Journal Of Korean Medical Science[JOURNAL]
Sun
200 papers
Perception of Family Genetic Testing for Hereditary Breast and Ovarian Cancer: A Survey of Patients and General Public.
Lee EJ, Kim JY, An J … +10 more , Yun J, Jang S, Jung M, Jeong YM, Cho C, Jeong TD, Jo J, Moon BI, So MK, Huh J
J Korean Med Sci · 2026 Mar · PMID 41943275 · Full text
BACKGROUND: Family genetic testing facilitates early cancer diagnosis and prevention for relatives of individuals carrying Breast Cancer Susceptibility Genes 1 and 2 ( pathogenic variants. This study evaluates perception...
BACKGROUND: Family genetic testing facilitates early cancer diagnosis and prevention for relatives of individuals carrying Breast Cancer Susceptibility Genes 1 and 2 ( pathogenic variants. This study evaluates perceptions of family genetic testing among Korean cancer patients and the general public, providing foundational data to guide strategies for implementation. METHODS: A total of 186 participants (86 patients with cancer and 100 public controls) were educated on hereditary breast and ovarian cancer and family genetic testing via a presentation video accessed through QR codes or smartphone links. Afterward, participants completed a 10-question knowledge test, and perceptions were assessed using a questionnaire featuring a hypothetical patient scenario to explore general characteristics and attitudes toward family genetic testing. RESULTS: Post-education, knowledge scores were significantly higher in the patient group than in the controls (median: 10 vs. 9, = 0.040). Overall, 54.6% of participants shared their genetic test results, with patients sharing more frequently than controls (59.6% vs. 50.0%, < 0.001). First-degree relatives were the most common recipients (patients: 81.0%, controls: 76.9%, = 0.163). Results were shared to inform relatives of cancer risks and encourage prevention, while weak familial relationships were cited as barriers. Face-to-face communication was the preferred sharing method. Most participants (75.8%) believed genetic results should be shared with children once they turn 19. CONCLUSION: Promoting family genetic testing requires effective communication and dissemination of accurate information. Developing systematic genetic counseling programs is essential to achieving these objectives.
Burnout and Depression of Medical Faculty: After Mass Resignation of Junior Doctors in Korea.
Seong SJ, Hwang JY, Song JY … +4 more , Park KJ, Jo YT, Lee JH, Park DG
J Korean Med Sci · 2026 Mar · PMID 41943274 · Full text
BACKGROUND: The mass resignation of residents and interns in protest against the proposed increase in medical school admissions triggered a healthcare crisis, significantly increasing the workload of the remaining medica...
BACKGROUND: The mass resignation of residents and interns in protest against the proposed increase in medical school admissions triggered a healthcare crisis, significantly increasing the workload of the remaining medical faculty. This study examines burnout and depression among faculty members and explores the contributing factors during this crisis. METHODS: Faculty from the University School of Medicine and its affiliated hospitals participated in an online survey distributed via group chat in May 2024. Burnout, depression, and stress levels were assessed using the Oldenburg Burnout Inventory, the Patient Health Questionnaire-9, and the Perceived Stress Scale, respectively. Factors associated with depression, burnout (disengagement and exhaustion) were identified. Causal mediation analysis was conducted to investigate whether depressive symptoms mediate the relationship between stress and burnout (disengagement and exhaustion). RESULTS: Depression was reported by 68.9% of participants, while 99.3% exhibited signs of disengagement or exhaustion. Depression was linked to working more than 52 hours per week and intensive care unit (ICU) duties. Disengagement was associated with specialty and ICU duties, and exhaustion was associated with gender, age, specialty, working hours, and ICU duties. Depressive symptoms mediated the relationship between stress and disengagement but not between stress and exhaustion. CONCLUSION: Burnout and depression were highly prevalent among medical faculty during the healthcare crisis. Abrupt policy change and the mass resignation of residents and interns may have exacerbated burnout and depression among the remaining faculty. The distinct components of burnout appear to have unique risk factors and relationships with depression. Targeted interventions are urgently needed to address burnout and depression among medical faculty members.
Economic Burden of Developmental Disorder Treatment in Korea and Various Overseas Policies: A Study on the Reinforcement for National Assistance.
Kim H, Han DG, Kim HS … +8 more , Seo S, Lee Y, Choi H, Lee J, Kang JG, Kim TH, Ko E, Park MH
J Korean Med Sci · 2026 Mar · PMID 41943273 · Full text
BACKGROUND: Developmental disorders are characterized by delays in motor skills, language, cognition, emotional regulation, and social abilities. The most common conditions within this category include intellectual disab...
BACKGROUND: Developmental disorders are characterized by delays in motor skills, language, cognition, emotional regulation, and social abilities. The most common conditions within this category include intellectual disabilities and autism spectrum disorder, which not only impact individuals and families but also have broader effects on the socioeconomic system. Despite the necessity of early detection and intensive treatment for developmental disorders, limited coverage by the national health insurance system in South Korea imposes a significant financial burden on families. METHODS: In this study, a structured survey was conducted on 105 caregivers of infants and children younger than six with developmental disorders, 52 medical doctors (child and adolescent psychiatrists, pediatricians, and rehabilitation physicians), and 51 treatment specialists to assess the economic circumstances related to developmental disorder treatment. RESULTS: Among 105 children (68.6% male), most initiated treatment between ages 2 and 4, with speech therapy (88.4%) and sensory therapy (64.0%) being the most utilized services. Although Applied Behavior Analysis had the highest session intensity and cost, its voucher utilization was remarkably low (2.4%), contributing to a significant perceived financial burden, with 72.4% of caregivers reporting high burden (mean score 3.99/5). Consequently, specialists reported a discrepancy between recommended and accessible treatments due to costs, rating the reasonableness of current voucher fees at only 1.98 out of 5. CONCLUSION: Given the substantial financial burden, the introduction of new policies and revisions to existing policies are urgently needed to support the treatment costs for individuals with developmental disorders.
The Impact of Vitamin D Deficiency and Osteoporosis on Benign Paroxysmal Positional Vertigo Recurrence: A Population-Based Study From the Korean National Health Insurance Service.
Kwak SH, Lee YH, Han JS … +3 more , Lim JH, Seo JH, Lee DH
J Korean Med Sci · 2026 Mar · PMID 41943272 · Full text
BACKGROUND: Benign paroxysmal positional vertigo (BPPV) is a common vestibular disorder characterized by brief episodes of vertigo triggered by changes in head position and is associated with displaced otoconia in the in...
BACKGROUND: Benign paroxysmal positional vertigo (BPPV) is a common vestibular disorder characterized by brief episodes of vertigo triggered by changes in head position and is associated with displaced otoconia in the inner ear. Emerging evidence suggests that metabolic conditions, such as vitamin D deficiency, osteoporosis, and obesity, increase the risk of BPPV recurrence. This study investigated the associations between BPPV recurrence and these metabolic conditions using a large population-based dataset. METHODS: A nested case-control study was conducted using data from the Korean National Health Insurance Service cohort, including 507,744 individuals diagnosed with BPPV between 2005 and 2017. BPPV cases were identified by International Classification of Diseases, 10th revision, Clinical Modification codes, vestibular function tests, and canalith repositioning procedures. Univariate and multivariate analyses were performed to assess the impact of vitamin D deficiency, osteoporosis, body mass index (BMI), and supplementation on BPPV recurrence. RESULTS: The overall BPPV recurrence rate was 20.8%. Patients with vitamin D deficiency had a significantly higher recurrence rate (25.2%) compared with those with normal vitamin D levels (20.8%) ( < 0.001). Vitamin D supplementation significantly reduced the risk of recurrence (adjusted hazard ratio [aHR], 1.099; 95% confidence interval [CI], 1.003-1.203; = 0.042), with a more pronounced effect in female patients (aHR, 1.110; 95% CI, 1.011-1.219; = 0.029). Overweight individuals (BMI 25-30 kg/m²) with vitamin D deficiency had a significantly increased risk of recurrence compared with normal BMI (hazard ratio [HR], 1.207; 95% CI, 1.045-1.393; = 0.010), whereas no significant difference in risk was observed in obese individuals (BMI ≥ 30 kg/m²) (HR, 1.096; 95% CI, 0.706-1.702; = 0.682). Osteopenia and osteoporosis were not identified as an independent risk factor for BPPV recurrence. However, among postmenopausal women (age 50-69), osteopenia was a significantly associated with an increased risk of BPPV recurrence. Notably, combined calcium and vitamin D supplementation was associated with increased recurrence risk (HR, 1.122; 95% CI, 1.011-1.246; = 0.030), especially in women aged 40-49 years (HR, 1.464; 95% CI, 1.030-2.082; = 0.034). CONCLUSION: Vitamin D deficiency, osteopenia among postmenopausal women and higher BMI are significant risk factors for BPPV recurrence. Vitamin D supplementation reduces recurrence risk, particularly in women and younger individuals. However, combined calcium and vitamin D supplementation may be associated with an increased risk of recurrence in specific subgroups. These findings underscore the importance of metabolic health in the pathophysiology and management of BPPV and suggest that targeted interventions reduce the burden of recurrent vertigo in affected populations.
Immersion Deaths in Seoul: Implications of Decomposition for Postmortem Diagnosis of Drowning.
Lee DY, Kim H, Kim GE … +3 more , Jung EB, Lee SD, Kim MY
J Korean Med Sci · 2026 Apr · PMID 41943264 · Full text
BACKGROUND: Drowning is defined as a process of respiratory impairment caused by submersion in water and is a significant cause of death worldwide. However, postmortem diagnosis of drowning remains a major challenge in f...
BACKGROUND: Drowning is defined as a process of respiratory impairment caused by submersion in water and is a significant cause of death worldwide. However, postmortem diagnosis of drowning remains a major challenge in forensic pathology, primarily because it relies on the exclusion of all other possible causes based on only a few pathognomonic findings during autopsy, particularly in cases involving decomposition. This study reviewed a series of immersion deaths in Seoul by analyzing demographic and epidemiological factors, their associations with the cause and manner of death, and the impact of decomposition on drowning diagnosis. METHODS: Autopsy data from 113 immersion death cases examined at the Medical Examiner's Office of Seoul National University College of Medicine between April 2016 and October 2023 were collected and analyzed. Drowning findings were assessed with a focus on foam in the airway, emphysema aquosum, fluid in the sphenoid sinus, petromastoid hemorrhage, drowning fluid in the stomach and duodenum, aortic hemolytic staining, and the diatom test results. RESULTS: The majority (47.8%) of immersed bodies were recovered from the Hangang River and determined to be drowning suicides. The cases in which the manner of death was undetermined exhibited more advanced decomposition compared to suicides, with epidemiological patterns suggesting social isolation or financial hardship. In terms of drowning findings, decomposition significantly affected the detection of foam in the airway, emphysema aquosum, aortic hemolytic staining, and the diatom test results, whereas other findings, such as fluid in the sphenoid sinus, petromastoid hemorrhage, and fluid in the stomach and duodenum, appeared relatively resistant to decomposition. CONCLUSION: This study outlines the landscape of immersion deaths in Seoul, emphasizing the impact of decomposition on diagnosing drowning and determining the manner of death. Further research is warranted to enhance diagnostic accuracy and to develop standardized guidelines for drowning diagnosis.
Effectiveness and Cost-Utility of Anti-Adhesion Agents in Intra-Abdominal Surgery Patients.
Lee YS, Park S, Park M … +4 more , Ha US, Lee SJ, Lee TJ, Shin E
J Korean Med Sci · 2026 Apr · PMID 41943263 · Full text
BACKGROUND: Adhesive intestinal obstruction (AIO) is a common and critical complication of intra-abdominal surgery, often requiring preventative measures such as using anti-adhesion agents (AAA). However, despite their p...
BACKGROUND: Adhesive intestinal obstruction (AIO) is a common and critical complication of intra-abdominal surgery, often requiring preventative measures such as using anti-adhesion agents (AAA). However, despite their prevalence and significance, a notable lack of long-term and large-scale clinical evidence exists supporting the effectiveness and cost-utility of these agents. This study aimed to evaluate the effectiveness and cost-utility of applying AAA in patients undergoing intra-abdominal surgery. METHODS: This is a retrospective observational study utilizing the Korean National Health Insurance Database in combination with the data from the Clinical Data Warehouse collected from six university-affiliated hospitals in Korea. The study included patients who underwent intra-abdominal surgeries between April and December 2016, with 2-year follow-up. The effectiveness of AAA was assessed by the incidence rate of AIO, and cost-utility was evaluated through calculating quality-adjusted life years (QALYs) and direct costs. Subgroup and sensitivity analyses were conducted to confirm the consistency and robustness of the study findings. RESULTS: A total of 2,831 patients were included in the study. Among them, 1,365 (47.2%) received AAA while 1,466 (52.8%) did not. The group that received AAA exhibited a significantly lower incidence of AIO, with a rate of 12.4% compared to 18.5% in the non-user group. Utility scores were higher in the user group, averaging 1.992 QALYs versus 1.986 in the non-user group. Direct costs were significantly lower in the user group, totaling 3,794 USD, which is 1,330 USD less than those incurred by the non-user group. Subgroup and sensitivity analyses reinforced these findings, demonstrating consistent reductions in AIO incidence, increased QALYs, and decreased costs observed across various subgroups, particularly among older patients and those without chronic conditions. CONCLUSION: These findings highlight the clinical effectiveness and cost-utility of AAA in patients undergoing intra-abdominal surgery. By significantly reducing the incidence of AIO and lowering healthcare costs, these agents provide empirical evidence supporting their broader adoption in clinical practice. This study addresses critical gaps in the understanding of postoperative management and offers valuable insights that could inform future healthcare policies.
Clinical Outcomes of Children With Autoimmune Hepatitis in Korea: A Nationwide Multicenter Study.
Ahn JE, Ko JS, Moon JS … +14 more , Choi S, Lee YJ, Lee EJ, Koh H, Choi HJ, Oh SH, Kim KM, Kang KS, Choe BH, Kim SH, Kim ES, Kim MJ, Kim SY, Lee KJ
J Korean Med Sci · 2026 Apr · PMID 41943262 · Full text
BACKGROUND: Autoimmune hepatitis (AIH) is a rare chronic liver disease with limited data on long-term outcomes. This study aimed to investigate the clinical characteristics and prognosis of pediatric AIH patients in Kore...
BACKGROUND: Autoimmune hepatitis (AIH) is a rare chronic liver disease with limited data on long-term outcomes. This study aimed to investigate the clinical characteristics and prognosis of pediatric AIH patients in Korea. METHODS: We retrospectively reviewed the medical records of 44 patients diagnosed with AIH under 19 years of age between January 2007 and August 2023 at nine tertiary university hospitals in Korea. Clinical data, including laboratory findings, treatment, and outcomes such as biochemical remission and survival rates, were analyzed. RESULTS: The median age at diagnosis was 12 years, and 57% were female. Type 1 AIH was predominant, and 7% of cases were autoimmune sclerosing cholangitis. Twenty-three percent of patients had coexisting autoimmune diseases. Jaundice was the most common symptom, and 7% of patients had cirrhosis at diagnosis. All patients were seropositive for autoantibodies, with 93% testing positive for antinuclear antibodies. Patients who received an initial corticosteroid dose of ≥ 1 mg/kg/day had higher biochemical remission rates from 6 months to 5 years compared to those who received a lower dose. Remission rates did not differ significantly between azathioprine monotherapy and corticosteroid combination therapy. The ten-year overall survival rate was 95%, while the clinical event-free survival was 70%. An initial total bilirubin level ≥ 1.0 mg/dL at diagnosis was associated with poorer clinical event-free survival. CONCLUSION: Type 1 AIH is predominant in Korean children, with a relatively low cirrhosis rate at diagnosis. Standard-dose corticosteroids were effective in achieving biochemical remission. Initial bilirubin levels may serve as a prognostic marker for long-term outcomes.
Extreme Ambient Temperature and Differential Risk of Mental Disorder-Related Emergency Department Visit by Disorder, Sex and Age: A Case-Time Series Analysis in Korea.
Jhang H, Lee W, Lee JT … +4 more , Kim Y, Sun S, Chang SS, Choe SA
J Korean Med Sci · 2026 Apr · PMID 41943261 · Full text
BACKGROUND: The impacts of extreme ambient temperatures on mental health may vary by type of disorders, age and sex. We examined the association between extreme ambient temperatures and emergency department (ED) visits f...
BACKGROUND: The impacts of extreme ambient temperatures on mental health may vary by type of disorders, age and sex. We examined the association between extreme ambient temperatures and emergency department (ED) visits for prevalent mental disorders, stratified by age and sex. METHODS: We analyzed the National Emergency Department Information System data in 2015-2021, Korea. Using a case-time series design, we calculated relative risks (RRs) of ED visits for prevalent mental disorders at extremely high (97.5th percentile) and low (2.5th) ambient temperatures, stratified by age (0-19, 20-39, 40-64, and ≥ 65) and sex. A lag period of 0-5 days was considered for ambient temperature and air pollution. RESULTS: Of 1,351,463 ED visits due to mental disorders, neurotic, stress-related and somatoform disorder (anxiety disorder, 31.5%), organic mental disorder (OMD, 25.2%), substance use disorder (SUD, 24.5%) and mood disorder (MD, 15.2%) were common. At extreme high temperatures, the RR of anxiety-related visits was 2.25 (95% confidence interval [CI], 1.87-2.71), with men 20-39 years at higher risk (4.02; 95% CI, 2.77-5.85) than women (1.65; 95% CI, 1.17-2.32, for difference < 0.001), versus minimum-risk ambient temperature. Extreme heat also raised RR for OMD in men 40-64 years (1.49; 95% CI, 1.01-2.21), SUD in women 20-39 years (2.72; 95% CI, 1.85-3.99) and MD in women ≥ 65 years (2.00; 95% CI, 1.42-2.80). Risk estimates at extreme low temperatures were generally imprecise, except for anxiety in men 20-64 years. These associations were not replicated among children and adolescents (0-19 years). CONCLUSION: Our findings emphasize the need for more tailored climate change adaptation strategies considering the varying vulnerabilities of populations to mental disorders.
Validation of the Korean Version of a Knowledge Assessment Tool for Children With Inflammatory Bowel Disease.
Park S, Noh J, Kim C … +5 more , Lim H, Lee EJ, Koh H, Day AS, Vernon-Roberts A
J Korean Med Sci · 2026 Apr · PMID 41943260 · Full text
BACKGROUND: Inflammatory bowel disease (IBD) is a chronic, relapsing disease of the intestine, with approximately 5-14% of patients diagnosed during childhood. Previous studies have shown that knowledge of IBD is associa...
BACKGROUND: Inflammatory bowel disease (IBD) is a chronic, relapsing disease of the intestine, with approximately 5-14% of patients diagnosed during childhood. Previous studies have shown that knowledge of IBD is associated with treatment adherence, highlighting that assessment of disease knowledge is an important component of ongoing management. The Inflammatory Bowel Disease Knowledge Inventory Device 2 (IBD-KID2) is a validated English-language knowledge assessment tool for children with IBD, but there is currently no Korean version. This study aimed to develop the Korean version of IBD-KID2 (K-IBD-KID2) and assess the validity and reliability in evaluating disease-related knowledge in Korean children with IBD. METHODS: The cross-cultural adaptation process was conducted in three stages. Conceptual equivalence was assessed by experts using the content validity index, with all items scored for cultural comprehension/appropriateness (proportion required ≥ 0.78). Semantic equivalence was assessed using the forward/back translation process. Measurement equivalence was assessed with a prospective study among Korean children with IBD at a tertiary care center. Participants completed the K-IBD-KID2 twice over a 2-week interval to assess reliability, validity, and generalizability, as measured against the overall scores from English-speaking children with IBD. RESULTS: Results indicated high conceptual equivalence, with all items scoring > 0.78. The prospective study included 50 children with IBD (mean age, 15.3 years, standard deviation, 2.2); 15 (30%) were female, and 40 (80%) with Crohn's disease The mean initial percentage score for the K-IBD-KID2 was 61.7% (standard deviation 16.3), with no association found with any independent variables. The repeat test showed a mean score of 61.3% (standard deviation 16.4), with no significant difference between baseline and repeat ( = 0.790, confidence interval, -0.39 to 0.51) and a high correlation (r = 0.792; < 0.001). The mean scores of Korean children with IBD were not significantly different from those of children in English-speaking cohorts and Italian cohorts ( = 0.9 and 0.8, respectively). Items with < 50% correct answers were observed for items related to IBD cause, osteoporosis, food triggers, and nutrient absorption. CONCLUSION: The Korean version of the IBD-KID2 is a valid and reliable tool for assessing disease-related knowledge among Korean children with IBD. It can facilitate tailored educational interventions to improve disease-related knowledge among children with IBD, potentially improving long-term management and outcomes.
Incidence of Metabolic Dysfunction-Associated Steatotic Liver Disease After Developing Depression: A Population-Based Cohort Study.
Kim E, Sohn W, Kim YT … +7 more , Oh KS, Shin YC, Jeon SW, Shin DW, Kim J, Yon DK, Cho SJ
J Korean Med Sci · 2026 Apr · PMID 41943259 · Full text
BACKGROUND: As a significant public health issue, research on metabolic dysfunction-associated steatotic liver disease (MASLD) has increased; however, studies exploring the relationship between MASLD and depression are s...
BACKGROUND: As a significant public health issue, research on metabolic dysfunction-associated steatotic liver disease (MASLD) has increased; however, studies exploring the relationship between MASLD and depression are scarce. Thus, our objective was to examine the impact of depression on the subsequent risk of developing MASLD in a large cohort of Korean adults and to investigate the stratification of this association by sex and menopausal status. METHODS: We utilized a large-scale, population-based cohort study in South Korea, specifically the Kangbuk Samsung Health Study. Hepatic steatosis was diagnosed using ultrasonography. Depressive symptoms were assessed by the Center for Epidemiologic Studies-Depression (CES-D) score, and participants were categorized into no-depression (CES-D < 8, reference), sub-threshold depression (CES-D: 8-15), and depression (CES-D ≥ 16). Cox proportional hazards models were used to estimate the adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs). Several interaction and stratification analyses were performed based on sex, age, and menopausal status. RESULTS: During the 1,016,691.99 person-years of follow-up, 170,981 Korean adults (men, 71,796 [42.0%]; women, 99,185 [58.0%]) were followed for a median of 5.4 years (maximum, 12.9 years). In total, 41,932 (24.5%) individuals with incident MASLD were identified. Compared with CES-D < 8, the aHRs (95% CIs) for incident MASLD were 1.03 (1.00-1.06; = 0.045) for CES-D: 8-15 and 1.06 (1.01-1.11; = 0.011) for CES-D ≥ 16 in men, and 1.05 (1.01-1.09; = 0.027) for CES-D: 8-15 and 1.18 (1.13-1.24; < 0.001) for CES-D ≥ 16 in women ( for interaction = 0.007). In women aged < 45, the risk of developing MASLD increased linearly with higher CES-D scores, indicating a positive association between depressive symptoms and MASLD incidence. CONCLUSION: Depression was associated with an increased risk of MASLD in both sexes and acted as a potential independent risk factor, particularly in women aged < 45. These findings suggest that screening for MASLD should be considered in younger women with depression.
COVID-19 Vaccination Strategy and Evidence in Korea.
Hwang YH, Park WB
J Korean Med Sci · 2026 Mar · PMID 41873448 · Full text
Coronavirus disease 2019 (COVID-19) has created major global challenges, with vaccination remaining the most effective measure to reduce severe outcomes and mortality. In Korea, six vaccines were approved, and the rapid...
Coronavirus disease 2019 (COVID-19) has created major global challenges, with vaccination remaining the most effective measure to reduce severe outcomes and mortality. In Korea, six vaccines were approved, and the rapid rollout initiated in February 2021 contributed to comparatively low global mortality. As the epidemiological landscape of COVID-19 evolved and evidence on vaccine immunogenicity and safety accumulated, Korea adapted its vaccination strategies. During the 2024-2025 season, two mRNA vaccines (Pfizer-BioNTech and Moderna) and one recombinant protein vaccine (Novavax) targeting JN.1 lineage were administered primarily to high-risk groups. Beginning in October 2025, two mRNA vaccines (Pfizer-BioNTech and Moderna) adapted to LP.8.1 variant have been introduced as the updated 2025-2026 season formulations. Although safety concerns arose initially, Korean studies confirmed that COVID-19 vaccines provided strong effectiveness and acceptable safety, consistent with international findings. To enhance preparedness for future pandemics and epidemics, sustaining surveillance systems and maintaining updated vaccination policies are critical to ensure effective public health responses.
Integrated Clinical and Social Impacts of the COVID-19 Pandemic in Korea: A Combined Systematic and Narrative Review.
Jang Y, Jung J, Peck KR
J Korean Med Sci · 2026 Mar · PMID 41873447 · Full text
Coronavirus disease 2019 (COVID-19) imposed substantial health and social burdens worldwide, disrupting healthcare delivery and challenging public health governance. Korea's early, coordinated response was associated wit...
Coronavirus disease 2019 (COVID-19) imposed substantial health and social burdens worldwide, disrupting healthcare delivery and challenging public health governance. Korea's early, coordinated response was associated with low mortality and maintained essential services, yet the prolonged pandemic exposed structural inequalities, workforce strain, and psychosocial impacts. To comprehensively understand these multidimensional effects, this review synthesizes systematic and narrative evidence on the clinical, epidemiologic, and societal consequences of COVID-19 in Korea. We conducted a combined systematic and narrative review of Korean evidence (2020-2025). The systematic review included studies from PubMed, Embase, KoreaMed, and KMbase, supplemented by manual journal searches. Eligible studies addressed key epidemiologic indicators, including seroprevalence, mortality among patients with comorbidities, severe outcomes in high-risk groups, and vaccination coverage by comorbidity. Quality was assessed using Joanna Briggs Institute tools. We additionally examined government white papers, national reports, policy briefs, and peer-reviewed articles to contextualize epidemiologic findings, synthesizing materials across health burden, healthcare system changes, social consequences, and policy responses. Twenty-four epidemiologic studies and 72 narrative sources were included. Seroprevalence remained below 1% during the early pandemic, increasing sharply after omicron's emergence. Patients with chronic illnesses consistently experienced higher risks of severe outcomes and mortality, while high-risk groups showed elevated odds of intensive care use and complications. Alongside clinical patterns, national data documented substantial reductions in outpatient visits, elective procedures, emergency care, and pediatric services. Burnout and psychological distress intensified among healthcare workers, while prolonged distancing and economic disruption contributed to widening social fatigue. Policy responses and vaccination improved population outcomes, although gaps persisted in communication strategies and addressing disparities across age, socioeconomic status, and comorbidity groups. Korea's experience underscores that preparedness must align clinical efficiency with social equity. Strengthening primary and emergency care, ensuring fair compensation and workforce protection, and maintaining transparent risk communication are essential for building a resilient, inclusive public health system to withstand future pandemics.
Severe COVID-19 in the Republic of Korea: Epidemiology, Risk Factors, Therapeutics, and Prognostic Models From Nationwide Data.
Choi JY
J Korean Med Sci · 2026 Mar · PMID 41873446 · Full text
Severe coronavirus disease 2019 (COVID-19) has posed ongoing clinical and public health challenges worldwide, with Korea providing a unique perspective due to its comprehensive surveillance system and extensive real-worl...
Severe coronavirus disease 2019 (COVID-19) has posed ongoing clinical and public health challenges worldwide, with Korea providing a unique perspective due to its comprehensive surveillance system and extensive real-world data. This review summarizes evidence from nationwide registries, cohort studies, and clinical trials in Korea, alongside global findings, to describe the epidemiology, risk factors, therapeutic interventions, and prognostic models for severe COVID-19. Between January 2020 and August 2023, Korea reported more than 34 million confirmed cases, with 38,112 classified as severe and 35,608 deaths, yielding one of the lowest case fatality rates among member countries comprising the Organisation for Economic Co-operation and Development. Severity was strongly associated with advanced age and comorbidities such as cardiovascular disease, diabetes mellitus, cancer, psychiatric disorders, and immunocompromised states, including solid organ transplantation and hematologic malignancies. Other risk modifiers included obesity, chronic kidney disease, asthma, and prolonged glucocorticoid therapy. Protective factors included vaccination, regular physical activity, and, in some studies, specific pharmacologic agents. The effectiveness of vaccines was consistently demonstrated, with booster doses markedly reducing hospitalization and mortality, including in high-risk groups such as pregnant women, patients with cancer, and transplant recipients. Antiviral therapies, notably nirmatrelvir/ritonavir and molnupiravir, significantly reduced severe outcomes, while immunomodulators such as dexamethasone and tocilizumab improved recovery in patients with severe disease. Advanced interventions, including extracorporeal membrane oxygenation and lung transplantation, were used for refractory respiratory failure, with favorable survival observed in selected patients. Prognostic models integrating clinical, radiological, and machine learning approaches have been developed to predict disease progression, supporting early risk stratification and resource allocation. The rapid generation of evidence on predicting, preventing, and treating severe disease is a critical element of pandemic preparedness. Although COVID-19 has transitioned to an endemic disease, sustaining and advancing the research expertise and infrastructure developed during the pandemic remains essential for responding to future emerging infectious disease outbreaks.
Pediatric COVID-19 in Korea: Lessons and Strategies for Future Disease-X Preparedness.
Choe YJ
J Korean Med Sci · 2026 Mar · PMID 41873445 · Full text
The coronavirus disease 2019 (COVID-19) pandemic has had distinct public health and societal impacts on children worldwidely, prompting calls to prepare for the next pandemic by incorporating children's needs. Republic o...
The coronavirus disease 2019 (COVID-19) pandemic has had distinct public health and societal impacts on children worldwidely, prompting calls to prepare for the next pandemic by incorporating children's needs. Republic of Korea's experience provides insights into pediatric-focused pandemic response. This review analyzes the impact of COVID-19 on children in Korea and evaluates the national response. This review encompasses the Korea Disease Control and Prevention Agency COVID-19 response white paper, National Medical Center response report, Ministry of Education and Seoul Metropolitan Office of Education white papers, focusing on pediatric data and policies. Key findings were supplemented with international studies on pediatric COVID-19 epidemiology, vaccination, and educational impacts. Children in Korea accounted for a substantial number of COVID-19 cases during omicron wave, yet severe outcomes remained rare. Surveillance adaptations included dedicated monitoring of pediatric multisystem inflammatory syndrome through antibody testing. The healthcare system rapidly adjusted to pediatric needs by allowing home isolation for mild cases and by permitting caregiver accompaniment during pediatric hospital isolation. Vaccine rollout for adolescents began in 2021 and for ages 5-11 in 2022, with an initial policy focusing on high-risk children and voluntary uptake for others. In the education sector, Korea implemented remote learning infrastructure, distributing devices and expanding internet access to bridge the digital divide. Korea's pandemic response illustrates the importance of pediatric-specific strategies: surveillance, child-friendly healthcare protocols, risk communication to improve vaccine acceptance, and treating schools and child services as essential infrastructure.
Lessons From the Coronavirus Disease 2019 Pandemic: Implications for Antimicrobial Stewardship for COVID-19 Management.
Kim T
J Korean Med Sci · 2026 Mar · PMID 41873444 · Full text
The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has resulted in millions of deaths worldwide and has now become a major respiratory infectious dis...
The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has resulted in millions of deaths worldwide and has now become a major respiratory infectious disease. Beyond the direct effects of the viral infection, one of the most significant and concerning issues to emerge is the exacerbated threat of antimicrobial resistance (AMR) by the indirect impacts of COVID-19. Early in the pandemic, widespread empirical antibiotic prescribing occurred despite low bacterial co-infection rates. In addition, azithromycin, whose antiviral effect remains unproven, was frequently used. This high, often unnecessary consumption, coupled with disrupted antimicrobial stewardship (AMS) and infection prevention and control (IPC) programs, created conditions favoring the emergence and spread of AMR. In patients with severe COVID-19, multidrug-resistant organisms were frequently implicated in secondary infections, particularly in intensive care units (ICUs). Nevertheless, previous studies analyzing AMR metrics before and during the COVID-19 pandemic have shown inconsistent results. Strategies to mitigate the COVID-19 pandemic, such as enhanced surveillance, social distancing resulting in lower respiratory infections, and strengthened IPC and targeted AMS interventions, could play protective roles to inhibit the development of AMR. Additionally, targeted interventions-such as prospective audit and feedback, biomarker-guided antibiotic discontinuation, diagnostic stewardship using a rapid molecular test to distinguish viral from bacterial infections, embedding AMS decision support into electronic medical records, and tailoring interventions to high-risk settings such as ICUs-demonstrated the feasibility of reducing unnecessary antimicrobial use (AMU) even during crisis conditions. Also, vaccination against SARS-CoV-2 may indirectly reduce AMU and AMR by lowering the incidence of severe disease and secondary bacterial infections. Future COVID-19-specific AMS frameworks must integrate these experiences during the pandemic. This review synthesizes current evidence on the interplay between COVID-19, AMR, and AMU, and outlines stewardship strategies to reduce AMR in COVID-19 management.
Maternal Diabetes Mellitus and Child Neurodevelopmental Disorders: Rethinking Causality in Light of Environmental Pollutants.
Lee DH, Suarez-Lopez JR
J Korean Med Sci · 2026 Mar · PMID 41844145 · Full text
Numerous epidemiological studies have linked maternal diabetes mellitus (DM) to neurodevelopmental disorders in offspring, such as autism spectrum disorder and attention-deficit/hyperactivity disorder. However, recent ev...
Numerous epidemiological studies have linked maternal diabetes mellitus (DM) to neurodevelopmental disorders in offspring, such as autism spectrum disorder and attention-deficit/hyperactivity disorder. However, recent evidence challenges a direct causal relationship: sibling-matched analyses show similar risks regardless of gestational DM status, and glycemic control during pregnancy does not consistently predict neurodevelopmental outcomes. We propose that exposure to environmental pollutants-rather than DM itself-may underlie these associations. Although usually examined separately, many pollutants both increase DM risk and disrupt fetal brain development, providing a biologically plausible basis for the observed epidemiological patterns. Because fetuses encounter these pollutants via placental transfer from maternal blood, understanding what determines maternal circulating pollutant levels is essential. Two major sources contribute: (1) ongoing external exposure through food, air, water, and consumer products, and (2) the release of previously accumulated lipophilic pollutants stored in adipose tissue. Often overlooked, adipose tissue serves as an important reservoir, and lipolysis mobilizes these compounds into circulation. Importantly, key pathophysiological features of DM-insulin resistance and insulin deficiency-accelerate lipolysis, increasing circulating pollutant levels. These pollutant-related mechanisms may also account for associations observed with other maternal conditions, such as obesity, eating disorders, psychological stress, and intrahepatic cholestasis of pregnancy, all of which may also be linked to elevated pollutant levels in maternal circulation. These insights suggest that maternal risk factors should be reconsidered in light of toxicokinetic dynamics, particularly the mobilization of lipophilic pollutants stored in fat. This perspective may offer a unifying explanation for otherwise disparate epidemiological findings and help guide more effective prevention strategies.
Factor Analysis of the Korean Version of the National Stressful Events Survey for PTSD - Short Scale (NSESSS-PTSD).
Kim D, Kim E, Yoon J
J Korean Med Sci · 2026 Mar · PMID 41844144 · Full text
BACKGROUND: Research shows that post-traumatic stress disorder (PTSD) is common in hospital settings and needs to be screened and diagnosed accordingly. The National Stressful Events Survey for PTSD-Short Scale (NSESSS-P...
BACKGROUND: Research shows that post-traumatic stress disorder (PTSD) is common in hospital settings and needs to be screened and diagnosed accordingly. The National Stressful Events Survey for PTSD-Short Scale (NSESSS-PTSD) is a 9-item screening measure for DSM-5 PTSD that has not been evaluated for its factor solution in PTSD population. METHODS: We used psychological data from 180 adults diagnosed with PTSD at a psychiatric outpatient unit of a university-affiliated hospital in South Korea. The data were randomly divided into exploratory and confirmatory factor analyses. RESULTS: Exploratory analysis revealed a two-factor structure of the scale, with a total variance of 52.1%. Factor 1 was labeled 'psychological reaction,' and Factor 2 was labeled 'physiological arousal.' The results of confirmatory factor analysis further supported this two-factor model. CONCLUSION: This study supported the factorial validity of the Korean version of the NSESSS and adds up the psychometric support for its use in the PTSD population.
Preference, Awareness, and Use of Sphygmomanometers in the Mercury-Free Era: A Cross-Sectional Survey of Physicians in Korea.
Kim YM, Kim EY, Shin J … +2 more , Kim KI, Lee EM
J Korean Med Sci · 2026 Mar · PMID 41844143 · Full text
BACKGROUND: In response to global mercury reduction initiated by the Minamata Convention, the use of mercury sphygmomanometers (MSs) as mercury-containing medical devices is being phased out from clinical practice. Howev...
BACKGROUND: In response to global mercury reduction initiated by the Minamata Convention, the use of mercury sphygmomanometers (MSs) as mercury-containing medical devices is being phased out from clinical practice. However, little is currently known about Korean physicians' preferences and their awareness of alternative blood pressure (BP) devices post-ban. METHODS: An online survey using a convenience sample was conducted with 1,728 physicians (98.9% response rate) from the following five specialties: cardiology (9.3%), internal medicine excluding cardiology (27.5%), family medicine (16.1%), general practice (21.6%), and other specialties (34.5%). The survey included 31 items assessing preferences, awareness of alternative BP devices, and compliance with standardized BP measurement protocols (Korean Society of Hypertension Guidelines). BP devices were categorized as either mercury-based (MS) or mercury-free (aneroid, hybrid, and automated devices). RESULTS: Following the mercury ban, preferences for BP devices shifted as follows: MS (28.2%→12.8%), aneroid (13%→17.4%), hybrid (12.6%→14.5%), and automated devices (46.2%→55.3%). Even after the ban, 12.8% of physicians continued to use MS. Only 50.3% had above-average awareness of mercury-free devices. Compliance with BP measurement standards was high for cuff placement (84.8%), pulse rate measurement (81%), and 5 minutes of rest (80.3%) whereas lower compliance was noted for duplicate BP measurements (59.5%), both-arm measurements (59.5%), and positional BP measurements (52.6%). CONCLUSION: Despite regulatory restrictions, a notable proportion of physicians continue to use MS, and awareness of mercury-free BP devices remains suboptimal. Comprehensive education is needed to enhance BP measurement practices and replace mercury-based devices.
Cancer Therapy-Related Cardiac Dysfunction in Breast Cancer Patients Receiving Combination Therapy of Candesartan and Carvedilol for Primary Prevention: A Prospective Longitudinal Study.
Yi JE, Chung WB, Rhu J … +1 more , Park CS
J Korean Med Sci · 2026 Mar · PMID 41844142 · Full text
BACKGROUND: The use of renin-angiotensin system inhibitors and beta-blockers for primary prevention of cancer therapy-related cardiac dysfunction (CTRCD) remains controversial. This study investigated the incidence, seve...
BACKGROUND: The use of renin-angiotensin system inhibitors and beta-blockers for primary prevention of cancer therapy-related cardiac dysfunction (CTRCD) remains controversial. This study investigated the incidence, severity and predictors of CTRCD under cardioprotective therapy with a combination of candesartan and carvedilol. METHODS: We included 851 subjects with a normal left ventricular ejection fraction (LVEF) (> 55%) who were scheduled to receive chemotherapy and/or trastuzumab (TZ) for breast cancer. Candesartan plus carvedilol were administered on the first day of chemotherapy or TZ and continued during and after cancer therapy. Patients underwent serial real-time three-dimensional (3D) echocardiograms before initiation of chemotherapy or TZ, every 3 months during cancer therapy, 6 months after completion of cancer therapy, and annually thereafter. CTRCD was defined by the European Society of Cardiology definitions using LVEF and global longitudinal strain (GLS) derived from 3D-echocardiographic images. RESULTS: A total of 577 patients (257 anthracycline [AC]/non-TZ, 111 AC/TZ, 47 non-AC/TZ, and 162 non-AC/non-TZ) were analyzed. During a median follow-up of 17.9 months, 24.6% of patients (28.8% AC/non-TZ vs. 43.2% AC/TZ vs. 21.3% non-AC/TZ vs. 6.2% non-AC/non-TZ; < 0.001) developed CTRCD. No symptomatic CTRCD was observed throughout the study period and most CTRCD cases had mild severity (96.5%). Older age, hypertension, and lower LVEF and better GLS value at baseline, and stage II disease or higher, but not the use of AC and/or TZ, were associated with the risk of developing CTRCD. For patients receiving AC and/or TZ, hypertension was a predictor of CTRCD in both the low (adjusted hazard ratio [HR], 5.471; 95% confidence interval [CI], 2.440-12.269; < 0.001) and intermediate-to-high (adjusted HR, 2.147; 95% CI, 1.329-3.469; = 0.002) baseline cardiovascular toxicity risk groups. CONCLUSION: In a primary prevention strategy with combined therapy of candesartan and carvedilol, asymptomatic CTRCD was still not uncommon and hypertension was a strong risk factor of CTRCD in breast cancer patients treated with cardiotoxic cancer therapy.
Effect of Metformin in Diabetic Patients After Treatment of Intracranial Aneurysm: A Nationwide Cohort Study.
Baik M, Jeon J, Song TJ … +2 more , Yoo J, Kim J
J Korean Med Sci · 2026 Mar · PMID 41844141 · Full text
BACKGROUND: Intracranial aneurysm (IA) is the most common cause of subarachnoid hemorrhage (SAH), causing high morbidity and mortality. Experimental data have shown that metformin, an antidiabetic agent, has protective e...
BACKGROUND: Intracranial aneurysm (IA) is the most common cause of subarachnoid hemorrhage (SAH), causing high morbidity and mortality. Experimental data have shown that metformin, an antidiabetic agent, has protective effects against IA rupture. This study assessed the effect of metformin on the long-term prognosis of diabetic patients treated for IA. METHODS: This retrospective cohort study included diabetic patients who underwent surgical clipping or endovascular coiling for IA between January 2009 and December 2020, based on Korean health insurance claims data. The primary outcome was the development of SAH. The risk associated with metformin use was evaluated using a multivariable Cox proportional hazards model supplemented with subgroup, propensity score matching, and time-varying Cox regression analyses. RESULTS: Of 14,086 diabetic patients treated for IA, 9,612 (68.2%) were metformin users. During a mean follow-up of 4.6 years, 120 (0.9%) patients experienced SAH. Metformin use was associated with a reduced risk of SAH (adjusted hazards ratio, 0.63; 95% confidence interval, 0.41-0.95; = 0.028). This finding was consistent in subgroup, propensity score matching, and time-varying Cox regression analyses. CONCLUSION: Metformin use in diabetic patients treated with clipping or coiling for IA was associated with reduced risk of SAH. These findings support the use of metformin as the preferred antidiabetic agent for such patients considering these benefits.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe