Acute and Critical Care

Original Article

Infection
Direct and indirect effects of the COVID-19 pandemic on mortality and critical care utilization in South Korea: Mindong Sung, Hye Jin Jang, Soyul Han, Sungho Won, Bora Lee, Young Sam Kim; Acute Crit Care. 2026;41(2):315-325. Published online March 27, 2026; DOI: https://doi.org/10.4266/acc.003375

2,157 View
16 Download

Abstract PDF Supplementary Material: Background
The coronavirus disease 2019 (COVID-19) pandemic has had unprecedented global impact, with significant effects on mortality and healthcare utilization. This study evaluated the direct and indirect impacts of COVID-19 on mortality and healthcare utilization in South Korea, a country that implemented strict public health measures. Methods: We conducted a retrospective analysis using national databases from January 2015 through May 2022. The study compared mortality patterns and intensive care unit (ICU) utilization during the epidemic period (2020–2021) with the reference period (2015–2019). We analyzed excess mortality using a random-coefficient Poisson regression model and examined cause-specific mortality patterns for pneumonia, cardiovascular disease, and cancer. ICU admission trends were assessed using annual percent change (APC) and average annual percent change (AAPC) analyses. Results: The study revealed a distinctive two-phase pattern in COVID-19-related excess mortality: minimal excess deaths until June 2021, followed by a significant increase culminating in 18,068 excess deaths (P-score, 68.39%) during the fifth wave in March 2022. COVID-19 deaths accounted for approximately 45% of excess deaths during this period. Analysis of cause-specific mortality demonstrated temporal shifts in cardiovascular disease and pneumonia deaths from their typical January peaks to March–April 2022. Cardiovascular disease showed significant excess mortality during the fifth wave (z=6.18, P<0.001), while pneumonia mortality was below expected levels when accounting for pre-existing trends. Case fatality rate declined from an initial 9.50% to below 1% by 2022, despite increased case numbers. ICU admissions for non-COVID patients showed a consistent declining trend, with the most substantial decrease (–11.48%) observed in April 2020 during the first epidemic wave. Conclusions: These findings suggest that COVID-19 affected population health through both direct viral infection and indirect effects on healthcare systems and utilization patterns. The study highlights the importance of maintaining critical care capacity for all patient groups during public health emergencies and the need for strategies to balance resource allocation.

Corrigendum

Meta-analysis
Comparison of safety and efficacy between therapeutic or intermediate versus prophylactic anticoagulation for thrombosis in COVID-19 patients: a systematic review and meta-analysis: Hyeon-Jeong Lee, Hye Jin Jang, Won-Il Choi, Joonsung Joh, Junghyun Kim, Jungeun Park, Miyoung Choi; Acute Crit Care. 2023;38(4):516-516. Published online November 28, 2023; DOI: https://doi.org/10.4266/acc.2022.01424.e1; Corrects: Acute Crit Care 2023;38(2):160

2,902 View
65 Download
1 Crossref

PDF

Citations

Citations to this article as recorded by

Scoping review about pathogenesis, risk factors, and treatment of venous and arterial thrombosis in coronavirus infection
Diana Malaeb, Sara Mansour, Nada Dia, Nada M. Kassem, Chadia Haddad, Mariam Dabbous, Ola Ismail, Farah Adel, May Gamal, Jisha Myalil Lucca, Sami El Khatib, Pascale Salameh, Souheil Hallit, Hassan Hosseini
Frontiers in Cardiovascular Medicine.2025;[Epub] CrossRef

Original Article

Meta-analysis
Comparison of safety and efficacy between therapeutic or intermediate versus prophylactic anticoagulation for thrombosis in COVID-19 patients: a systematic review and meta-analysis: Hyeon-Jeong Lee, Hye Jin Jang, Won-Il Choi, Joonsung Joh, Junghyun Kim, Jungeun Park, Miyoung Choi; Acute Crit Care. 2023;38(2):160-171. Published online May 25, 2023; DOI: https://doi.org/10.4266/acc.2022.01424; Correction in: Acute Crit Care 2023;38(4):516

10,308 View
218 Download
5 Web of Science
3 Crossref

Abstract PDF Supplementary Material

Background
Patients with coronavirus disease 2019 (COVID-19) infections often have macrovascular or microvascular thrombosis and inflammation, which are known to be associated with a poor prognosis. Heparin has been hypothesized that administration of heparin with treatment dose rather than prophylactic dose for prevention of deep vein thrombosis in COVID-19 patients.
Methods
Studies comparing therapeutic or intermediate anticoagulation with prophylactic anticoagulation in COVID-19 patients were eligible. Mortality, thromboembolic events, and bleeding were the primary outcomes. PubMed, Embase, the Cochrane Library, and KMbase were searched up to July 2021. A meta-analysis was performed using random-effect model. Subgroup analysis was conducted according to disease severity.
Results
Six randomized controlled trials (RCTs) with 4,678 patients and four cohort studies with 1,080 patients were included in this review. In the RCTs, the therapeutic or intermediate anticoagulation was associated with significant reductions in the occurrence of thromboembolic events (5 studies, n=4,664; relative risk [RR], 0.72; P=0.01), and a significant increase in bleeding events (5 studies, n=4,667; RR, 1.88; P=0.004). In the moderate patients, therapeutic or intermediate anticoagulation was more beneficial than prophylactic anticoagulation in terms of thromboembolic events, but showed significantly higher bleeding events. In the severe patients, the incidence of thromboembolic and bleeding events in the therapeutic or intermediate.
Conclusions
The study findings suggest that prophylactic anticoagulant treatment should be used in patients with moderate and severe COVID-19 infection groups. Further studies are needed to determine more individualized anticoagulation guidance for all COVID-19 patients.

Citations

Citations to this article as recorded by

COVID-19: a vascular nightmare unfolding
Qinan Yin, Youjin Huang, Hulin Wang, Yin Wang, Xuefei Huang, Yujie Song, Yueyuan Wang, Lizhu Han, Bian Yuan
Frontiers in Immunology.2025;[Epub] CrossRef
The Community Pharmacy as a Study Center for the Epidemiological Analysis of the Population Vaccination against SARS-CoV-2: Evaluation of Vaccine Safety and Pharmaceutical Service
Jacopo Raffaele Dibenedetto, Michela Cetrone, Marina Antonacci, Domenico Pio Cannone, Stefania Antonacci, Pasquale Bratta, Francesco Leonetti, Domenico Tricarico
Pharmacy.2024; 12(1): 16. CrossRef
Specific and Non-specific Aspects and Future Challenges of ICU Care Among COVID-19 Patients with Obesity: A Narrative Review
Alexandra Beurton, Emma J. Kooistra, Audrey De Jong, Helmut Schiffl, Mercedes Jourdain, Bruno Garcia, Damien Vimpère, Samir Jaber, Peter Pickkers, Laurent Papazian
Current Obesity Reports.2024; 13(3): 545. CrossRef

First
Prev
Page of 1
Next
Last

Search