Context: Studies of lungs in patients with COVID-19 have focused on early findings. Objective: To systematically study histopathologic, imaging features and presence of SARSCoV-2 RNA in lung tissue from patients in later stages of COVID-19. Design: Autopsies, explants, surgical lung biopsies; and transbronchial, cryo, and needle biopsies were studied from patients with COVID-19, whose onset of symptoms/confirmed diagnosis was more than 28 days before the procedure. Available images were reviewed. Reverse transcription droplet digital polymerase chain reaction (RT-ddPCR) for SARS-CoV-2 RNA was performed on lung tissue. Results: Forty-four specimens (43 patients, median age 59.3 years, 26 [60.5%] male) showed features of acute lung injury (ALI) in 39 (88.6%), predominantly organizing pneumonia (OP) and diffuse alveolar damage (DAD), up to 298 days after onset of COVID-19. Fibrotic changes were found in 33 specimens (75%), most commonly fibrotic DAD (N=22) and cicatricial OP (N=12). Time between acquiring COVID-19 and specimen was shorter in patients with diffuse ALI (median 61.5 days) compared to patients with focal (140 days) or no ALI (130 days) (P=.009). Sixteen (of 20, 80%) SARS-CoV-2 RT-ddPCR tests were positive, up to 174 days after COVID-19 onset. Time between COVID-19 onset and most recent CT in patients with consolidation on imaging was shorter (median 43.0 days) versus patients without consolidation (87.5 days; P=.02). Reticulations were associated with longer time after COVID-19 onset to CT (median 82 days vs 23.5 days, P=.006). Conclusions: ALI and SARS-CoV-2 RNA can be detected in patients with COVID-19 for many months. ALI may evolve into fibrotic interstitial lung disease.
Background COVID-19 was first reported in Wuhan, China, in December 2019, and it has since spread worldwide. The Association of Korean Medicine (AKOM) established the COVID-19 telemedicine center of Korean medicine (KM telemedicine center) in Daegu and Seoul. Objective The aim of this study was to describe the results of the KM telemedicine center and the clinical possibility of using herbal medicines for COVID-19. Methods All procedures were conducted by voice call following standardized guidelines. The students in the reception group obtained informed consent from participants and they collected basic information. Subsequently, Korean Medicine doctors assessed COVID-19–related symptoms and prescribed the appropriate herbal medicine according to the KM telemedicine guidelines. The data of patients who completed the program by June 30, 2020, were analyzed. Results From March 9 to June 30, 2020, 2324 patients participated in and completed the KM telemedicine program. Kyung-Ok-Ko (n=2285) was the most prescribed herbal medicine, and Qingfei Paidu decoction (I and II, n=2053) was the second most prescribed. All COVID-19–related symptoms (headache, chills, sputum, dry cough, sore throat, fatigue, muscle pain, rhinorrhea, nasal congestion, dyspnea, chest tightness, diarrhea, and loss of appetite) improved after treatment (P<.001). Conclusions The KM telemedicine center has provided medical service to 10.8% of all patients with COVID-19 in South Korea (as of June 30, 2020), and it is still in operation. We hope that this study will help to establish a better health care system to overcome COVID-19.
Traditional Korean medicine (TKM) is formally integrated into the Korean national health system and monitored through the systematic and computerized system, which could grasp the whole medical services utilization in Korea. This study analyzed TKM resources as input and utilization as output using data from 2008–2017 and compared them to Conventional Medicine (CM). As a result, 25.4% of Koreans utilized TKM yearly, and the proportion of TKM medical expenditure (ME) to total ME in national health insurance was around 4% between 2008 to 2017. The proportion of ME has been stagnating or decreasing over the past ten years. Primary users are the elderly, women, and patients with musculoskeletal diseases. The Korean Ministry of health and welfare has also developed and operated programs that have taken advantage of the strengths of TKM. This study analyzes the current status of TKM in Korea comparing with that of CM. It also explores how and why the patterns of TKM and CM are different. Although the study focuses on input and output indicators, it also highlights the challenge of evaluating whether these lead to outcomes. Lastly, it seeks to inform relevant authorities of the importance of monitoring roles and evidence-informed policymaking.
Objectives: This study investigated public opinion on the use of modern diagnostic medical devices by Korean Medicine doctors.Methods: A questionnaire looking into perceptions on the use of modern medical devices was developed. It was distributed by a third party and data was collected. Results were analyzed through frequency analysis, chi-square analysis (<i>χ</i>²-test), frequency and cross analysis using R program. The measurement variable in the study was the respondent’s perspectives and expectations on the use of modern diagnostic medical devices by Korean Medicine doctors. The maximum significance level was 0.05.Results: There were a total of 3,000 responses and 80.8% of the respondents replied that there is a need for government-level discussion on endowing rights to Korean Medicine doctors as supervisors for safety management of radiation generating devices. Also, 83.3% of the respondents agreed the use of ultrasound imaging equipment in Korean Medicine clinics should be legalized.Conclusions: According to this study, respondents strongly support the use of modern diagnostic medical devices by Korean Medicine doctors. This is the first study to investigate public opinion in this area and it provides a significant insight into the public needs and desires for a wider scope of practice for Korean Medicine in the healthcare system.
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