Coronavirus disease 2019 (COVID-19) is a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection affecting multiple organs and may progress to severe acute respiratory distress syndrome (ARDS). In South Korea, the shortage of intensive care unit (ICU) and application of extracorporeal membrane oxygenation (ECMO) are increasing due to the recent rapid increase in the number of critically ill patients with COVID-19. ECMO has been used in ARDS and reduces the 60-day mortality compared to that with conventional management (1). In the metaanalysis by Combes et al., 90-day mortality was significantly lower in the ECMO group than in the conventional management group [36% vs. 48%; relative risk 0.75; 95% confidence interval (CI): 0.6-0.94; P=0.013] (2). Mortalityrelated factors in ECMO include the age, malignancy, liver cirrhosis, ventilator setting [positive end-expiratory pressure (PEEP)], peak inspiratory pressure (PIP)], respiratory ECMO survival prediction (RESP) score, and predicting death due to severe ARDS on VV-ECMO (PRESERVE) score (3,4).Age is highly correlated with ECMO prognosis (3-5). The meta-analysis by Ramanathan et al., patients with COVID-19 who underwent ECMO showed that the duration, age, and body mass index were associated with mortality (6). Various scores have been used to predict the prognosis after ECMO initiation. However, despite the increasing application of ECMO due to COVID-19, whether the scoring system and age are helpful in predicting the prognosis of patients with COVID-19 who underwent ECMO is unclear. Therefore, we investigated the patients with COVID-19. This is a single-center retrospective study on patients admitted at the 1200-bed tertiary academic hospital and ECMO referral center in South Korea. All data were obtained from electronic medical records. A total of 991 patients with COVID-19 hospitalized from January 2020 to December 2021 were included, excluding 952 patients (96.1%) who did not undergo ECMO. So, 39 patients (3.9%) who underwent ECMO were included in this study. The types of ECMO were venovenous in 31 patients (79.5%), venoarterial in five patients (12.8%), and venoarterial-venous in three patients (7.7%).Reverse transcription-polymerase chain reaction analysis confirmed SARS-CoV-2 infection. ECMO was considered for patients with COVID-19 who worsened rapidly despite invasive mechanical ventilation (MV) and severe ARDS (PaO 2 /FiO 2 ratio ≤100 mmHg), then their caregivers agreed to ECMO. The initiation of ECMO was decided Letter to the Editor
In the modern times, people have been concerning more about their skin diseases resulting from environmental pollution and climate changes. At the same time, the cosmeceutical market whose roles have become segmented and specialized has expanded its reach. This study aimed to investigate the consumption values and consumer satisfaction of cosmeceuticals depending on skin diseases. It is meaningful in that it suggests basic data which are needed for manufacturers to set a direction for production and develop marketing strategies. According to this study, respondents believe that ‘functional value’ is most important among consumption values. As ‘functional value’ increased, consumer satisfaction improved accordingly. Satisfaction with cosmeceuticals was high in all groups because most cosmeceuticals are now of high quality and perceived as the products which are effective in easing diverse skin diseases with soothing, moisturizing and whitening effects. Therefore, it is required for manufacturers to develop more diverse and new technologies and enhance product quality and performances. More diverse studies are required to facilitate the steadily growing cosmeceutical market.
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