Publications by authors named "Hyeontaek Hwang"

3 Publications

  • Page 1 of 1

A systematic review and meta-analysis of regional risk factors for critical outcomes of COVID-19 during early phase of the pandemic.

Sci Rep 2021 05 7;11(1):9784. Epub 2021 May 7.

Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea.

The mortality rates of COVID-19 vary across the globe. While some risk factors for poor prognosis of the disease are known, regional differences are suspected. We reviewed the risk factors for critical outcomes of COVID-19 according to the location of the infected patients, from various literature databases from January 1 through June 8, 2020. Candidate variables to predict the outcome included patient demographics, underlying medical conditions, symptoms, and laboratory findings. The risk factors in the overall population included sex, age, and all inspected underlying medical conditions. Symptoms of dyspnea, anorexia, dizziness, fatigue, and certain laboratory findings were also indicators of the critical outcome. Underlying respiratory disease was associated higher risk of the critical outcome in studies from Asia and Europe, but not North America. Underlying hepatic disease was associated with a higher risk of the critical outcome from Europe, but not from Asia and North America. Symptoms of vomiting, anorexia, dizziness, and fatigue were significantly associated with the critical outcome in studies from Asia, but not from Europe and North America. Hemoglobin and platelet count affected patients differently in Asia compared to those in Europe and North America. Such regional discrepancies should be considered when treating patients with COVID-19.
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http://dx.doi.org/10.1038/s41598-021-89182-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8105319PMC
May 2021

Outcomes of multidrug-resistant tuberculosis treated with bedaquiline or delamanid.

Clin Infect Dis 2021 Apr 10. Epub 2021 Apr 10.

Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea.

Background: Since September 1, 2016, bedaquiline and delamanid have been administered for treatment of patients with multidrug-resistant/rifampicin-resistant tuberculosis after the official approval in South Korea. This study aimed to assess and compare the final treatment outcomes of patients who received bedaquiline with those of patients who received delamanid.

Methods: This is a nationwide cohort study of patients with multidrug-resistant/rifampicin-resistant tuberculosis in whom bedaquiline or delamanid was administered from September 1, 2016, to February 28, 2018, after receiving the official approval in South Korea. Patients were classified into the bedaquiline and delamanid group according to the first used drug. We evaluated and compared the final treatment outcomes between the groups.

Results: During the study period, 284 patients with multidrug-resistant/rifampicin-resistant tuberculosis were approved to use bedaquiline or delamanid and 260 were included in the final analysis; 119 (45.8%) and 141 patients (54.2%) were classified into bedaquiline and delamanid groups, respectively. Among them, 30 patients (11.5%) exhibited additional resistance to second-line injectable drugs, 94 patients (36.2%) had additional resistance to fluoroquinolones, and 37 patients (14.2%) had resistance to both drugs. The overall treatment success rate was 79.2%. Initiation of bedaquiline rather than delamanid was not associated with treatment success (adjusted odds ratio = 0.671, 95% confidence interval = 0.350-1.285). Frequencies of adverse events were not significantly different between the two groups.

Conclusions: Initial choice of bedaquiline or delamanid did not make any significant difference in the final treatment outcome or the frequencies of adverse events among patients with multidrug-resistant/rifampicin-resistant tuberculosis.
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http://dx.doi.org/10.1093/cid/ciab304DOI Listing
April 2021

Validation of age, PaO/FlO and plateau pressure score in Korean patients with acute respiratory distress syndrome: a retrospective cohort study.

Respir Res 2020 Apr 22;21(1):94. Epub 2020 Apr 22.

Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, College of Medicine, Daehak-ro 101, Jongro-gu, Seoul, 03080, Republic of Korea.

Background: A predictive scoring system for acute respiratory distress syndrome (ARDS) patients, which incorporates age, PaO/FlO, and plateau pressure, APPS, was developed recently. It was validated externally in a Caucasian population but has not been studied in Asian populations. The aim of this study was to validate APPS in Korean ARDS patients.

Methods: We retrospectively reviewed the medical records of patients who were diagnosed with ARDS using the Berlin criteria and admitted to the medical ICU at Seoul National University Hospital from January 2015 to December 2016. The validation of the APPS was performed by evaluating its calibration and predictive accuracy. Its calibration was plotted and quantified using the Hosmer-Lemeshow test. Its predictive accuracy was assessed by calculating the area under the receiver operating characteristics (AUC-ROC) curve.

Results: A total of 116 patients were analyzed, 32 of whom survived. Of the 116 patients, 11 (9.5%) were classified as APPS grade 1 (score 3-4), 88 (75.9%) as grade 2 (score 5-7) and 17 (14.6%) as grade 3 (score 8-9). In-hospital mortality was 27.3% for grade 1, 73.9% for grade 2 and 94.1% for grade 3 (P for trend <ā€‰0.001). The APPS was well calibrated (Hosmer-Lemeshow test, Pā€‰=ā€‰0.578) and its predictive accuracy was acceptable (AUC-ROC 0.704, 95% confidence interval 0.599-0.809).

Conclusions: The APPS predicted in-hospital mortality in Korean patients with ARDS with similar power to its application in a Western population and with acceptable predictive accuracy.

Trial Registration: Retrospectively registered.
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http://dx.doi.org/10.1186/s12931-020-01357-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7178575PMC
April 2020