As of September 3, 2022, 5,388,338 coronavirus disease 2019 (COVID-19) cases and 46 deaths (3 in 2021 and 43 in 2022) were reported in children ≤ 18 years in Korea. Cumulative confirmed cases accounted for 67.3% of the population aged ≤ 18 years and case fatality rate was 0.85/100,000. Among 46 fatal cases, 58.7% were male and median age was 7 years. Underlying diseases were present in 47.8%; neurologic diseases (63.6%) and malignancy (13.6%) most common. Only four had history of COVID-19 immunization. COVID-19 associated deaths occurred at median 2 days from diagnosis (range: −1 to 21). Among COVID-19 deaths, 41.3% occurred before admission; 2 before hospital arrival and 17 in the emergency department. Among children whose cause was documented, myocarditis, respiratory and multiorgan failure were most common. COVID-19 associated death was seen early after diagnosis in children and public health policies to provide access to medical care for children with COVID-19 are essential during the pandemic.

Background:We aimed to identify the problems in response and to present the importance of infection control in nursing homes (NHs) through an epidemiological analysis of the first and second COVID-19 outbreaks in Gyeonggi province. Methods:We reviewed the NH's structural and operational data and in-depth epidemiologic reports for confirmed cases that were obtained as part of an emergency public health response.Results: Two COVID-19 outbreaks in NHs stemmed from infected nursing home workers (NHWs), and cohorting measures were implemented as a method of infection control. However, the outcome of cohorting was unfavorable due to the unexpected spread to NHWs wearing personal protective equipment (PPE) during work. As a result, the majority of confirmed cases was nursing home residents with a median age of 86, and they accounted for 72% and 60% of confirmed cases in NH A and NH B, respectively. Moreover, all cases of mortality were nursing home residents, and the case-fatality rates were 44.44% and 33.33%, respectively. Conclusion:We confirmed that NHs and NHWs were closely involved in the process and outcomes of outbreaks. Enhanced infection control techniques for NHs and NHWs should be mandatory to prevent further transmission in addition to external factors such as social measures and medical supplies.

Objectives: This study aimed to classify coronavirus disease 2019 (COVID-19)-related deaths according to whether COVID-19 was listed as the cause of death, and to investigate the differences in demographic characteristics and risk factors for COVID-19 death classifications.Methods: A total of 5,625 deaths in South Korea among patients with confirmed COVID-19 from January 20, 2020 to December 31, 2021 were selected. Excluding false reports and unnatural deaths, 5,597 deaths were analyzed. Based on death report data, deaths were classified according to whether the cause of death was listed as COVID-19 (CD) or not (NCD). The epidemiological characteristics and causes of deaths were investigated using descriptive, univariate, and multivariate statistical analyses. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to analyze the risk factors.Results: The case fatality ratio was 0.89% and increased with age. Additionally, 96.4% of the subjects had an underlying disease, and 53.4% died in winter. The proportion of NCDs was 9.3%, of whom 19.1% died at home and 39.0% were confirmed to have COVID-19 after death. Malignant neoplasms (102/416 vs. 637/4,442; OR, 1.71; 95% CI, 1.36−2.16; p<0.001) were significantly associated with NCD.Conclusion: This is the first study to analyze risk factors by cause of death using COVID-19 death report data in South Korea. These results are expected to be used as evidence for establishing a death monitoring system that can collect timely information in a new infectious disease pandemic.

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