patient-reported symptoms, including otolaryngologic and general symptoms, was evaluated in adults who underwent testing for COVID-19. True-positive, true-negative, false-positive, and false-negative data were extracted from each study. The methodological quality of the included studies was evaluated using the quality assessment of diagnostic accuracy studies tool (ver. 2). RESULTS Twenty-eight prospective and retrospective studies were included in the meta-analysis. The diagnostic odds ratio (DOR) of a change in olfaction and/or taste was 10.20 (95% confidence interval [CI], 8.43-12.34). The area under the summary receiver operating characteristic curve was 0.8. Olfactory and/or taste changes had a low sensitivity (0.57; 95% CI, 0.47-0.66) but moderate negative (0.78; 95% CI, 0.69-0.85] and positive (0.78; 95% CI, 0.66-0.87) predictive values and a high specificity (0.91; 95% CI, 0.83-0.96). Olfactory and/or taste changes had a higher diagnostic value than the other otolaryngologic symptoms, a higher DOR and specificity, and a similar or higher diagnostic value than the other general symptoms. CONCLUSION Among otolaryngologic symptoms, olfactory and/or taste dysfunction was the most closely associated with COVID-19 and its general symptoms, and should therefore be considered when screening for the disease.
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Affiliation(s)
- Do Hyun Kim
- Department of Otolaryngology-Head and Neck Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sung Won Kim
- Department of Otolaryngology-Head and Neck Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Gulnaz Stybayeva
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, USA
| | - So Yun Lim
- Department of Otolaryngology-Head and Neck Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Se Hwan Hwang
- Department of Otolaryngology-Head and Neck Surgery, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Lim SY, Kim JY, Lee JA, Kwon JS, Park JY, Cha HH, Suh MH, Lee HJ, Kim H, Kim S, Bae S, Jung J, Kim EH, Jee Y, Kim SH. Immune responses and reactogenicity after ChAdOx1 in individuals with past SARS-CoV-2 infection and those without. J Infect 2021; 84:94-118. [PMID: 34332017 PMCID: PMC8316626 DOI: 10.1016/j.jinf.2021.07.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 07/24/2021] [Indexed: 01/31/2023]
Affiliation(s)
- So Yun Lim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Ji Yeun Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jin Ah Lee
- Institut Pasteur Korea, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Ji-Soo Kwon
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Ji Young Park
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Hye Hee Cha
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Mi Hyun Suh
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Hyun Jung Lee
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Hyeonju Kim
- Institut Pasteur Korea, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Seungtaek Kim
- Institut Pasteur Korea, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Seongman Bae
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jiwon Jung
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Eui Ho Kim
- Institut Pasteur Korea, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Youngmee Jee
- Institut Pasteur Korea, Seongnam-si, Gyeonggi-do, Republic of Korea.
| | - Sung-Han Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
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Lee YW, Lim SY, Lee JH, Lim JS, Kim M, Kwon S, Joo J, Kwak SH, Kim EO, Jung J, Kwon HS, Kim TB, Kim SH, Bae S. Adverse Reactions of the Second Dose of the BNT162b2 mRNA COVID-19 Vaccine in Healthcare Workers in Korea. J Korean Med Sci 2021; 36:e153. [PMID: 34060261 PMCID: PMC8167406 DOI: 10.3346/jkms.2021.36.e153] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 05/11/2021] [Indexed: 01/14/2023] Open
Abstract
We conducted a prospective, mobile-based survey on the self-reported adverse reactions in healthcare workers (HCWs) who received both doses of the BNT162b2 mRNA vaccine. Of the 342 HCWs who completed the two-dose vaccination, 265 (77.5%) responded to the survey at least once. Overall, the rates of adverse reactions were higher after the second dose compared with the first dose (89.1% vs. 80.1%, P = 0.006). The most common systemic reactions were muscle ache (69.1%), fatigue (65.7%), headache (48.7%), chills (44.2%), and fever (32.1%), and were notably more common after the second dose vaccine as well. We also noted a sex difference in which the frequency of adverse reactions after the second dose of the vaccine was significantly higher in females, which was not observed after the first dose. The rates of adverse reactions were lower in older age groups, and the rates and severities of the adverse reactions decreased during the 3-day period following vaccination.
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Affiliation(s)
- Yun Woo Lee
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - So Yun Lim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ji Hyang Lee
- Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Joon Seo Lim
- Clinical Research Center, Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Miseo Kim
- Office for Infection Control, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seonhee Kwon
- Office for Infection Control, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jiyeon Joo
- Office for Infection Control, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sun Hee Kwak
- Office for Infection Control, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Eun Ok Kim
- Office for Infection Control, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jiwon Jung
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- Office for Infection Control, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hyouk Soo Kwon
- Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Tae Bum Kim
- Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sung Han Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- Office for Infection Control, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seongman Bae
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
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Lim SY, Lee YW, Jung J, Kim MJ, Chong YP, Lee SO, Choi SH, Kim YS, Choi EJ, Park HS, Lee JH, Lee JH, Lee KH, Kim SH. Diagnostic yield of a bronchoalveolar lavage fluid galactomannan assay in patients with negative serum galactomannan results suspected to have invasive pulmonary aspergillosis. Mycoses 2021; 64:1124-1131. [PMID: 33740824 DOI: 10.1111/myc.13269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 03/09/2021] [Accepted: 03/12/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND OBJECTIVES There are limited data in real clinical practice on the diagnostic value of a bronchoalveolar lavage (BAL) fluid galactomannan (GM) assay in patients with suspected invasive pulmonary aspergillosis (IPA) who had negative serum GM results. Thus, we investigated the diagnostic performance of a BAL GM assay in patients with negative serum GM assay results who were suspected to have IPA. METHODS This retrospective study was performed between May 2008 and April 2019 at a tertiary-care hospital in Seoul, South Korea. All patients with suspected IPA whose serum GM assays revealed negative results who sequentially underwent BAL were enrolled in this study. RESULTS A total of 341 patients with suspected IPA including four cases of proven IPA, 38 cases of probable IPA, 107 cases of possible IPA and 192 patients without IPA were enrolled. Of these 341 patients, 107 (31%) with possible IPA were excluded from the final analysis. Of 42 patients with proven and probable IPA who had initial negative serum GM results, 24 (57%) had positive BAL GM results (n = 24) or BAL fungal culture results (n = 8). In addition, BAL revealed evidence of other opportunistic infections including Pneumocystis jirovecii pneumonia (14% [26/190]), cytomegalovirus (CMV) pneumonia (5% [9/188]) and respiratory viral pneumonia (6% [12/193]). CONCLUSION Sequential BAL in patients with suspected IPA who had initial negative serum GM results provided additional diagnostic yield in approximately half of patients with evidence of another co-infection.
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Affiliation(s)
- So Yun Lim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yun Woo Lee
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jiwon Jung
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Min Jae Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yong Pil Chong
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sang-Oh Lee
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sang-Ho Choi
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yang Soo Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Eun-Ji Choi
- Department of Hematology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Han-Seung Park
- Department of Hematology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jung-Hee Lee
- Department of Hematology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Je-Hwan Lee
- Department of Hematology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Kyoo-Hyung Lee
- Department of Hematology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sung-Han Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Lim SY, Wang R, Tan DJH, Chin YH, Ng CH, Tham HY, Buan BJL, Chong CS. 368 Perioperative Outcomes in Open versus Laparoscopic Surgery in Elderly Patients Undergoing Right Hemicolectomy. Br J Surg 2021. [DOI: 10.1093/bjs/znab134.548] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Introduction
With the global aging population, elderly patients are increasingly undergoing colorectal surgery. This study aims to evaluate postoperative outcomes in open (OS) and laparoscopic surgery (LS) for right hemicolectomy in elderly patients.
Method
We retrospectively reviewed patients aged 70 and above undergoing right hemicolectomy for malignancies at our institution. Additionally, Embase and Medline databases were reviewed, and comparative meta-analysis was conducted.
Results
84 patients were included in our cohort (OS = 34; LS = 50). No significant difference in anastomotic leak (AL) (OS = 4; LS = 2; p = 0.176), surgical site infection (SSI) (OS = 4; LS = 2; p = 0.216), and ileus (OS = 10; LS = 16; p = 0.801) was observed. LS was associated with decreased postoperative stay (p = 0.001). Additionally, LS had faster return of bowel function (ROBF) (p = 0.068) and resumption of diet (p = 0.147), albeit without significance. Overall survival (p = 0.062), and disease-free survival (p = 0.067) did not significantly differ between LS and OS.
Pooled analysis of 463 patients yielded no significant difference in AL (OR:1.15; 95%CI: 0.17-8.01; p = 0.89), SSI (OR:0.88; 95%CI: 0.44-1.76; p = 0.71), and ileus (OR:1.42; 95%CI: 0.69 – 2.92; p = 0.35). Postoperative stay (WMD:1.90 days; 95%CI: -1.81–5.61 days; p = 0.31), and ROBF (WMD:14.49 hours; 95%CI: -4.07–33.05 hours; p = 0.13) were shortened in LS, although without significance.
Conclusions
LS is associated with improved functional outcomes without an increased risk of postoperative morbidity or mortality.
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Affiliation(s)
- S Y Lim
- Yong Loo Lin School of Medicine, National University Singapore, Singapore, Singapore
| | - R Wang
- Yong Loo Lin School of Medicine, National University Singapore, Singapore, Singapore
| | - D J H Tan
- Yong Loo Lin School of Medicine, National University Singapore, Singapore, Singapore
| | - Y H Chin
- Yong Loo Lin School of Medicine, National University Singapore, Singapore, Singapore
| | - C H Ng
- Yong Loo Lin School of Medicine, National University Singapore, Singapore, Singapore
| | - H Y Tham
- National University Hospital, Singapore, Singapore
| | - B J L Buan
- National University Hospital, Singapore, Singapore
| | - C S Chong
- National University Hospital, Singapore, Singapore
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Bae S, Lee YW, Lim SY, Lee JH, Lim JS, Lee S, Park S, Kim SK, Lim YJ, Kim EO, Jung J, Kwon HS, Kim TB, Kim SH. Adverse Reactions Following the First Dose of ChAdOx1 nCoV-19 Vaccine and BNT162b2 Vaccine for Healthcare Workers in South Korea. J Korean Med Sci 2021; 36:e115. [PMID: 33942579 PMCID: PMC8093607 DOI: 10.3346/jkms.2021.36.e115] [Citation(s) in RCA: 100] [Impact Index Per Article: 33.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 04/11/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND We performed a prospective survey on the adverse reactions following the first dose of two types of vaccines against coronavirus disease 2019 (COVID-19) in healthcare workers (HCWs) in South Korea. METHODS HCWs at a tertiary referral hospital in Seoul, South Korea, received a chimpanzee adenovirus-vectored vaccine (ChAdOx1 nCoV-19) or an mRNA-based vaccine (BNT162b2) between March 5 and March 26, 2021. The HCWs were asked to report adverse reactions through a mobile self-report questionnaire for three days after vaccination. RESULTS A total of 7,625 HCWs received the first dose of ChAdOx1 or BNT162b2 vaccine during the study period. Of them, 5,866 (76.9%) HCWs (ChAdOx1, n = 5,589 [95.3%]; BNT162b2, n = 277 [4.7%]) participated at least once in the survey, of whom 77% were female and 86% were younger than 50 years. The overall adverse reaction rate was 93% in the ChAdOx1 group and 80% in the BNT162b2 group (P < 0.001). Both local and systemic reactions were more commonly reported in the ChAdOx1 group, and the difference was larger in systemic reactions such as fever and fatigue. In the ChAdOx1 group, the incidence of adverse reactions was significantly higher in females and those in the younger age groups, while the BNT162b2 group showed such difference according to age. CONCLUSION In our prospective survey, vaccine-associated adverse reactions were more commonly reported in the ChAdOx1 group than in the BNT162b2 group. Females and younger age groups experienced vaccine-associated adverse reactions more frequently.
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Affiliation(s)
- Seongman Bae
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yun Woo Lee
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - So Yun Lim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ji Hyang Lee
- Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Joon Seo Lim
- Clinical Research Center, Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sojeong Lee
- Office for Infection Control, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Soyeon Park
- Office for Infection Control, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sun Kyung Kim
- Office for Infection Control, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Young Ju Lim
- Office for Infection Control, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Eun Ok Kim
- Office for Infection Control, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jiwon Jung
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- Office for Infection Control, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hyouk Soo Kwon
- Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Tae Bum Kim
- Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sung Han Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- Office for Infection Control, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
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Kim HW, Min J, Shin AY, Koo HK, Lim SY, Park MJ, Park YB, Lee J, Lee SS, Park JS, Kim JS. Reasons why patients with tuberculosis in South Korea stop anti-TB treatment: a cross-sectional study. Int J Tuberc Lung Dis 2021; 24:1016-1023. [PMID: 33126933 DOI: 10.5588/ijtld.19.0684] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND: As there had been no reduction in the TB burden in South Korea since 2000, a public-private mix (PPM) strategy was launched in 2011. The purpose of this study was to investigate the reasons for lost to follow-up (LTFU) among TB patients and their clinical characteristics.METHOD: A multicentre, cross-sectional study based on in-depth interviews with patients and their families by TB specialist nurses was conducted. Patients who were reported with a final outcome of LTFU in 2015-2017 at all PPM hospitals across the country were enrolled. Enrolled patients were classified into six subgroups by age and three major reasons for LTFU (adverse effects, refusal of treatment, marginalisation) and their clinical features were compared.RESULTS: Among 780 patients, those who were lost to follow-up due to adverse effects accounted for the largest proportion (n = 387). LTFU in those aged <65 years who refused treatment (n = 189) and those aged <65 years who were marginalised (n = 108) were related to having smear-positive TB and a previous history of unfavourable outcomes.CONCLUSION: To reduce LTFU in South Korea, comprehensive strategies, including management of adverse effects, systematic counselling and education, should be implemented.
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Affiliation(s)
- H W Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Incheon St Mary´s Hospital
| | - J Min
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Daejeon St Mary´s Hospital, College of Medicine, The Catholic University of Korea, Seoul
| | - A Y Shin
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Incheon St Mary´s Hospital
| | - H-K Koo
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang
| | - S Y Lim
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul
| | - M J Park
- Department of Pulmonary and Critical Care Medicine, Kyung Hee University Medical Center, Seoul
| | - Y B Park
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Hallym University Kangdong Sacred Heart Hospital, Seoul
| | - J Lee
- Division of TB Epidemic Investigation, Korea Centers for Disease Control and Prevention, Osong
| | - S-S Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang
| | - J S Park
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Republic of Korea
| | - J S Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Incheon St Mary´s Hospital
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Kang J, Oh YM, Lee JH, Kim EK, Lim SY, Kim WJ, Yoon HI, Kim TH, Park TS, Kim SO, Lee SW, Lee SD, Lee JS. Distinctive patterns of pulmonary function change according to baseline lung volume and diffusing capacity. Int J Tuberc Lung Dis 2021; 24:597-605. [PMID: 32553011 DOI: 10.5588/ijtld.19.0401] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING: Multicentre retrospective study in South Korea.OBJECTIVE: To longitudinally evaluate changes in lung volume and diffusing capacity for carbon monoxide (DLCO) with forced expiratory volume in 1 sec (FEV1).DESIGN: A total of 155 patients with chronic obstructive pulmonary disease (COPD), whose pulmonary function parameters were measured annually for 5 years, were selected from a prospective cohort in South Korea. A random coefficients model was used to estimate mean annual FEV1, lung volume parameter and DLCO change rates.RESULTS: Patients were classified into four groups based on baseline DLCO and residual volume/total lung capacity (RV/TLC) measurements. The annual FEV1 decline rate was greater in patients with low DLCO than in those with normal DLCO, with the greatest decline occurring in patients with low DLCO and normal RV/TLC. RV and RV/TLC declined in patients with high RV/TLC, whereas these increased in patients with normal RV/TLC. DLCO decreased longitudinally in all four groups, with the greatest decline occurring in patients with normal DLCO and normal RV/TLC.CONCLUSIONS: Different subgroups of patients with COPD exhibited distinctive pulmonary function change patterns. Baseline DLCO and RV/TLC may be used as physiological markers to predict long-term changes in pulmonary function.
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Affiliation(s)
- J Kang
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul
| | - Y-M Oh
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul
| | - J-H Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Bundang CHA Hospital, College of Medicine, CHA University, Seongnam
| | - E K Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Bundang CHA Hospital, College of Medicine, CHA University, Seongnam
| | - S Y Lim
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul
| | - W J Kim
- Department of Internal Medicine, College of Medicine, Kangwon National University, Chuncheon
| | - H I Yoon
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam
| | - T-H Kim
- Division of Pulmonology, Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri
| | - T S Park
- Division of Pulmonology, Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri
| | - S O Kim
- Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, Seoul, South Korea
| | - S W Lee
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul
| | - S-D Lee
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul
| | - J S Lee
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul
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