Journal of Preventive Medicine and Public Health

Systematic Review

Association of Particulate Matter (PM_2.5) With COVID-19 Infection and Mortality in Low-and Middle-income Asian Countries: A Systematic Review and Meta-analysis: Frisca Rahmadina, Riris Andono Ahmad, Aditya Lia Ramadona; J Prev Med Public Health. 2026;59(1):12-24. Published online January 17, 2026; DOI: https://doi.org/10.3961/jpmph.25.499

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Abstract Summary PDF Supplementary Material: Objectives
Low-income and middle-income countries in Asia bear a disproportionate burden of particulate matter with an aerodynamic diameter of 2.5 micrometers or less (PM_2.5) pollution, yet data remain scarce. This systematic review and meta-analysis aimed to quantify the association between PM_2.5 exposure and the risks of coronavirus disease 2019 (COVID-19) infection and mortality in this vulnerable region.
Methods
A systematic search was conducted in PubMed, Scopus, and other major databases for studies published up to December 31, 2024. We included observational studies reporting associations between PM_2.5 and COVID-19 outcomes in low-income and middle-income Asian countries. Pooled effect sizes and 95% confidence intervals (CIs) were calculated using a random-effects model. The study was registered with PROSPERO (CRD42022316008).
Results
Fourteen studies met the inclusion criteria. Separate analyses demonstrated statistically significant positive associations between PM_2.5 exposure and COVID-19 infection for both short-term exposure (pooled risk ratio [RR], 1.12; 95% CI, 1.07 to 1.18) and long-term exposure (pooled RR, 1.41; 95% CI, 1.28 to 1.56). For mortality, the analysis identified a statistically non-significant positive association with short-term exposure (pooled RR, 1.37; 95% CI, 0.80 to 2.33). Substantial heterogeneity was observed across all analyses (I²>75%); however, sensitivity analyses confirmed that the findings for infection were robust.
Conclusions
Our findings provide robust evidence that PM_2.5 exposure is a significant risk factor for COVID-19 infection in low-income and middle-income Asian countries. The available evidence was insufficient to establish a clear association with mortality. These results underscore the urgent need for strengthened air quality control policies as a critical component of public health strategies to mitigate the burden of respiratory pandemics.; Summary

Key Message
This systematic review and meta-analysis confirms that both short-term and long-term PM 2.5 exposure significantly increase COVID-19 infection risks in Asian LMICs, with long-term exposure showing a substantially higher risk ratio. These findings highlight a critical intersection between air quality and infectious disease vulnerability. Consequently, integrating air quality management into public health strategies is essential for strengthening preparedness against future respiratory pandemics.

Original Articles

Frailty Index Predicts Future All-cause Mortality and Quality of Life: A 2-Year Follow-up Study Among Korean Older Adults From a Population-based Cohort Study: Woolim Ko, Hyunsuk Jeong, Hyeon Woo Yim; J Prev Med Public Health. 2025;58(6):572-580. Published online November 10, 2025; DOI: https://doi.org/10.3961/jpmph.25.210

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Abstract Summary PDF Supplementary Material: Objectives
The frailty index (FI), a proxy measure of accelerated biological aging, predicts adverse outcomes in older adults. We investigated whether the FI predicts mortality in a community-based Korean older adult population and its association with subjective health status over 2 years.
Methods
This prospective cohort study included 936 community-dwelling individuals aged ≥60 years. The FI, calculated from 28 self-reported baseline variables, was scored on a scale from 0 to 1 (<0.25: non-frail; 0.25-0.34: mildly frail; ≥0.35: moderately to severely frail). The primary outcome was 2-year all-cause mortality. Relative risks (RRs) and 95% confidence intervals (CIs) were calculated. Quality of life was assessed using the European Quality of Life Five-Dimension Three-Level (EQ-5D-3L), with the proportions reporting extreme problems and prevalence ratios of problems across frailty groups. Analyses were conducted using the GENMOD procedure in SAS version 9.4.
Results
Of the 936 participants, 111 (11.9%) were non-frail, 230 (24.6%) were mildly frail, and 595 (63.6%) were moderately to severely frail. The prevalence of moderate to severe frailty increased with age. The moderate-severe frailty group had a ≥5-fold increased risk of mortality compared to the non-frail group (adjusted RR, 5.79; 95% CI, 1.39 to 24.07). Among those completing follow-up, the moderate-severe frailty group reported more problems across all EQ-5D-3L domains at 2 years.
Conclusions
Frail older adults are at increased risk of mortality, but this risk was significant only for those in the moderate-to-severe frailty category at 2-year follow-up. The FI is a valuable predictor of premature death and health challenges in older adults.; Summary

Korean summary
2년의 추적 관찰 기간 동안, 기저 시점의 중등도에서 중증의 노쇠 상태에 있던 노인은 노쇠하지 않은 노인에 비해 사망 위험이 5배 이상 높았으며, EQ-5D-3L로 평가한 다양한 삶의 질 영역에서도 더 큰 어려움을 겪는 것으로 나타났다. 이러한 결과는 특히 중등도에서 중증의 노쇠 상태가 임상적 위험뿐만 아니라 주관적 삶의 질을 개선하기 위한 우선적 개입이 필요할 수 있음을 시사한다. 본 연구는 노인의 건강 결과를 향상시키기 위해서는 개별 질환 관리뿐 아니라 노쇠 상태를 체계적으로 평가하고 관리하는 것이 중요함을 제안한다.

Key Message
During the two-year follow-up period, older adults who were moderately to severely frail at baseline had a more than fivefold higher risk of death compared with those who were non-frail, and they also experienced greater difficulties across various quality-of-life domains as measured by the EQ-5D-3L. These findings suggest that moderate to severe frailty may require high-priority interventions to improve not only clinical risks but also subjective quality of life. This study indicates that, to improve health outcomes in older adults, it is important to systematically assess and manage frailty in addition to addressing individual diseases.

Rapid Antiretroviral Therapy Initiation Reduces Mortality Among People Living With HIV in Indonesia: A Retrospective Observational Study: Ifael Yerosias Mauleti, Krishna Adi Wibisana, Djati Prasetio Syamsuridzal, Sri Mulyati, Vivi Lisdawati, Harimat Hendarwan, Ika Saptarini; J Prev Med Public Health. 2025;58(4):360-369. Published online February 22, 2025; DOI: https://doi.org/10.3961/jpmph.24.622

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Abstract Summary PDF

Objectives
Current recommendations for managing human immunodeficiency virus (HIV) propose that initiating antiretroviral therapy (ART) promptly after diagnosis, regardless of CD4 cell count, may decrease illness and mortality risk. This study aimed to investigate factors associated with reduced mortality, including the time to ART initiation after diagnosis with HIV.
Methods
We conducted a retrospective cohort study using the medical records of 326 people living with human immunodeficiency virus (PLHIV) aged 18 years or older who initiated ART at a tertiary hospital between January 2018 and December 2022. We employed Cox regression models to estimate survival and identify mortality predictors, considering variables with p-values less than 0.05 as statistically significant.
Results
From 2018 to 2022, 19.9% of PLHIV initiated ART within 7 days of diagnosis, and 57 participants died. The final multivariable Cox proportional hazards model indicated that earlier ART initiation significantly reduced mortality risk compared with starting ART more than 60 days after diagnosis, with adjusted hazard ratios of 0.36 for initiation within 7 days and 0.42 for initiation between 8 days and 60 days. Additional characteristics associated with reduced mortality risk included a CD4 count above 200 cells/mm 3 before ART initiation, a lower World Health Organization clinical stage, and tuberculosis post-exposure prophylaxis.
Conclusions
Earlier ART initiation significantly lowered mortality rates. Furthermore, a pre-ART CD4 count above 200 cells/mm³, a lower clinical stage, and tuberculosis preventive therapy were associated with reduced mortality risk among PLHIV. Future studies should investigate additional predictors of mortality within a prospective cohort study framework.

Summary

Key Message
In a retrospective cohort of 326 people living with HIV in Jakarta, Indonesia, rapid ART initiation within 7 days of diagnosis reduced mortality by 64% compared to initiation after 60 days (aHR 0.36; 95% CI 0.14–0.93). Initiating ART between 8 and 60 days conferred a 58% reduction in mortality risk (aHR 0.42; 95% CI 0.22–0.81). Additionally, pre-ART CD4 counts >200 cells/mm³, lower WHO clinical stage, and receipt of TB post-exposure prophylaxis independently predicted improved survival.

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Marginal structural Cox model for estimating the effect of Chinese medicine on the survival of people living with HIV: a 17-year real-world retrospective cohort study
Wanqi Pan, Qianlei Xu, Yanmin Ma, Liran Xu, Huangchao Jia, Dongli Wang, Keying Zhu, Miao Zhang, Juan Wang, Huijun Guo, Yantao Jin
Frontiers in Public Health.2025;[Epub] CrossRef

Factors Associated With Post-term Birth and Its Relationship to Neonatal Mortality in Japan: An Analysis of National Data From 2017 to 2022: Tasuku Okui, Naoki Nakashima; J Prev Med Public Health. 2024;57(6):564-571. Published online September 24, 2024; DOI: https://doi.org/10.3961/jpmph.24.355

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Abstract Summary PDF Supplementary Material: Objectives
Prior research has not yet examined the relationship between post-term birth and neonatal mortality in Japan, along with factors associated with post-term birth. We investigated these associations utilizing nationwide birth data from Japan.
Methods
Birth and mortality data were obtained from the Vital Statistics of Japan for the years 2017 to 2022. The post-term birth rate was calculated by birth characteristics, and the neonatal mortality rates for post-term and term births were computed. Additionally, log-binomial regression analysis was employed to explore the associations between post-term birth and neonatal mortality, as well as between various characteristics and post-term birth. The characteristics considered included infant sex, maternal age group, parity, maternal nationality, maternal marital status, and household occupation.
Results
This study analyzed data from 4 698 905 singleton infants born at 37 weeks of gestational age or later. Regression analysis revealed that post-term birth was positively associated with neonatal mortality. The adjusted risk ratio for neonatal mortality in post-term compared to term births was 8.07 (95% confidence interval, 5.06 to 12.86). Factors positively associated with post-term birth included female infant sex, older maternal age, primiparity, non-Japanese maternal nationality, unmarried status, and various household occupations, including farmer, full-time worker at a smaller company, other type of worker, and unemployed. Younger maternal age was inversely associated with post-term birth.
Conclusions
In Japan, post-term birth represents a risk factor for neonatal mortality. Additionally, socio-demographic characteristics, such as maternal marital status, nationality, and parity were found to be predictors of post-term birth.; Summary

Key Message
This study investigated the relationship between post-term birth and neonatal mortality in Japan, along with factors associated with post-term birth. Regression analysis revealed that post-term birth was significantly and positively associated with neonatal mortality. Additionally, socio-demographic characteristics, such as older maternal age, primiparity, non-Japanese maternal nationality, and unmarried status were found to be predictors of post-term birth.

Incidence and Influencing Factors of Avoidable Mortality in Korea From 2013-2022: Analysis of Cause-of-death Statistics: Jeong Min Yang, Jieun Hwang; J Prev Med Public Health. 2024;57(6):540-551. Published online September 23, 2024; DOI: https://doi.org/10.3961/jpmph.24.232

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Abstract Summary PDF Supplementary Material

Objectives
This study aimed to identify trends in avoidable mortality (AVM) in 16 provincial and metropolitan regions of Korea and determine the factors influencing AVM.
Methods
First, the avoidable mortality rate (AVMR) was calculated using the Statistics Korea cause-of-death and population data by age and region from 2013 to 2022. Second, a health determinants model was built, and we identified the factors influencing AVM using generalized estimating equations analysis.
Results
Although the AVMR per 100 000 people displayed a steadily decreasing trend from 2013 to 2020, it began to increase in 2021. Meanwhile, Jeonnam, Jeonbuk, Gyeongnam, Gyeongbuk, Chungnam, Chungbuk, and Gangwon Provinces showed a higher AVMR than the national average. The analysis revealed that each 1-unit increase in the older adult population, smoking, perceived stress, or non-local medical utilization was associated with an increase in the AVMR. Conversely, 1-unit increases in the male-to-female ratio, marriage rate, positive self-rated health, local medical utilization, doctor population, influenza vaccination rate, cancer screening rate, or financial independence were associated with decrease in the AVMR.
Conclusions
This study established that the AVMR, which had been continuously decreasing across the 16 regions, shifted to an increasing trend in 2021. We also identified several factors influencing AVM. Further studies are needed to confirm the reasons for this shift in the AVMR and explore the factors that influence AVM across Korea’s 16 provincial and metropolitan regions.

Summary

Korean summary
본 연구는 전국 및 16개 시도의 회피가능사망률 추이를 파악하고 건강결정요인 모형을 통해 영향요인을 파악하기 위함이다. 분석 결과, 전반적으로 2013년부터 2020년까지 회피가능사망률은 감소 추세를 보였으나, 2021년을 기점으로 회피가능사망률이 증가하였으며, 지역별 회피가능사망률의 편차가 존재하였다. 본 연구를 통해 우리나라의 회피가능사망 현황을 파악할 수 있으며, 향후 조기사망 감소를 위한 기초 근거로 활용될 수 있을 것으로 판단한다.

Key Message
This study examines trends in avoidable mortality (AVM) rates across Korea and its 16 provinces, identifying factors using a health determinant model. From 2013 to 2020, AVM rates declined, but an increase was observed from 2021. These findings highlight the current state of AVM in Korea and offer key insights for strategies to reduce premature deaths.

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Exploring the association between community-level factors and health literacy using multilevel analysis
Inhyung Cho, Sung-il Cho
BMC Public Health.2025;[Epub] CrossRef

Excess Deaths in Korea During the COVID-19 Pandemic: 2020-2022: So-Jin Im, Ji-Yeon Shin, Duk-Hee Lee; J Prev Med Public Health. 2024;57(5):480-489. Published online August 20, 2024; DOI: https://doi.org/10.3961/jpmph.24.254

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Abstract Summary PDF Supplementary Material

Objectives
Excess deaths, an indicator that compares total mortality rates before and during a pandemic, offer a comprehensive view of the pandemic’s impact. However, discrepancies may arise from variations in estimating expected deaths. This study aims to compare excess deaths in Korea during the coronavirus disease 2019 pandemic using 3 methods and to analyze patterns using the most appropriate method.
Methods
Expected deaths from 2020 to 2022 were estimated using mortality data from 2015-2019 as reference years. This estimation employed 3 approaches: (1) simple average, (2) age-adjusted average, and (3) age-adjusted linear regression. Excess deaths by age, gender, and cause of death were also presented.
Results
The number of excess deaths varied depending on the estimation method used, reaching its highest point with the simple average and its lowest with the age-adjusted average. Age-adjusted linear regression, which accounts for both the aging population and declining mortality rates, was considered most appropriate. Using this model, excess deaths were estimated at 0.3% for 2020, 4.0% for 2021, and 20.7% for 2022. Excess deaths surged among individuals in their 20s throughout the pandemic, largely attributed to a rise in self-harm and suicide. Additionally, the results indicated sharp increases in deaths associated with “endocrine, nutritional, and metabolic diseases” and “symptoms, signs, and abnormal clinical and laboratory findings, not elsewhere classified.”
Conclusions
Substantial variations in excess deaths were evident based on estimation method, with a notable increase in 2022. The heightened excess deaths among young adults and specific causes underscore key considerations for future pandemic responses.

Summary

Korean summary
초과 사망은 팬데믹 영향을 종합적으로 평가하는 핵심 지표로 잘 알려져 있으나, 추정 방법에 따라 결과가 다양한 것으로 보고되고 있다. 코로나19 팬데믹동안 흔하게 사용된 3가지 방법 – 단순 평균, 연령보정 평균, 연령 보정 선형 회귀식-을 이용하여 초과사망을 추정하였을 때, 추정 방법에 따라서 초과사망에 큰 차이가 있었다. 3가지 방법 중 인구 고령화와 사망률 감소 추이를 고려한 연령 보정 선형 회귀식이 가장 적절한 것으로 판단되었으며, 이 방법을 이용한 한국의 초과 사망은 2020년 0.3%, 2021년 4.0%, 2022년 20.7%로 추정되었다. 또한 팬데믹 전 기간 동안 20대 초과 사망이 급증했는데 이는 주로 자해와 자살의 증가로 인한 것이었으며, '내분비, 영양 및 대사 질환' 및 ' 달리 분류되지 않은 증상, 징후와 임상 및 검사의 이상소견”으로 인한 초과사망도 급증하였다.

Key Message
● Excess deaths, a comprehensive indicator of the pandemic’s impact, varied by estimation method.
● Using an age-adjusted linear regression approach, which considers an aging population and declining mortality rates, excess deaths in Korea during the COVID-19 pandemic were estimated at 0.3% for 2020, 4.0% for 2021, and 20.7% for 2022.
● Excess deaths surged among individuals in their 20s throughout the pandemic, mainly due to increased self-harm and suicide, alongside a sharp rise in deaths related to ‘endocrine, nutritional, and metabolic diseases’, and ‘symptoms, signs, and abnormal clinical and laboratory findings, not elsewhere classified’.

Citations

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Imputing missing data with statistical-learning estimates: impacts on mortality risks attributable to area- and source-specific PM2.5.
Youngkwon Kim, Cinoo Kang, Seung-Muk Yi, JongBae Heo, Hwajin Kim, Woojoo Lee, Ho Kim, Philip K. Hopke, Young Su Lee, Hye-Jung Shin, Jungmin Park, Myungsoo Yoo, Kwonho Jeon, Jieun Park
Atmospheric Pollution Research.2026; 17(3): 102785. CrossRef
Cause of death statistics in 2022 in the Republic of Korea
Jung-Hyun Oh, Juhee Seo, Hyun Jung Park
Ewha Medical Journal.2025; 48(3): e46. CrossRef
Excess mortality and healthcare costs during the COVID-19 pandemic among patients with ten major chronic diseases in South korea: a nationwide analysis
Jihun Song, Hye Jun Kim, Seogsong Jeong, Sun Jae Park, Hyun-Young Shin, Eun-kyeong Jeong, Jaehun Jung, Geehyuk Kim, Sang Min Park
BMC Infectious Diseases.2025;[Epub] CrossRef

Smoking-attributable Mortality in Korea, 2020: A Meta-analysis of 4 Databases: Eunsil Cheon, Yeun Soo Yang, Suyoung Jo, Jieun Hwang, Keum Ji Jung, Sunmi Lee, Seong Yong Park, Kyoungin Na, Soyeon Kim, Sun Ha Jee, Sung-il Cho; J Prev Med Public Health. 2024;57(4):327-338. Published online July 3, 2024; DOI: https://doi.org/10.3961/jpmph.23.471

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Abstract Summary PDF Supplementary Material

Objectives
Estimating the number of deaths caused by smoking is crucial for developing and evaluating tobacco control and smoking cessation policies. This study aimed to determine smoking-attributable mortality (SAM) in Korea in 2020.
Methods
Four large-scale cohorts from Korea were analyzed. A Cox proportional-hazards model was used to determine the hazard ratios (HRs) of smoking-related death. By conducting a meta-analysis of these HRs, the pooled HRs of smoking-related death for 41 diseases were estimated. Population-attributable fractions (PAFs) were calculated based on the smoking prevalence for 1995 in conjunction with the pooled HRs. Subsequently, SAM was derived using the PAF and the number of deaths recorded for each disease in 2020.
Results
The pooled HR for all-cause mortality attributable to smoking was 1.73 for current men smokers (95% confidence interval [CI], 1.53 to 1.95) and 1.63 for current women smokers (95% CI, 1.37 to 1.94). Smoking accounted for 33.2% of all-cause deaths in men and 4.6% in women. Additionally, it was a factor in 71.8% of men lung cancer deaths and 11.9% of women lung cancer deaths. In 2020, smoking was responsible for 53 930 men deaths and 6283 women deaths, totaling 60 213 deaths.
Conclusions
Cigarette smoking was responsible for a significant number of deaths in Korea in 2020. Monitoring the impact and societal burden of smoking is essential for effective tobacco control and harm prevention policies.

Summary

Korean summary
한국의 흡연율은 상당 수준 감소하였지만 흡연의 장기적인 건강영향은 지속적으로 나타나고 있다. 4개의 대규모 코호트와 1995년 흡연율을 사용하여 2020년 한국의 흡연기인 사망자수를 산출한 결과 남성 53,930명, 여성 6283명으로 총 60,213명이였다. 효과적인 담배규제와 금연 정책을 위하여 장기적인 사망자수 모니터링이 필요할 것이다.

Key Message
Despite the significant decrease in smoking rates in South Korea, the long-term health effects of smoking continue to manifest. Our analysis using four large-scale cohorts and 1995 smoking prevalence revealed that in 2020, the number of smoking-attributable death in South Korea was 53,930 for men and 6,283 for women, totaling 60,213. Long-term monitoring is necessary for effective tobacco control and smoking cessation policies.

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Scientific Reports.2026;[Epub] CrossRef
Risk of all-cause mortality by various cigarette smoking indices: A longitudinal study using the Korea National Health Examination Baseline Cohort in South Korea
Heewon Kang, Eunsil Cheon, Jieun Hwang, Suyoung Jo, Kyoungin Na, Seong Yong Park, Sung-il Cho
Tobacco Induced Diseases.2025; 23(January): 1. CrossRef
Cohort profile: the Korean National Health Examination Baseline (KNHEB) cohort for longitudinal health monitoring in South Korea
Suyoung Jo, Eunsil Cheon, Heewon Kang, Min Kyung Lim, Wankyo Chung, Sun Ha Jee, Keum Ji Jung, Yeun Soo Yang, Seong Yong Park, Sunmi Lee, Jin-Kyoung Oh, Kyoungin Na, Soyeon Kim, Jieun Hwang, Sung-il Cho
BMC Public Health.2025;[Epub] CrossRef
Preventable Cancers Caused by Infection in Korea From 2015 to 2030
Sungji Moon, Jeoungbin Choi, Soseul Sung, Youjin Hong, Kwang-Pil Ko, Jung Eun Lee, Inah Kim, Seungho Ryu, Sun Ha Jee, Guen Hui Kim, Sun Young Yang, Aesun Shin, Sun-Seog Kweon, Jeongseon Kim, Jieun Jang, Sangjun Lee, Kyungsik Kim, Woojin Lim, Yoon-Jung Cho
Journal of Korean Medical Science.2025;[Epub] CrossRef
Analysis of clinical and epidemiological interactions of phenol and phthalate levels in blood and urine with anamnestic and biochemical health measures during the formation of multisystem organ pathology
I. Yu. Torshin, O. A. Gromova, T. E. Bogacheva, A. N. Gromov
FARMAKOEKONOMIKA. Modern Pharmacoeconomics and Pharmacoepidemiology.2025; 18(3): 376. CrossRef
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Excess Deaths During the COVID-19 Pandemic in Southern Iran: Estimating the Absolute Count and Relative Risk Using Ecological Data: Mohammadreza Zakeri, Alireza Mirahmadizadeh, Habibollah Azarbakhsh, Seyed Sina Dehghani, Maryam Janfada, Mohammad Javad Moradian, Leila Moftakhar, Mehdi Sharafi, Alireza Heiran; J Prev Med Public Health. 2024;57(2):120-127. Published online February 7, 2024; DOI: https://doi.org/10.3961/jpmph.23.198

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Abstract Summary PDF Supplementary Material

Objectives
The coronavirus disease 2019 (COVID-19) pandemic led to increased mortality rates. To assess this impact, this ecological study aimed to estimate the excess death counts in southern Iran.
Methods
The study obtained weekly death counts by linking the National Death Registry and Medical Care Monitoring Center repositories. The P-score was initially estimated using a simple method that involved calculating the difference between the observed and expected death counts. The interrupted time series analysis was then used to calculate the mean relative risk (RR) of death during the first year of the pandemic.
Results
Our study found that there were 5571 excess deaths from all causes (P-score=33.29%) during the first year of the COVID-19 pandemic, with 48.03% of these deaths directly related to COVID-19. The pandemic was found to increase the risk of death from all causes (RR, 1.26; 95% confidence interval [CI], 1.19 to 1.33), as well as in specific age groups such as those aged 35-49 (RR, 1.21; 95% CI, 1.12 to 1.32), 50-64 (RR, 1.38; 95% CI, 1.28 to 1.49), and ≥65 (RR, 1.29; 95% CI, 1.12 to 1.32) years old. Furthermore, there was an increased risk of death from cardiovascular diseases (RR, 1.17; 95% CI, 1.11 to 1.22).
Conclusions
There was a 26% increase in the death count in southern Iran during the COVID-19 pandemic. More than half of these excess deaths were not directly related to COVID-19, but rather other causes, with cardiovascular diseases being a major contributor.

Summary

Key Message
During the first year of the COVID-19 pandemic in southern Iran, there was a notable increase in excess deaths, representing a 33.29% rise compared to expected figures. Approximately half of these excess deaths were directly attributed to COVID-19. Moreover, the pandemic heightened the risk of death across all causes by 26%, with specific age groups, notably those aged 50-64, experiencing heightened vulnerability. Notably, cardiovascular diseases emerged as a significant contributor to excess mortality during this period, while decreases were observed in deaths related to chronic respiratory diseases and cancers.

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Jeong Pil Choi, Sangwan Kim, Jung Su Park, Mi-Sook Kim, Nam-Kyong Choi, Cheol Min Shin, Joongyub Lee
Journal of Preventive Medicine and Public Health.2025; 58(1): 21. CrossRef
Lived experiences of COVID-19 survivors admitted to the respiratory intensive care unit (RICU): phenomenological study in Southern Iran
Esmaeil Barkhori Mehni, Foozieh Rafati, Mohsen Abbasi, Shideh Rafati, Sudabeh Ahmadidarrehsima
BMC Psychology.2025;[Epub] CrossRef

Vaccination Status and In-hospital Mortality Among Adults With COVID-19 in Jakarta, Indonesia: A Retrospective Hospital-based Cohort Study: Hotma Martogi Lorensi Hutapea, Pandji Wibawa Dhewantara, Anton Suryatma, Raras Anasi, Harimat Hendarwan, Mondastri Korib Sudaryo, Dwi Gayatri; J Prev Med Public Health. 2023;56(6):542-551. Published online October 30, 2023; DOI: https://doi.org/10.3961/jpmph.23.360

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Abstract Summary PDF Supplementary Material: Objectives
Prospective studies on vaccination status and mortality related to coronavirus disease 2019 (COVID-19) in low-resource settings are still limited. We assessed the association between vaccination status (full, partial, or none) and in-hospital mortality among COVID-19 patients at most hospitals in Jakarta, Indonesia during the Delta predomination wave.
Methods
We conducted a retrospective cohort study among hospitalized COVID-19 patients who met the study criteria (>18 years old and admitted for inpatient treatment because of laboratory-confirmed severe acute respiratory syndrome coronavirus 2 infection). We linked individual-level data in the hospital admission database with vaccination records. Several socio-demographic and clinical characteristics were also analyzed. A Cox proportional hazards regression model was used to explore the association between vaccination status and in-hospital mortality in this patient group.
Results
In total, 40 827 patients were included in this study. Of these, 70% were unvaccinated (n=28 543) and 19.3% (n=7882) died during hospitalization. The mean age of the patients was 49 years (range, 35-59), 53.2% were female, 22.0% had hypertension, and 14.2% were treated in the intensive care unit, and the median hospital length of stay across the group was 9 days. Our study showed that the risk of in-hospital mortality among fully and partially vaccinated patients was lower than among unvaccinated adults (adjusted hazard ratio [aHR], 0.43; 95% confidence interval [CI], 0.40 to 0.47 and aHR, 0.70; 95% CI, 0.64 to 0.77, respectively).
Conclusions
Vaccinated patients had fewer severe outcomes among hospitalized adults during the Delta wave in Jakarta. These features should be carefully considered by healthcare professionals in treating adults within this patient group.; Summary

Key Message
During the COVID-19 pandemic the Delta variant of SARS-CoV-2 was dominating and challenging. Vaccination is one of many approaches to control the pandemic. We assessed the association between vaccination status and in-hospitalized mortality in COVID-19 patients. We found that vaccination status was associated with lower mortality, and fully vaccinated patients experienced lower risk of in-hospitalized mortality compared to partially vaccinated ones.

Sleep Duration, Comorbidities, and Mortality in Korean Health Examinees: A Prospective Cohort Study: Sukhong Min, Woo-Kyoung Shin, Katherine De la Torre, Dan Huang, Hyung-Suk Yoon, Aesun Shin, Ji-Yeob Choi, Daehee Kang; J Prev Med Public Health. 2023;56(5):458-466. Published online September 26, 2023; DOI: https://doi.org/10.3961/jpmph.23.311

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Abstract Summary PDF Supplementary Material

Objectives
The association between long sleep duration and mortality is frequently attributed to the confounding influence of comorbidities. Nevertheless, past efforts to account for comorbidities have yielded inconsistent outcomes. The objective of this study was to evaluate this relationship using a large prospective cohort in Korea.
Methods
The study included 114 205 participants from the Health Examinees Study, who were followed for a median of 9.1 years. A composite comorbidity score was developed to summarize the effects of 21 diseases. Using Cox proportional hazards regression, hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause, cancer, and cardiovascular mortality associated with sleep duration were estimated. These estimates were adjusted for socio-demographic factors, lifestyle factors, body mass index, and comorbidity score. Additionally, a stratified analysis by subgroups with and without comorbidities was conducted.
Results
Throughout the follow-up period, 2675 deaths were recorded. After all adjustments, an association was observed between a sleep duration of 8 hours or more and all-cause mortality (HR, 1.10; 95% CI, 1.01 to 1.20). However, no such association was detected in the stratified analysis for the subgroups based on comorbidity status.
Conclusions
Long sleep duration was found to be associated with all-cause mortality among Koreans, even after adjusting for comorbidities. Additional studies are required to explore the mechanism underlying the association between sleep duration and major causes of mortality.

Summary

Korean summary
- 한국의 대규모 코호트 자료를 이용, 긴 수면 시간과 사망률 간의 연관성이 동반 상병으로 인한 교란 효과로 인한 것인지를 검토하였다. - 수면 시간과 총 사망률, 암 사망률, 심혈관질환 사망률 간의 연관성을 확인하였고, 이 중 총 사망률과 긴 수면 시간이 동반 상병 지수로 보정 한 뒤에도 유의한 연관성을 보였다.

Key Message
Using a large prospective cohort in Korea, the association between long sleep duration and mortality was evaluated, after adjusting for the confounding influence of comorbidities. When 114,205 participants from the Health Examinees Study were followed for a median of 9.1 years, sleep duration of 8 hours or more were found to be associated with all-cause mortality (HR, 1.10; 95% CI, 1.01 to 1.20). Additional studies are required to explore the mechanism underlying the association between sleep duration and major causes of mortality.

Citations

Citations to this article as recorded by

Imbalanced sleep increases mortality risk by 14–34%: a meta-analysis
Zoltan Ungvari, Mónika Fekete, Péter Varga, János Tibor Fekete, Andrea Lehoczki, Annamaria Buda, Ágnes Szappanos, György Purebl, Anna Ungvari, Balázs Győrffy
GeroScience.2025; 47(3): 4545. CrossRef
Non-linear association of sleep duration with osteoarthritis among U.S. middle-aged and older adults
Guoliang Ma, Bo Xu, Zhizhuang Wang, Weili Duan, Xin Chen, Liguo Zhu, Bowen Yang, Dian Zhang, Xiaokuan Qin, He Yin, Xu Wei
BMC Public Health.2024;[Epub] CrossRef

Effect Modification of Kidney Function on the Non-linear Association Between Serum Calcium Levels and Cardiovascular Mortality in Korean Adults: Jung-Ho Yang, Sun-Seog Kweon, Young-Hoon Lee, Seong-Woo Choi, So-Yeon Ryu, Hae-Sung Nam, Hye-Yeon Kim, Min-Ho Shin; J Prev Med Public Health. 2023;56(3):282-290. Published online May 31, 2023; DOI: https://doi.org/10.3961/jpmph.23.068

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Abstract Summary PDF Supplementary Material

Objectives
This study aimed to evaluate the potential interaction between kidney function and the non-linear association between serum calcium levels and cardiovascular disease (CVD) mortality.
Methods
This study included 8927 participants enrolled in the Dong-gu Study. Albumin-corrected calcium levels were used and categorized into 6 percentile categories: <2.5th, 2.5-25.0th, 25.0-50.0th, 50.0-75.0th, 75.0-97.5th, and >97.5th. Restricted cubic spline analysis was used to examine the non-linear association between calcium levels and CVD mortality. Cox proportional hazard regression was used to estimate hazard ratios (HRs) for CVD mortality according to serum calcium categories. All survival analyses were stratified by the estimated glomerular filtration rate.
Results
Over a follow-up period of 11.9±2.8 years, 1757 participants died, of whom 219 died from CVD. A U-shaped association between serum calcium and CVD mortality was found, and the association was more evident in the low kidney function group. Compared to the 25.0-50.0th percentile group for serum calcium levels, both low and high serum calcium tended to be associated with CVD mortality (<2.5th: HR, 6.23; 95% confidence interval [CI], 1.16 to 33.56; >97.5th: HR, 2.56; 95% CI, 0.76 to 8.66) in the low kidney function group. In the normal kidney function group, a similar association was found between serum calcium levels and CVD mortality (<2.5th: HR, 1.37; 95% CI, 0.58 to 3.27; >97.5th: HR, 1.65; 95% CI, 0.70 to 3.93).
Conclusions
We found a non-linear association between serum calcium levels and CVD mortality, suggesting that calcium dyshomeostasis may contribute to CVD mortality, and kidney function may modify the association.

Summary

Korean summary
- 혈중 칼슘 농도와 심혈관 질환에 의한 사망은 U자형의 비선형 연관성을 보였다. - 혈중 칼슘 농도와 심혈관 질환에 의한 사망의 비선형 연관성은 신기능이 정상인 그룹보다 신기능이 낮은 그룹에서 더 유의하게 나타났다.

Citations

Citations to this article as recorded by

Diabetes‐Specific Serum Calcium Thresholds for Mortality Risk: A NHANES Nutritional Epidemiology Study
Ling Li, Shuangyu Yang, Xiao Ran, Sudong Liu
Food Science & Nutrition.2025;[Epub] CrossRef

Determinant Factors of Mortality in Pre-elderly and Elderly Patients With COVID-19 in Jakarta, Indonesia: Thresya Febrianti, Ngabila Salama, Inggariwati , Dwi Oktavia; J Prev Med Public Health. 2023;56(3):231-237. Published online May 31, 2023; DOI: https://doi.org/10.3961/jpmph.23.008

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