Journal of Korean Medical Science最新文献

{"title":"Association of Age, Sex and Education With Access to the Intravenous Thrombolysis for Acute Ischemic Stroke.","authors":"Yoona Ko, Beom Joon Kim, Youngran Kim, Jong-Moo Park, Kyusik Kang, Jae Guk Kim, Jae-Kwan Cha, Tai Hwan Park, Kyungbok Lee, Jun Lee, Keun-Sik Hong, Byung-Chul Lee, Kyung-Ho Yu, Dong-Eog Kim, Joon-Tae Kim, Jay Chol Choi, Jee Hyun Kwon, Wook-Joo Kim, Kyu Sun Yum, Sung-Il Sohn, Hyungjong Park, Sang-Hwa Lee, Kwang-Yeol Park, Chi Kyung Kim, Sung Hyuk Heo, Moon-Ku Han, Anjail Z Sharrief, Sunil A Sheth, Hee-Joon Bae","doi":"10.3346/jkms.2025.40.e49","DOIUrl":"10.3346/jkms.2025.40.e49","url":null,"abstract":"<p><strong>Background: </strong>Barriers to treatment with intravenous thrombolysis (IVT) for patients with acute ischemic stroke (AIS) in South Korea remain incompletely characterized. We analyze a nationwide prospective cohort to determine patient-level features associated with delayed presentation and non-treatment of potential IVT-eligible patients.</p><p><strong>Methods: </strong>We identified consecutive patients with AIS from 01/2011 to 08/2023 from a multicenter and prospective acute stroke registry in Korea. Patients were defined as IVT candidates if they presented within 4.5 hours from the last known well, had no lab evidence of coagulopathy, and had National Institute of Health Stroke Scale (NIHSS) ≥ 4. Multivariable generalized linear mixed regression models were used to investigate the associations between their characteristics and the IVT candidates or the use of IVT among the candidates.</p><p><strong>Results: </strong>Among 84,103 AIS patients, 41.0% were female, with a mean age of 69 ± 13 years and presentation NIHSS of 4 [interquartile range, 1-8]. Out of these patients, 13,757 (16.4%) were eligible for IVT, of whom 8,179 (59.5%) received IVT. Female sex (adjusted risk ratio [RR], 0.90; 95% confidence interval [CI], 0.86-0.94) and lower years of education (adjusted RR, 0.90; 95% CI, 0.84-0.97 for 0-3 years, compared to ≥ 13 years) were associated with a decreased likelihood of presenting as eligible for IVT after AIS; meanwhile, young age (adjusted RR, 1.12; 95% CI, 1.01-1.24 for ≤ 44 years, compared to 75-84 years) was associated with an increased likelihood of being an IVT candidate. Among those who were eligible for IVT, only age was significantly associated with the use of IVT (adjusted RR, 1.09; 95% CI, 1.03-1.16 for age 65-74 and adjusted RR, 0.83; 95% CI, 0.76-0.90 for ≥ 85 years, respectively).</p><p><strong>Conclusion: </strong>Most patients with AIS present outside IVT eligibility in South Korea, and only 60% of eligible patients were ultimately treated. We identified increased age, female sex and lower education as key features on which to focus interventions for improving IVT utilization.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 13","pages":"e49"},"PeriodicalIF":3.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tuberculous and Malignant Pleural Effusions With Adenosine Deaminase Levels of 40-70 IU/L: Trends in New Cases Over Time and Differentiation Between Groups.","authors":"Jaehee Lee, Jongmin Park, Jae Kwang Lim, Ji Eun Park, Yong Hoon Lee, Sun Ha Choi, Hyewon Seo, Seung Soo Yoo, Shin Yup Lee, Seung-Ick Cha, Jae Yong Park, Chang Ho Kim","doi":"10.3346/jkms.2025.40.e35","DOIUrl":"10.3346/jkms.2025.40.e35","url":null,"abstract":"<p><strong>Background: </strong>The diagnosis of tuberculous pleural effusion (TPE) often relies on pleural fluid adenosine deaminase (ADA) levels. The diagnostic utility of ADA, however, is influenced by the prevalence of tuberculosis (TB) in local populations. Malignant pleural effusion (MPE) cases can exhibit moderately elevated ADA levels comparable to those seen in TPE. As population aging potentially impacts ADA levels, global TB incidence is decreasing whereas the burden of malignancy is on the rise. Consequently, epidemiological shifts and temporal changes in ADA distribution complicate the differential diagnosis between TPE and MPE when ADA levels are within the 40-70 IU/L range. Nonetheless, data specific to this subset are scarce.</p><p><strong>Methods: </strong>This retrospective study included consecutive patients aged > 18 years with confirmed TPE and MPE, spanning from 2012 to 2023. ADA levels in pleural fluid were categorized into three groups: < 40 IU/L, 40-70 IU/L, and > 70 IU/L. The study examined annual trends in the frequency of new cases and ADA level distributions over time and identified discriminating factors between TPE and MPE in cases with ADA levels of 40-70 IU/L.</p><p><strong>Results: </strong>In total, 297 TPE and 369 MPE cases were included in this study. Over the study period, the frequency of TPE progressively declined, while that of MPE increased. In the most recent four-year period, new TPE and MPE cases with ADA levels of 40-70 IU/L occurred at comparable numbers. Multivariable analysis identified pleural fluid carcinoembryonic antigen (CEA) levels and the number of focal pleural nodules as independent predictors for MPE. Specifically, the presence of either CEA levels > 15.7 ng/mL or more than eight pleural nodules yielded the highest diagnostic accuracy with a sensitivity of 88%, specificity of 100%, and an area under the curve of 0.95.</p><p><strong>Conclusion: </strong>The differential diagnosis between TPE and MPE with pleural ADA levels of 40-70 IU/L has become increasingly critical due to evolving epidemiological patterns and ADA distribution changes over time. Pleural fluid CEA levels and the characteristics of pleural nodules may offer valuable guidance in distinguishing between TPE and MPE within this diagnostic gray zone.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 13","pages":"e35"},"PeriodicalIF":3.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Variability in the Length of Stay and Daily Medical Expenses in Inpatient Care in Korea, 2010-2019: Hypertension and Pneumonia.","authors":"Haejong Lee, Jin-Won Noh, Sanghee Lee, Jung-Kyu Choi, Jin Yong Lee, Hyejin Lee, Jung-Hoe Kim","doi":"10.3346/jkms.2025.40.e120","DOIUrl":"10.3346/jkms.2025.40.e120","url":null,"abstract":"<p><p>This study examined the variability in the length of stay (LOS) and daily medical expenses (DME) for hypertension and pneumonia inpatient care. Using 10 years of National Health Insurance Service data (2010-2019), a multilevel analysis assessed variability at the patient and institutional levels. During the study period, the mean LOS decreased, whereas the DME increased for both hypertension and pneumonia. Institutional level variability in the LOS increased during the study period, demonstrating greater variability than that for pneumonia. For both conditions, institutional-level variability was more marked in smaller institutions (hospitals and clinics) than in larger institutions (general and tertiary hospitals). These findings indicate a need for standardized healthcare service protocols to promote consistent and efficient patient care.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 13","pages":"e120"},"PeriodicalIF":3.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Woman Doctor Leadership on the Editorial Board of the Korean Medical Journals.","authors":"Eunji Ko, Hyebin Jeon, Yun Hee Kim, Choon Hak Lim","doi":"10.3346/jkms.2025.40.e47","DOIUrl":"10.3346/jkms.2025.40.e47","url":null,"abstract":"<p><strong>Background: </strong>The proportion of women doctors has been rising globally and South Korea mirrors this trend. Despite this growth, women doctors' representation in leadership roles in academic medical fields remains scarce. This study investigates the representation and trends of women doctors' leadership in editorial boards of South Korean medical journals, and compares the gender ratio of specialists.</p><p><strong>Methods: </strong>This non-clinical data analysis examined the editorial boards of 45 major medical academic journals published in 2015, 2020, and 2024 to investigate women leadership within journal editorial boards, compares the gender ratio of specialists, and observed changes over time.</p><p><strong>Results: </strong>The study included data from 1,475 members in 2015, 1,598 in 2020, and 2,531 in 2024. In 2020, 23.8% of specialists were women, but only 19.5% of editorial board members were women (<i>P</i> < 0.001). Nine journals had less than 10% women representation on their editorial boards. Over nine years, women representation on editorial boards increased from 16.8% in 2015 to 21.3% in 2024 (<i>P</i> = 0.001), with significant increases in societies of clinical medicine (14.6% vs. 20.0%; <i>P</i> < 0.001) but not in basic medicine. Journals with women editors-in-chief had significantly higher women representation on their boards compared to ones with male editors-in-chief (36.7 ± 13.5% vs. 18.4 ± 10.9%, <i>P</i> < 0.001). The proportion of women senior editorial roles and that of women executive society members showed a significant positive correlation with the proportion of women on editorial boards (<i>P</i> < 0.001 and <i>P</i> < 0.001, respectively).</p><p><strong>Conclusion: </strong>The study highlights the considerable underrepresentation of women in editorial leadership compared to their presence as specialists. However, the number of women editorial board members has increased over the past decade, especially in clinical medicine. Women doctors' leadership positively correlates with higher women participation on boards, which suggests that promoting women leaders could enhance gender diversity in academic medicine. Further qualitative research is needed to explore the impact of women doctors' leadership on medical research and patient outcomes. This study provides critical insights into gender disparities in South Korean medical academia and underscores the need for policies to promote women doctors' leadership.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 13","pages":"e47"},"PeriodicalIF":3.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In This Issue on 07-April-2025.","authors":"Jin-Hong Yoo","doi":"10.3346/jkms.2025.40.e134","DOIUrl":"https://doi.org/10.3346/jkms.2025.40.e134","url":null,"abstract":"","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 13","pages":"e134"},"PeriodicalIF":3.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the Quality and Reliability of YouTube as a Source of Information on Extracorporeal Membrane Oxygenation: A Call to Publish More Quality Videos by Professionals.","authors":"Bekzhan A Permenov, Olena Zimba, Marlen Yessirkepov, Ainur B Qumar, Darkhan Suigenbayev, Burhan Fatih Kocyigit","doi":"10.3346/jkms.2025.40.e34","DOIUrl":"10.3346/jkms.2025.40.e34","url":null,"abstract":"<p><strong>Background: </strong>Extracorporeal membrane oxygenation (ECMO) is a medical intervention employed to provide life-sustaining support for patients. YouTube is a dynamic and widely utilized platform for distributing health-related information. The aim of this study was to evaluate ECMO-related videos on YouTube and assess the frequency of misleading information in the accumulation of ECMO videos.</p><p><strong>Methods: </strong>On September 17, 2024, an in-depth examination on YouTube was conducted using search phrases \"Extracorporeal Membrane Oxygenation\" and \"ECMO treatment.\" The study included 55 selected videos. Video parameters and sources were analyzed. Content assessments were conducted utilizing the Global Quality Scale (GQS), the modified DISCERN instrument, the <i>Journal of the American Medical Association</i> (JAMA) Benchmark Criteria, and the Patient Education Materials Assessment Tool for Audio/Visual Materials (PEMAT-A/V). The authors conducted comparisons among quality groups.</p><p><strong>Results: </strong>Among the 55 videos analyzed, 30.9% (n = 17) were categorized as low quality, 21.8% (n = 12) as intermediate quality, and 47.3% (n = 26) as high quality. Physicians (75%) provided the most high-quality videos. News outlets (83.3%) provided the most low-quality videos. No statistically significant difference was observed between quality groups in daily views, likes, and comments (<i>P</i> > 0.05). Significant correlations were identified between video duration and GQS (<i>r</i> = 0.585), modified DISCERN questionnaire (<i>r</i> = 0.557), JAMA Benchmark Criteria (<i>r</i> = 0.511), PEMAT-A/V Understandability (<i>r</i> = 0.530), and PEMAT-A/V Actionability scores (<i>r</i> = 0.433) (<i>P</i> < 0.001 for all correlation analyses).</p><p><strong>Conclusion: </strong>There is a wide variety in the quality of YouTube ECMO videos. Although YouTube content created by physicians is more likely to provide accurate and beneficial information, substandard videos present a significant public health threat by disseminating misinformation. The critical role of quality control methods on social media platforms in ensuring the accurate and high-quality transmission of health-related information is readily evident.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 13","pages":"e34"},"PeriodicalIF":3.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychotropic Drug Use in Korean Patients With Osteoarthritis.","authors":"Seong-Hun Kang, Hyun Ah Kim, Insun Choi, Chan Mi Park, Hoyol Jhang, Jinhyun Kim, Dong Jin Go, Suhyun Jang","doi":"10.3346/jkms.2025.40.e53","DOIUrl":"10.3346/jkms.2025.40.e53","url":null,"abstract":"<p><strong>Background: </strong>There are few safe effective ways to relieve osteoarthritis (OA) pain; as a result, off-label psychotropic drug prescriptions have increased worldwide. This study examined the change in psychotropic drug prescriptions for patients with OA from 2011 to 2020 using the Korean National Health Insurance Service dataset.</p><p><strong>Methods: </strong>The study population consisted of patients with hip or knee OA aged ≥ 65 years. Psychotropic drugs included opioids, benzodiazepines, non-benzodiazepine hypnotics (Z-drugs), anti-epileptics, tricyclic antidepressants, selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), typical antipsychotics, atypical antipsychotics, and anxiolytics. The prevalence and long-term (> 3 months) prescription rates of psychotropic drugs in OA patients were calculated.</p><p><strong>Results: </strong>The study included 1,821,158 patients with OA (mean age 71.7 years; 65.32% female). Of the cohort, 49% had comorbidities for which psychotropics were indicated. The prevalence of psychotropic prescriptions decreased from 58.2% to 52.0% in 2018 and then leveled off. The long-term prescription rate remained constant until 2018 and then increased slightly. The most commonly prescribed psychotropics were opioids and long- and short-acting benzodiazepines. The prescription rates of opioids and long-acting benzodiazepines decreased from 2011 to 2020. For those with psychiatric co-morbidities, the prescription rates of anti-epileptics and SNRIs increased, while the prescription rates of anti-epileptics, SSRIs, other antidepressants, and atypical psychotropics increased for those without such co-morbidities. The most commonly prescribed psychotropics were diazepam and alprazolam, excluding tramadol and tramadol-acetaminophen combination. For those with psychiatric co-morbidities, the prescription rates of gabapentin and fentanyl increased, while for those without such co-morbidities, the prescription rates of lorazepam, fentanyl, escitalopram and quetiapine increased.</p><p><strong>Conclusion: </strong>A significant number of older Korean patients with OA were prescribed psychotropic drugs in the absence of comorbidities requiring such drugs, including drugs that have little effect on OA and unfavorable safety profiles in older adults.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 12","pages":"e53"},"PeriodicalIF":3.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11964901/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-Linear Association Between Physical Activities and Type 2 Diabetes in 2.4 Million Korean Population, 2009-2022: A Nationwide Representative Study.","authors":"Wonwoo Jang, Seokjun Kim, Yejun Son, Soeun Kim, Hayeon Lee, Jaeyu Park, Kyeongmin Lee, Jiseung Kang, Damiano Pizzol, Jiyoung Hwang, Sang Youl Rhee, Dong Keon Yon","doi":"10.3346/jkms.2025.40.e42","DOIUrl":"10.3346/jkms.2025.40.e42","url":null,"abstract":"<p><strong>Background: </strong>Although excessive physical activity (PA) does not always confer additional health benefits, there is a paucity of studies that have quantitatively examined the dose-response relationship between PA and type 2 diabetes. Therefore, this study investigated the relationship between the type 2 diabetes prevalence and intensity, frequency, and metabolic equivalent of task (MET) score of PA in a large population sample.</p><p><strong>Methods: </strong>We conducted a nationwide cross-sectional analysis examining sociodemographic variables, PA habits, and type 2 diabetes prevalence in 2,428,448 participants included in the Korea Community Health Survey. The non-linear association between MET score and odds ratios (ORs) for type 2 diabetes prevalence was plotted using a weighted generalized additive model. Categorical analysis was used to examine the joint association of moderate-intensity PA (MPA) and vigorous-intensity PA (VPA), and the influence of PA frequency.</p><p><strong>Results: </strong>MET score and diabetes prevalence revealed a non-linear association with the nadir at 1,028 MET-min/week, beyond which ORs increased with additional PA. Joint analysis of MPA and VPA showed the lowest OR of 0.79 (95% confidence interval, 0.75-0.84) for those engaging in 300-600 MET-min/week of MPA and > 600 MET-min/week of VPA concurrently, corresponding with World Health Organization recommendations. Additionally, both \"weekend warriors\" and \"regularly active\" individuals showed lower ORs compared to the inactive, although no significant difference was noted between the active groups.</p><p><strong>Conclusion: </strong>In a large South Korean sample, higher PA is not always associated with a lower prevalence of type 2 diabetes, as the association follows a non-linear pattern; differences existed across sociodemographic variables. Considering the joint association, an adequate combination of MPA and VPA is recommended. The frequency of PA does not significantly influence the type 2 diabetes prevalence.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 12","pages":"e42"},"PeriodicalIF":3.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11964904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AI-ECG Supported Decision-Making for Coronary Angiography in Acute Chest Pain: The QCG-AID Study.","authors":"Jiesuck Park, Joonghee Kim, Soyeon Ahn, Youngjin Cho, Yeonyee E Yoon","doi":"10.3346/jkms.2025.40.e105","DOIUrl":"10.3346/jkms.2025.40.e105","url":null,"abstract":"<p><p>This pilot study evaluates an artificial intelligence (AI)-assisted electrocardiography (ECG) analysis system, QCG, to enhance urgent coronary angiography (CAG) decision-making for acute chest pain in the emergency department (ED). We retrospectively analyzed 300 ED cases, categorized as non-coronary chest pain (Group 1), acute coronary syndrome (ACS) without occlusive coronary artery disease (CAD) (Group 2), and ACS with occlusive CAD (Group 3). Six clinicians made urgent CAG decision using a conventional approach (clinical data and ECG) and a QCG-assisted approach (including QCG scores). The QCG-assisted approach improved correct CAG decisions in Group 2 (36.0% vs. 45.3%, <i>P</i> = 0.003) and Group 3 (85.3% vs. 90.0%, <i>P</i> = 0.017), with minimal impact in Group 1 (92.7% vs. 95.0%, <i>P</i> = 0.125). Diagnostic accuracy for ACS improved from 77% to 81% with QCG assistance and reached 82% with QCG alone, supporting AI's potential to enhance urgent CAG decision-making for ED chest pain cases.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 12","pages":"e105"},"PeriodicalIF":3.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11964906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rapid Recovery From SARS-CoV-2 Infection Among Immunocompromised Children Despite Limited Neutralizing Antibody Response: A Virologic and Sero-Immunologic Analysis of a Single-Center Cohort.","authors":"Doo Ri Kim, Byoung Kwon Park, Jin Yang Baek, Areum Shin, Ji Won Lee, Hee Young Ju, Hee Won Cho, Keon Hee Yoo, Ki Woong Sung, Chae-Hong Jeong, Tae Yeul Kim, June-Young Koh, Jae-Hoon Ko, Yae-Jean Kim","doi":"10.3346/jkms.2025.40.e52","DOIUrl":"10.3346/jkms.2025.40.e52","url":null,"abstract":"<p><strong>Background: </strong>Immunocompromised (IC) pediatric patients are at increased risk of severe acute respiratory syndrome coronavirus 2 infection, but the viral kinetics and sero-immunologic response in pediatric IC patients are not fully understood.</p><p><strong>Methods: </strong>From April to June 2022, a prospective cohort study was conducted. IC pediatric patients hospitalized for coronavirus disease 2019 (COVID-19) were enrolled. Serial saliva swab and serum specimens were subjected to reverse transcription polymerase chain reaction assays with mutation sequencing, viral culture, anti-spike-protein, anti-nucleocapsid antibody assays, plaque reduction neutralization test (PRNT) and multiplex cytokine assays.</p><p><strong>Results: </strong>Eleven IC children were evaluated. Their COVID-19 symptoms resolved promptly (median, 2.5 days; interquartile range, 2.0-4.3). Saliva swab specimens contained lower viral loads than nasopharyngeal swabs (<i>P</i> = 0.008). All cases were BA.2 infection, and 45.5% tested negative within 14 days by saliva swab from symptom onset. Eight (72.7%) showed a time-dependent increase in BA.2 PRNT titers, followed by rapid waning. Multiplex cytokine assays revealed that monocyte/macrophage activation and Th₁ responses were comparable to those of non-IC adults. Activation of interleukin (IL)-1Ra and IL-6 was brief, and IL-17A was suppressed. Activated interferon (IFN)-γ and IL-18/IL-1F4 signals were observed.</p><p><strong>Conclusion: </strong>IC pediatric patients rapidly recovered from COVID-19 with low viral loads. Antibody response was limited, but cytokine analysis suggested an enhanced IFN-γ- and IL-18-mediated immune response without excessive activation of inflammatory cascades. To validate our observation, immune cell-based functional studies need to be conducted among IC and non-IC children.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 12","pages":"e52"},"PeriodicalIF":3.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11964902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}