Risk Factors for Sudden Death Within 2 Days After Diagnosis of COVID-19 in Korea

Background@#We aimed to analyze the risk factors for sudden death after diagnosis of coronavirus disease 2019 (COVID-19) in South Korea and to provide evidence for informing prevention and control interventions for patients at risk of sudden death. @*Methods@#We included 30,302 COVID-19 related deaths registered in the patient management information system (Central Disease Control Headquarters) between January 1, 2021, and December 15, 2022. We collected their epidemiological data recorded by the reporting city, province, or country. We performed multivariate logistic regression analysis to identify risk factors for sudden death after diagnosis of COVID-19. @*Results@#Among the 30,302 deaths, there were 7,258 (24.0%) and 23,044 (76.0%) sudden and non-sudden deaths, respectively. Sudden death means a person who died within 2 days of diagnosis and who did not receive inpatient treatment. Underlying condition, vaccination status, and place of death were significantly associated with the survival period in all age groups. Moreover, region, sex, and prescription were significantly associated with the survival period only in certain age groups. However, reinfection was not significantly associated with the survival period in any age group. @*Conclusion@#To our knowledge, this is the first study on the risk factors for sudden death after a diagnosis of COVID-19, which included age, underlying condition, vaccination status, and place of death. Additionally, individuals aged < 60 years without an underlying condition were at high risk for sudden death. However, this group has relatively low interest in health, as can be seen from the high non-vaccination rate (16.1% of the general population vs. 61.6% of the corresponding group). Therefore, there is a possibility for the presence of an uncontrolled underlying disease in this population. In addition, many sudden deaths occurred due to delayed hospital visits to continue economic activities even after the onset of COVID-19 symptoms (7 days overall vs. 10 days average for the group). In conclusion, ‘continued interest in health’ is a key factor in avoiding sudden death in the economically active group (under 60 years of age).

Risk factors for deaths associated with COVID-19 according to the cause of death classification in Republic of Korea

Objectives@#This study aimed to classify coronavirus disease 2019 (COVID-19)-related deaths according to whether COVID-19 was listed as the cause of death, and to investigate thedifferences in demographic characteristics and risk factors for COVID-19 death classifications. @*Methods@#A total of 5,625 deaths in South Korea among patients with confirmed COVID-19 from January 20, 2020 to December 31, 2021 were selected. Excluding false reports and unnatural deaths, 5,597 deaths were analyzed. Based on death report data, deaths were classified according to whether the cause of death was listed as COVID-19 (CD) or not (NCD). The epidemiological characteristics and causes of deaths were investigated using descriptive, univariate, and multivariate statistical analyses. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to analyze the risk factors. @*Results@#The case fatality ratio was 0.89% and increased with age. Additionally, 96.4% of the subjects had an underlying disease, and 53.4% died in winter. The proportion of NCDs was 9.3%, of whom 19.1% died at home and 39.0% were confirmed to have COVID-19 after death. Malignant neoplasms (102/416 vs. 637/4,442; OR, 1.71; 95% CI, 1.36−2.16; p < 0.001) were significantly associated with NCD. @*Conclusion@#This is the first study to analyze risk factors by cause of death using COVID-19death report data in South Korea. These results are expected to be used as evidence forestablishing a death monitoring system that can collect timely information in a new infectiousdisease pandemic.

Pediatric Deaths Associated With Coronavirus Disease 2019 (COVID-19) in Korea

As of September 3, 2022, 5,388,338 coronavirus disease 2019 (COVID-19) cases and 46 deaths (3 in 2021 and 43 in 2022) were reported in children ≤ 18 years in Korea. Cumulative confirmed cases accounted for 67.3% of the population aged ≤ 18 years and case fatality rate was 0.85/100,000. Among 46 fatal cases, 58.7% were male and median age was 7 years.Underlying diseases were present in 47.8%; neurologic diseases (63.6%) and malignancy (13.6%) most common. Only four had history of COVID-19 immunization. COVID-19 associated deaths occurred at median 2 days from diagnosis (range: −1 to 21). Among COVID-19 deaths, 41.3% occurred before admission; 2 before hospital arrival and 17 in the emergency department. Among children whose cause was documented, myocarditis, respiratory and multiorgan failure were most common. COVID-19 associated death was seen early after diagnosis in children and public health policies to provide access to medical care for children with COVID-19 are essential during the pandemic.

Children with COVID-19 after Reopening of Schools, South Korea

Purpose@#To describe pediatric coronavirus disease 2019 (COVID-19) cases after the reopening of schools in the Republic of Korea and their transmission routes. @*Methods@#All case report forms and epidemiologic investigation forms for children aged 3–18 years reported as COVID-19 cases to the National Notifiable Disease Surveillance System from May 1 to July 12, 2020, were reviewed. @*Results@#After the schools were reopened in May 2020, a total of 127 pediatric COVID-19 cases were confirmed until July 12. Of these, 59 children (46%) were exposed to severe acute respiratory syndrome coronavirus 2 through family and relatives, followed by 18 children (14%) through cram schools or private lessons, 8 children (6%) through multi-use facilities, and 3 children (2%) through school. @*Conclusions@#The present data do not suggest an increased risk of COVID-19 transmission in the context of stringent school-based infection prevention measures introduced across the country.

Children with COVID-19 after Reopening of Schools, South Korea

Purpose@#To describe pediatric coronavirus disease 2019 (COVID-19) cases after the reopening of schools in the Republic of Korea and their transmission routes. @*Methods@#All case report forms and epidemiologic investigation forms for children aged 3–18 years reported as COVID-19 cases to the National Notifiable Disease Surveillance System from May 1 to July 12, 2020, were reviewed. @*Results@#After the schools were reopened in May 2020, a total of 127 pediatric COVID-19 cases were confirmed until July 12. Of these, 59 children (46%) were exposed to severe acute respiratory syndrome coronavirus 2 through family and relatives, followed by 18 children (14%) through cram schools or private lessons, 8 children (6%) through multi-use facilities, and 3 children (2%) through school. @*Conclusions@#The present data do not suggest an increased risk of COVID-19 transmission in the context of stringent school-based infection prevention measures introduced across the country.

Seroprevalence of Middle East respiratory syndrome coronavirus (MERS-CoV) in public health workers responding to a MERS outbreak in Seoul, Republic of Korea, in 2015

@#The first case of Middle East respiratory syndrome coronavirus (MERS-CoV) in the Republic of Korea was confirmed in May 2015 after a traveller returned from the Middle East. There were 186 cases, including 38 deaths, within two months. The potential of a single MERS-confirmed patient to result in such a large MERS outbreak constitutes a serious global health concern.