Publications by authors named "Euijin Chang"

6 Publications

  • Page 1 of 1

Genetic regulation of nonsense-mediated decay underlies association with risk of severe COVID-19.

medRxiv 2021 Jul 13. Epub 2021 Jul 13.

Genomic regions have been associated with COVID-19 susceptibility and outcomes, including the chr12q24.13 locus encoding antiviral proteins OAS1-3. Here, we report genetic, functional, and clinical insights into genetic associations within this locus. In Europeans, the risk of hospitalized vs. non-hospitalized COVID-19 was associated with a single 19Kb-haplotype comprised of 76 variants included in a 95% credible set within a large genomic fragment introgressed from Neandertals. The risk haplotype was also associated with impaired spontaneous but not treatment-induced SARS-CoV-2 clearance in a clinical trial with pegIFN-λ1. We demonstrate that two exonic variants, rs10774671 and rs1131454, affect splicing and nonsense-mediated decay of . We suggest that genetically-regulated loss of expression contributes to impaired spontaneous clearance of SARS-CoV-2 and elevated risk of hospitalization for COVID-19. Our results provide the rationale for further clinical studies using interferons to compensate for impaired spontaneous SARS-CoV-2 clearance, particularly in carriers of the risk haplotypes.
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http://dx.doi.org/10.1101/2021.07.09.21260221DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8288155PMC
July 2021

Clinical Application of the Standard Q COVID-19 Ag Test for the Detection of SARS-CoV-2 Infection.

J Korean Med Sci 2021 Apr 12;36(14):e101. Epub 2021 Apr 12.

Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.

We evaluated the Standard Q COVID-19 Ag test for the diagnosis of coronavirus disease 2019 (COVID-19) compared to the reverse transcription-polymerase chain reaction (RT-PCR) test. We applied both tests to patients who were about to be hospitalized, had visited an emergency room, or had been admitted due to COVID-19 confirmed by RT-PCR. Two nasopharyngeal swabs were obtained; one was tested by RT-PCR and the other by the Standard Q COVID-19 Ag test. A total of 118 pairs of tests from 98 patients were performed between January 5 and 11, 2021. The overall sensitivity and specificity for detecting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) for the Standard Q COVID-19 Ag test compared to RT-PCR were 17.5% (95% confidence interval [CI], 8.8-32.0%) and 100% (95% CI, 95.3-100.0%). Analysis of the results using RT-PCR cycle thresholds of ≤ 30 or ≤ 25 increased the sensitivity to 26.9% (95% CI, 13.7-46.1%), and 41.1% (95% CI, 21.6-64.0%), respectively.
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http://dx.doi.org/10.3346/jkms.2021.36.e101DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8042480PMC
April 2021

The Importance of Proper History Taking: Asking a Fever Pattern in Patients with Vivax Malaria.

J Korean Med Sci 2020 Nov 9;35(43):e386. Epub 2020 Nov 9.

Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.

Characteristic fever patterns of malarial infection are clues for diagnosis. However, checking fever patterns in febrile patients has been usually missed, and unnecessary tests have been performed. We reviewed electrical medical record to check whether history-taking included questions on fever pattern in febrile patients. Main outcomes were time interval between visit and diagnosis of vivax malaria and proportion of patients who had taken unnecessary tests. Among 134 vivax malarial patients, asking about fever pattern was done in 64 (47.8%). Median time interval between visit and diagnosis was significantly shorter in patients whose fever pattern was asked than those not asked (3.2 hours vs. 18.6 hours; < 0.001). Unnecessary diagnostic tests were conducted in 27% (17/64) of patients asked about fever pattern and 71% (50/70) in patients not asked ( < 0.001). Proper history-taking can reduce time elapsed for diagnosis and performing unnecessary diagnostic tests in vivax malaria.
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http://dx.doi.org/10.3346/jkms.2020.35.e386DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7653167PMC
November 2020

A Universal Screening Strategy for SARS-CoV-2 Infection in Intensive Care Units: Korean Experience in a Single Hospital.

Infect Chemother 2020 Sep 19;52(3):352-359. Epub 2020 Aug 19.

Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.

Background: Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection is not differentiated clinically from other respiratory infections, and intensive care units (ICUs) are vulnerable to in-hospital transmission due to interventions inducing respiratory aerosols. This study evaluated the effectiveness of universal SARS-CoV-2 screening in ICUs in terms of screened-out cases and reduction in anxiety of healthcare personnel (HCP).

Materials And Methods: This prospective single-armed observational study was conducted in 2 ICUs of a single hospital. The number of patients diagnosed with SARS-CoV-2 infection by the screening program and healthcare workers in ICUs that visited the SARS-CoV-2 screening clinic or infection clinic were investigated.

Results: During the 7-week study period, no positive screening case was reported among a total of 142 patients. Among 86 HCP in the ICUs, only 2 HCP sought medical consultation for SARS-CoV-2 infection during the initial 2 weeks.

Conclusion: A universal screening program for SARS-CoV-2 infection in ICUs with the coordination of other countermeasures in the hospital was reasonably effective in preventing in-hospital transmission in a pandemic situation and making clinical practices and HCP stable.
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http://dx.doi.org/10.3947/ic.2020.52.3.352DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7533210PMC
September 2020

Limited Positive Predictive Value of β-d-Glucan in Hematologic Patients Receiving Antimold Prophylaxis.

Open Forum Infect Dis 2020 Mar 12;7(3):ofaa048. Epub 2020 Feb 12.

Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.

Background: Diagnostic value of β-d-glucan (BDG) in populations with low prevalence of invasive fungal infection (IFI), such as hematologic patients receiving antimold prophylaxis, should be re-evaluated.

Methods: We retrospectively reviewed episodes with BDG results in hematologic patients receiving antimold prophylaxis from January 2017 to August 2019 in a tertiary hospital. The episodes were classified as true positive ([TP] positive BDG with IFI), true negative ([TN] negative BDG without IFI), false positive ([FP] positive BDG without IFI), false negative ([FN] negative BDG with IFI), and nonevaluable.

Results: A total of 203 episodes were analyzed: 101 episodes (49.8%) were from stem cell transplants, 89 (43.8%) were from induction chemotherapy, and 13 (6.4%) were from graft-versus-host disease treatment. There were 62 nonevaluable episodes. Among 141 evaluable ones, there were 8 (5.7%) episodes of probable/proven IFI. True positive, TN, FP, and FN cases were 4 (2.8%), 112 (79.4%), 21 (14.9%), and 4 (2.8%) episodes, respectively. Sensitivity, specificity, positive predictive value, and negative predictive value were 50.0%, 84.2%, 16.1%, and 96.5%, respectively. Positive predictive value was 26.7% and 0.0% in diagnostic and surveillance episodes, respectively.

Conclusions: β-d-glucan test should be used to exclude IFI rather than for diagnosis in these patients.
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http://dx.doi.org/10.1093/ofid/ofaa048DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7051035PMC
March 2020

Application of the severe fever with thrombocytopenia syndrome prediction score: Differentiation of febrile diseases using basic laboratory parameters.

PLoS One 2020 5;15(3):e0229920. Epub 2020 Mar 5.

Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.

Background: The prolonged manifestation of concurrent leukopenia, thrombocytopenia and normal C-reactive protein (CRP) (named as SFTS prediction score) in febrile diseases is not usual and may be used to make an initial differential diagnosis, which is a characteristic finding of severe fever with thrombocytopenia syndrome (SFTS).

Methods: The dynamics of SFTS prediction scores was investigated in SFTS patients. The study subjects for the comparison were febrile patients aged ≥ 16 years with SFTS scores of 2 (S2) or 3 (S3) who visited an emergency room for a 4-year study period. The dynamic distribution of S2 and S3 at presentation with regards to onset of illness, the characteristics of responsible diseases and the predictability of SFTS in both groups were described.

Results: In 104 patients with SFTS, the daily proportion of S2 or S3 ranged from 58.3 to 100% from day (D) 1 to D12 after the onset of illness. The S2 subtype of 'leukopenia plus thrombocytopenia' and S3 represented 72.7-100% of all scores. In contrast, for the 130 patients in the febrile cohort, 73.8% of evaluations were distributed between D1 and D4 after the onset of illness, and 68.8% of patients had the S2 subtype of 'leukopenia plus normal CRP'. Upper respiratory infection was the most frequent (50.0%) cause of diseases. Pneumonia (13.8%) and urosepsis (6.2%) initially presented with either S2 with normal CRP or S3 but had poor prognosis. The presence of S2 or S3 predicted SFTS with sensitivity and specificity of 0.85 (0.42-0.99; 95% CI) and 0.98 (0.98-0.98; 95% CI), respectively.

Conclusion: The temporal distribution and composition of S2 or S3 were unique in several febrile diseases including SFTS, and the SFTS prediction score may be useful for differentiating febrile diseases in primary care settings of SFTS endemic areas.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0229920PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7059982PMC
June 2020
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