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Considering the significant burden of post-acute COVID-19 conditions among patients infected with SARS-CoV-2, we aimed to identify the risk of acute respiratory complications or post-acute respiratory sequelae. A binational population-based cohort study was conducted to analyze the risk of acute respiratory complications or post-acute respiratory sequelae after SARS-CoV-2 infection. We used a Korean nationwide claim-based cohort (K-COV-N; n = 2,312,748; main cohort) and a Japanese claim-based cohort (JMDC; n = 3,115,606; replication cohort) after multi-to-one propensity score matching. Among 2,312,748 Korean participants (mean age, 47.2 years [SD, 15.6]; 1,109,708 [48.0%] female), 17.1% (394,598/2,312,748) were infected with SARS-CoV-2. The risk of acute respiratory complications or post-acute respiratory sequelae is significantly increased in people with SARS-CoV-2 infection compared to the general population (acute respiratory complications: HR, 8.06 [95% CI, 6.92-9.38]; post-acute respiratory sequelae: 1.68 [1.62-1.75]), and the risk increased with increasing COVID-19 severity. We identified COVID-19 vaccination as an attenuating factor, showing a protective association against acute or post-acute respiratory conditions. Furthermore, while the excess post-acute risk diminished with time following SARS-CoV-2 infection, it persisted beyond 6 months post-infection. The replication cohort showed a similar pattern in the association. Our study comprehensively evaluates respiratory complications in post-COVID-19 conditions, considering attenuating factors such as vaccination status, post-infection duration, COVID-19 severity, and specific respiratory conditions. Respiratory complications of SARS-CoV-2 infection have been described in the acute (within 30 days) and post-acute (after 30 days) phase. Here, the authors characterise the risk of acute and post-acute respiratory complications of SARS-CoV-2 using population-based data from South Korea and Japan. [ABSTRACT FROM AUTHOR]

Previous studies have proposed alopecia areata (AA) as a potential outcome of COVID‐19 infection among autoimmune diseases, yet the findings might be inconclusive and difficult to generalize due to limited sample sizes and evidence levels. Thus, we aimed to investigate in detail the long‐term risk of AA following SARS‐CoV‐2 infection based on large, binational, general population‐based cohort studies. Our study investigated the long‐term AA risk after SARS‐CoV‐2 infection by analyzing bi‐national, claim‐based cohorts in South Korea and Japan: a Korean nationwide cohort (K‐COV‐N cohort; discovery cohort; total n = 10 027 506) and a Japanese claims‐based cohort (JMDC cohort; validation cohort; total n = 12 218 680). AA was identified based on the international classification of diseases 10th revision code (L63) requiring at least three claims within 1 year. After exposure‐driven propensity score matching, SARS‐CoV‐2 infection was associated with an increased risk of incident AA (aHR, 1.66; 95% CI, 1.38–1.99). This increased risk was observed and persisted for up to 6 months. A similar pattern was observed in the validation cohort. As modifiable factors, severe COVID‐19 increased the risk of AA, whereas receiving two or more doses of the COVID‐19 vaccine before infection decreased the risk of AA. Through a bi‐national cohort study in South Korea and Japan, SARS‐CoV‐2 infection was associated with an elevated risk for incident AA in the aspect of long COVID. [ABSTRACT FROM AUTHOR]

As mounting evidence suggests a higher incidence of adverse consequences, such as disruption of the immune system, among patients with a history of COVID-19, we aimed to investigate post-COVID-19 conditions on a comprehensive set of allergic diseases including asthma, allergic rhinitis, atopic dermatitis, and food allergy. We used nationwide claims-based cohorts in South Korea (K-CoV-N; n = 836,164; main cohort) and Japan (JMDC; n = 2,541,021; replication cohort A) and the UK Biobank cohort (UKB; n = 325,843; replication cohort B) after 1:5 propensity score matching. Among the 836,164 individuals in the main cohort (mean age, 50.25 years [SD, 13.86]; 372,914 [44.6%] women), 147,824 were infected with SARS-CoV-2 during the follow-up period (2020−2021). The risk of developing allergic diseases, beyond the first 30 days of diagnosis of COVID-19, significantly increased (HR, 1.20; 95% CI, 1.13−1.27), notably in asthma (HR, 2.25; 95% CI, 1.80−2.83) and allergic rhinitis (HR, 1.23; 95% CI, 1.15−1.32). This risk gradually decreased over time, but it persisted throughout the follow-up period (≥6 months). In addition, the risk increased with increasing severity of COVID-19. Notably, COVID-19 vaccination of at least two doses had a protective effect against subsequent allergic diseases (HR, 0.81; 95% CI, 0.68−0.96). Similar findings were reported in the replication cohorts A and B. Although the potential for misclassification of pre-existing allergic conditions as incident diseases remains a limitation, ethnic diversity for evidence of incident allergic diseases in post-COVID-19 condition has been validated by utilizing multinational and independent population-based cohorts. SARS-CoV-2 infection has been linked to various persistent or new-onset health consequences, including disruption of the immune system. Here, the authors investigate the risk of new-onset allergic diseases following SARS-CoV-2 infection using data from South Korea, Japan, and the UK. [ABSTRACT FROM AUTHOR]

Preliminary evidence suggests a possible higher incidence of diagnosis of autoimmune inflammatory rheumatic diseases (AIRDs) among patients with a history of COVID-19, but whether this association is specific to SARS-CoV-2 infection is unclear. This study compared the risk for AIRD in patients with a recent SARS-CoV-2 infection versus those with recent influenza infection and those with no infection. Visual Abstract. Long-Term Autoimmune Inflammatory Rheumatic Outcomes of COVID-19: Preliminary evidence suggests a possible higher incidence of diagnosis of autoimmune inflammatory rheumatic diseases (AIRDs) among patients with a history of COVID-19, but whether this association is specific to SARS-CoV-2 infection is unclear. This study compared the risk for AIRD in patients with a recent SARS-CoV-2 infection versus those with recent influenza infection and those with no infection. Background: Some data suggest a higher incidence of diagnosis of autoimmune inflammatory rheumatic diseases (AIRDs) among patients with a history of COVID-19 compared with uninfected patients. However, these studies had methodological shortcomings. Objective: To investigate the effect of COVID-19 on long-term risk for incident AIRD over various follow-up periods. Design: Binational, longitudinal, propensity-matched cohort study. Setting: Nationwide claims-based databases in South Korea (K-COV-N cohort) and Japan (JMDC cohort). Participants: 10 027 506 Korean and 12 218 680 Japanese patients aged 20 years or older, including those with COVID-19 between 1 January 2020 and 31 December 2021, matched to patients with influenza infection and to uninfected control patients. Measurements: The primary outcome was onset of AIRD (per appropriate codes from the International Classification of Diseases, 10th Revision) 1, 6, and 12 months after COVID-19 or influenza infection or the respective matched index date of uninfected control patients. Results: Between 2020 and 2021, among the 10 027 506 Korean participants (mean age, 48.4 years [SD, 13.4]; 50.1% men), 394 274 (3.9%) and 98 596 (0.98%) had a history of COVID-19 or influenza, respectively. After propensity score matching, beyond the first 30 days after infection, patients with COVID-19 were at increased risk for incident AIRD compared with uninfected patients (adjusted hazard ratio, 1.25 [95% CI, 1.18 to 1.31]) and influenza-infected control patients (adjusted hazard ratio, 1.30 [CI, 1.02 to 1.59]). The risk for incident AIRD was higher with more severe acute COVID-19. Similar patterns were observed in the Japanese cohort. Limitations: Referral bias due to the pandemic; residual confounding. Conclusion: SARS-CoV-2 infection was associated with increased risk for incident AIRD compared with matched patients without SARS-CoV-2 infection or with influenza infection. The risk for incident AIRD was higher with greater severity of acute COVID-19. Primary Funding Source: National Research Foundation of Korea. [ABSTRACT FROM AUTHOR]

Background: We aimed to quantify the identification of mild cognitive impairment and/or Alzheimer's disease using olfactory-stimulated functional near-infrared spectroscopy using machine learning through a post hoc analysis of a previous diagnostic trial and an external additional trial. Methods: We conducted two independent, patient-level, single-group, diagnostic interventional trials (original and additional trials) involving elderly volunteers (aged > 60 years) with suspected declining cognitive function. All volunteers were assessed by measuring the oxygenation difference in the orbitofrontal cortex using an open-label olfactory-stimulated functional near-infrared spectroscopy approach, medical interview, amyloid positron emission tomography, brain magnetic resonance imaging, Mini-Mental State Examination, and Seoul Neuropsychological Screening Battery. Results: In total, 97 (original trial) and 36 (additional trial) elderly volunteers with suspected decline in cognitive function met the eligibility criteria. The statistical model reported classification accuracies of 87.3% in patients with mild cognitive impairment and Alzheimer's disease in internal validation (original trial) but 63.9% in external validation (additional trial). The machine learning algorithm achieved 92.5% accuracy with the internal validation data and 82.5% accuracy with the external validation data. For the diagnosis of mild cognitive impairment, machine learning performed better than statistical methods with internal (86.0% versus 85.2%) and external validation data (85.4% versus 68.8%). Interpretation: In two independent trials, machine learning models using olfactory-stimulated oxygenation differences in the orbitofrontal cortex were superior in diagnosing mild cognitive impairment and Alzheimer's disease compared to classic statistical models. Our results suggest that the machine learning algorithm is stable across different patient groups and increases generalization and reproducibility. Trial registration: Clinical Research Information Service (CRiS) of Republic of Korea; CRIS numbers, KCT0006197 and KCT0007589. [ABSTRACT FROM AUTHOR]

School counsellors in South Korea face significant emotional exhaustion due to their challenging occupational environment. Previous studies have shown that cognitive reappraisal (CR) reduces emotional exhaustion, whereas expressive suppression (ES) increases it. However, these findings predominantly rely on trait questionnaires within cross‐sectional approaches, overlooking the dynamic nature of emotion regulation (ER) strategy selection. Individuals may choose strategies that deviate from their general tendencies based on situational demands. There is limited empirical knowledge regarding the interaction between trait and state regulation strategies and their influence on exhaustion. Utilizing the strategy‐situation fit hypothesis, this study examines the context‐specific effects of ER strategies, considering both situational contexts and individual response tendencies. A multilevel analysis was performed to examine the influence of state and trait ER strategies on daily emotional exhaustion. A daily diary study was conducted for 5 days with 111 Korean school counsellors. Daily CR was associated with lower daily exhaustion and daily ES predicted higher daily exhaustion. Contrastingly, none of the trait ER strategies had an impact on daily exhaustion, but the trait level of both strategies significantly moderated the relationship between daily CR and exhaustion. The positive impact of daily CR was more pronounced in school counsellors who often utilized suppression strategies, and this impact was also evident in trait reappraisal. Re‐evaluating daily emotions instead of suppressing them may assist in coping with emotional exhaustion caused by work. The effectiveness of these strategies may vary based on an individual's inclination to regulate emotions as state and trait. ER may aid in implementing preventive interventions for school counsellors experiencing emotional exhaustion. [ABSTRACT FROM AUTHOR]

Introduction: A high consumption of carbonated soft drinks (i.e., soda drinks) and fast food is potentially associated with the observed global rise in adolescent allergic diseases. Thus, our study aimed to examine the potential associations between the consumption of soda drinks and fast food and allergic conditions, identifying specific relationships across subgroups and each allergic condition (asthma, allergic rhinitis, and atopic dermatitis). Methods: This study uses large-scale data from the Korea Youth Risk Behavior Web-Based Survey (total n = 865,614). Soda drinks and fast food were defined by a self-reported questionnaire and allergic conditions by physician-diagnosed within 1 year. Multivariable logistic regression was used to analyze the weighted odds ratios (ORs), along with 95% confidence intervals (CIs), for allergic diseases associated with the intake of soda drinks and fast food. Results: Among 865,614 adolescents in grades 7–12 (male, 51.40%), patients with asthma, allergic rhinitis, and atopic dermatitis were 18,568 (2.15%), 153,536 (17.74%), and 59,014 (6.82%), respectively. Current asthma was associated with soda drinks (OR, 1.07; 95% CI, 1.03–1.12) and fast food consumption (1.25; 1.17–1.33). Interestingly, stronger associations were observed for female high schoolers, compared to male high schoolers and middle schoolers, in relation to the consumption of soda drinks (1.31; 1.19–1.44) and fast food (1.46; 1.26–1.69) with asthma. Current allergic rhinitis and atopic dermatitis had no significant association with fast food consumption and soda drinks. Conclusion: This first large-scale study suggests that fast food and soda drinks consumption are potentially associated with current asthma, with stronger associations observed in females than males, underscoring the need for sex-specific allergy prevention programs. [ABSTRACT FROM AUTHOR]