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Autism spectrum disorder is considered a vulnerability for many diseases including coronavirus disease 2019. This study investigated trends in coronavirus disease 2019 among children and adolescents with and without autism spectrum disorder and to evaluate whether there are differences in the prevalence, severity, and case fatality rate. We used data from the National Health Insurance Service for all people [greater than or equal to] 19 years of age. Among 9,187,211 children and adolescents [greater than or equal to] 19 years of age, 402,499 (4.4%) were coronavirus disease 2019-positive. Of the total population, 63,054 (0.7%) were diagnosed with autism spectrum disorder, among whom 2557 (4.1%) were coronavirus disease 2019-positive. The coronavirus disease 2019 prevalence was lower among children and adolescents with autism spectrum disorder, with 4055 per 100,000 versus 4383 per 100,000 without autism spectrum disorder (p < 0.001). However, children and adolescents with autism spectrum disorder exhibited a higher proportion of hospitalization (24.8% vs 21.5%) and severe disease (0.2% vs 0.01%) than those without autism spectrum disorder (p < 0.001); the length of hospital stay among inpatients was not different between the two groups (9.5 vs 9.4 days, respectively; p = 0.48). There were six deaths in total, with no deaths among children and adolescents with autism spectrum disorder. The quarantine policies have played a great role in sustaining low prevalence and higher hospitalization rates among children and adolescents with autism spectrum disorder.

Background: We investigated whether periodontal diseases contribute to the development of medication‐related osteonecrosis of the jaw (MRONJ) in addition to tooth extraction, which is a major risk factor for MRONJ occurrence. Methods: This retrospective, nationwide cohort study was performed using South Korea's National Health Insurance Service database on women aged > 50 years who took bisphosphonates for at least 1 year between 2010 and 2015. MRONJ, periodontal disease, and tooth extraction were defined using the claims data. Results: Among the 27,168 patients analyzed, the incidence of confirmed MRONJ was significantly higher in the periodontal disease group (0.58%) than in the nonperiodontal disease group (0.31%). While extraction alone showed an increased risk of MRONJ development (hazard ratio [HR] = 1.61, 95% confidence interval [CI]: 0.74–3.52), periodontal disease without tooth extraction also indicated a similar risk (HR = 1.68, 95% CI: 0.86–3.28); when a history of both periodontal disease and tooth extraction was present, the HR significantly increased to 2.55 (95% CI: 1.41–4.64). Conclusions: The risk of MRONJ increased significantly when tooth extraction was performed in patients diagnosed with periodontal disease; therefore, periodontal diseases should be proactively managed in patients taking bisphosphonates. [ABSTRACT FROM AUTHOR]

Background: Dizziness/vertigo is one of the most common symptoms for which people seek healthcare. However, the healthcare expenditure attributable to dizziness/vertigo in South Korea remains poorly understood. We investigated the healthcare costs due to six major disorders causing dizziness/vertigo using claims data., Methods: The healthcare costs were evaluated using all the claims data submitted to the Health Insurance Review and Assessment Service from January 1 to December 31, 2022. The six major vestibular disorders included for analysis were benign paroxysmal positional vertigo (BPPV), psychogenic/persistent postural perceptual dizziness (PPPD), vascular vertigo/dizziness (VVD), vestibular migraine (VM), Meniere's disease (MD), and vestibular neuritis (VN)., Results: During the 1-year study period, 4.1% of adults aged 20 or older visited hospitals due to dizziness/vertigo in South Korea. Compared to the general population, the patients with dizziness/vertigo were more often elderly, female, and residents of small towns. The total healthcare cost for the six major vestibular disorders was ₩547.8 billion (approximately $406.5 million). BPPV incurred the highest annual healthcare cost (₩183.5 billion, 33.5%), followed by VVD (₩158.8 billion, 29.0%), MD (₩82.2 billion, 15.0%), psychogenic/PPPD (₩60.3 billion, 11.0%), VN (₩32.9 billion, 6.0%), and VM (₩30.1 billion, 5.5%). The mean healthcare cost per hospital visit due to dizziness/vertigo was ₩96,524 (95% confidence interval, ₩96,194-₩96,855), 30% higher than the average (₩73,948) of the overall healthcare cost per hospital visit over the same period., Conclusion: Owing to higher healthcare costs for dizziness/vertigo and increased prevalence of dizziness/vertigo in the aged population, healthcare costs due to dizziness/vertigo will increase rapidly in South Korea. Thus, a guideline for cost-effective management of dizziness/vertigo should be established to reduce the healthcare costs due to these common symptoms., Competing Interests: Dr. Ji-Soo Kim serves as an Associate Editor of Frontiers in Neuro-otology and on the editorial boards of the Journal of Clinical Neurology, Frontiers in Neuro-ophthalmology, Journal of Neuro-ophthalmology, and Journal of Vestibular Research, Journal of Neurology and Medicine. The other authors have nothing to disclose., (© 2024 The Korean Academy of Medical Sciences.)

Background: We aimed to investigate mortality, severity, and risk of hospitalization in coronavirus disease 2019 (COVID-19) patients with cancer., Methods: Data of all patients aged 40-79 years from the Korean Disease Control and Prevention Agency-COVID19-National Health Insurance Service who were diagnosed with COVID-19 between January 1, 2020 and March 31, 2022, in Korea were included. After 1:1 propensity score matching, 397,050 patients with cancer and 397,050 patients without cancer were enrolled in the main analysis. A cancer survivor was defined as a patient who had survived 5 or more years since the diagnosis of cancer. Multiple logistic regression analysis was performed to compare the risk of COVID-19 according to the diagnosis of cancer and time since diagnosis., Results: Cancer, old age, male sex, incomplete vaccination against COVID-19, lower economic status, and a higher Charlson comorbidity index were associated with an increased risk of hospitalization, hospitalization with severe state, and death. Compared to patients without cancer, the adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for hospitalization, hospitalization with severe state, and death in patients with cancer were 1.09 (1.08-1.11), 1.17 (1.11-1.24), and 1.94 (1.84-2.05), respectively. Compared to patients without cancer, the ORs (95% CIs) for hospitalization in cancer survivors, patients with cancer diagnosed 2-5 years, 1-2 years, and < 1 year ago were 0.96 (0.94-0.98), 1.10 (1.07-1.13), 1.30 (1.25-1.34), and 1.82 (1.77-1.87), respectively; the ORs (95% CIs) for hospitalization for severe disease among these patients were 0.90 (0.85-0.97), 1.22 (1.12-1.32), 1.60 (1.43-1.79), and 2.29 (2.09-2.50), respectively., Conclusion: The risks of death, severe state, and hospitalization due to COVID-19 were higher in patients with cancer than in those without; the more recent the diagnosis, the higher the aforementioned risks. Cancer survivors had a lower risk of hospitalization and hospitalization with severe disease than those without cancer., Competing Interests: The authors have no potential conflicts of interest to disclose., (© 2024 The Korean Academy of Medical Sciences.)

Purpose: Poor oral health is associated with head and neck cancer (HNC). We evaluated whether a national oral health screening program (OHSP) could reduce the risk of HNC., Materials and Methods: Data from 408,247 healthy individuals aged ≥ 40 years from the National Health Insurance System-National Health Screening program during 2003 and 2004 in Korea were analyzed. The risk of HNC was compared between subjects who underwent OHSP (HEALS-Dental+, n=165,292) and routine health check-ups only (HEALS-Dental‒, n=242,955). The impact of individual oral health-related factors on HNC risk was evaluated in HEALS-Dental+., Results: A total of 1,650 HNC cases were diagnosed. The 10-year HNC-free rate was 99.684% with a median follow-up of 11 years. The risk of all HNC (hazard ratio [HR], 1.16; 95% confidence interval [CI], 1.03 to 1.29; p=0.011) and oropharyngeal cancer (HR, 1.48; 95% CI, 1.13 to 1.94; p=0.005) was significantly higher in HEALS-Dental‒ than in HEALS-Dental+. In HEALS-Dental+, oral cavity cancer was marginally reduced (p=0.085), and missing teeth was a significant factor for HNC (HR, 1.24; 95% CI, 1.02 to 1.50; p=0.032). Toothbrushing was a significant factor in univariate analysis (p=0.028), but not in multivariate analysis (p=0.877)., Conclusion: The National OHSP significantly reduced the long-term HNC risk, particularly the incidence of oropharyngeal cancer. Routine OHSP should be considered at the population level.