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Comparative efficacy and optimal duration of first-line antibiotic regimens for acute otitis media in children and adolescents:a systematic review and network meta-analysis of 89 randomized clinicaltrials

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World Journal of Pediatrics 2024年第3期20卷 219-229页

作者： Min Seo kim Jae Han kim Seohyun Ryu Seung Won Lee Dong Keon yon Eunyoung kim Ai Koyanagi Elena Dragioti Jae Il Shin Lee Smith Samsung Advanced Institute forHealth Sciences&Technology(SAIHST) Samsung Medical CenterSungkyunkwan UniversitySeoulRepublic of Korea yonsei University Collegeof Medicine SeoulRepublicof Korea Department of Precision Medicine Sungkyunkwan University School of MedicineSuwonRepublic of Korea Center for Digital Health Medical Science Research InstituteKyung Hee University College of MedicineSeoulRepublic of Korea Evidence-Based Research Laboratory Department of Clinical Pharmacy and Pharmaceutical CareCollege of PharmacyChung-Ang UniversitySeoulRepublic of Korea Parc Sanitari Sant Joan de Deu/CIBERSAM/ISCIII Universitat de BarcelonaFundacio Sant Joan de Déu.Sant Boi de LlobregatBarcelonaSpain ICREA Pg.Lluis Companys 23BarcelonaSpain Pain and Rehabilitation Centre and Department of Medical and Health SciencesLinkoping University58185 LinkopingSweden Department of Pediatrics Yonsei University College of MedicineYonsei-ro 50Seodaemun-gu8044Seoul 03722Republic of Korea Centre for Health Performanceand WellbeingAnglia Ruskin UniversityCambridge CB11PTUK Research Laboratory Psychology of Patients Families&Health ProfessionalsDepartment of NursingSchool of Health SciencesUniversity of IoanninaIoannina 45500Greece

Introduction Antibiotic use for acute otitis media(AOM)is one of the major sources of antimicrobial resistance.However,the effective minimal antibiotic duration for AOM remains unclear.Moreover,guidelines often recommend broad ranges(5-10 days)of antibiotic use,yet the clinical impact of such a wide window has not been assessed.Methods We systematically searched PubMed/MEDLINE,Embase,Scopus,Web of Science,and Cochrane Library from database inception to 6 October 2021.Network meta-analysis was conducted on randomized controlled trials that assessed antibiotic treatment for AOM in children(PROSPERO CRD42020196107).Results For amoxicillin and amoxicillin-clavulanate,7-day regimens were noninferior to 10-day regimens in clinical responses[amoxicillin:risk ratio(RR)0.919(95%CI 0.820-1.031),amoxicillin-clavulanate:RR 1.108(0.957-1.282)],except for≤2 years.For the third-generation cephalosporins,7-day and 10-day regimens had similar clinical responses compared to placebo[7-day:RR 1.420(1.190-1.694),10-day:RR 1.238(1.125-1.362)compared to placebo].However,5-day regimens of amoxicillin-clavulanate and third-generation cephalosporins were inferior to 10-day regimens.Compared to amoxicillin,a shorter treatment duration was tolerable with amoxicillin-clavulanate.Conclusions Our findings indicated that 1O days of antibiotic use may be unnecessarily long,while the treatment duration should be longer than 5 days.Otherwise,5-day regimens would be sufficient for a modest treatment goal.Our findings revealed that the current wide range of recommended antibiotic durations may have influenced the clinical outcome of AOM,and a narrower antibiotic duration window should be re-established.

关键词： Amoxicillin-potassium Amoxicillin Antibacterial agents Cephalosporins Duration of therapy

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Prenatal and postnatal factors associated with sudden infant death syndrome:an umbrella review of meta-analyses

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World Journal of Pediatrics 2024年第5期20卷 451-460页

作者： Tae Hyeon kim Hyeri Lee Selin Woo Hayeon Lee Jaeyu Park Gullume Fond Laurent Boyer Jong Woo Hahn Jiseung Kang Dong Keon yon Department of Medicine Kyung Hee University College of MedicineSeoulSouth Korea Center for Digital Health Medical Science Research InstituteKyung Hee University College of MedicineSeoulSouth Korea Department of Regulatory Science Kyung Hee UniversitySeoulSouth Korea Department of Biomedical Engineering Kyung Hee UniversityYonginSouth Korea CEReSS-Health Service Research and Quality of Life Center Assistance Publique des Hôpitaux de MarseilleAix-Marseille UniversityMarseilleFrance Department of Pediatrics Seoul National University College of MedicineSeoulSouth Korea Department of Pediatrics Seoul National University Bundang HospitalSeongnamSouth Korea Department of Anesthesia Critical Care and Pain MedicineMassachusetts General Hospital14913th StreetRoom 4140CharlestownBostonMAUSA Division of Sleep Medicine Harvard Medical SchoolBostonMAUSA Department of Pediatrics Kyung Hee University Medical CenterKyung Hee University College of Medicine23 Kyungheedae-roDongdaemun-guSeoul02447South Korea Department of Precision Medicine Kyung Hee University College of MedicineSeoulSouth Korea

Background Comprehensive quantitative evidence on the risk and protective factors for sudden infant death syndrome(SIDS)effects is lacking.We investigated the risk and protective factors related to SIDS.Methods We conducted an umbrella review of meta-analyses of observational and interventional studies assessing SIDS-related factors.PubMed/MEDLINE,Embase,EBSCO,and Google Scholar were searched from inception until January 18,2023.Data extraction,quality assessment,and certainty of evidence were assessed by using A Measurement Tool Assessment Systematic Reviews 2 following PRISMA guidelines.According to observational evidence,credibility was graded and classified by class and quality of evidence(CE;convincing,highly suggestive,suggestive,weak,or not significant).Our study protocol was registered with PROSPERO(CRD42023458696).The risk and protective factors related to SIDS are presented as equivalent odds ratios(eORs).Results We identified eight original meta-analyses,including 152 original articles,covering 12 unique risk and protective factors for SIDS across 21 countries/regions and five continents.Several risk factors,including prenatal drug exposure[eOR=7.84(95%CI=4.81–12.79),CE=highly suggestive],prenatal opioid exposure[9.55(95%CI=4.87–18.72),CE=suggestive],prenatal methadone exposure[9.52(95%CI=3.34–27.10),CE=weak],prenatal cocaine exposure[4.38(95%CI=1.95–9.86),CE=weak],prenatal maternal smoking[2.25(95%CI=1.95–2.60),CE=highly suggestive],postnatal maternal smoking[1.97(95%CI=1.75–2.22),CE=weak],bed sharing[2.89(95%CI=1.81–4.60),CE=weak],and infants found with heads covered by bedclothes after last sleep[11.01(95%CI=5.40–22.45),CE=suggestive],were identified.On the other hand,three protective factors,namely,breastfeeding[0.57(95%CI=0.39–0.83),CE=non-significant],supine sleeping position[0.48(95%CI=0.37–0.63),CE=suggestive],and pacifier use[0.44(95%CI=0.30–0.65),CE=weak],were also identified.Conclusions Based on the evidence,we propose several risk and protective factors for SIDS.This study suggests the need

关键词： Infant Protective factor Risk factor Sudden infant death syndrome Umbrella review

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How has the disease course of pediatric ulcerative colitis changed throughout the biologics era?A comparison with the IBSEN study

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World Journal of Gastroenterology 2022年第28期28卷 3666-3681页

作者： Yiyoung Kwon Eun Sil kim yon Ho Choe Mi Jin kim Department of Pediatrics Samsung Medical CenterSeoul 06351South Korea Department of Pediatrics Kangbuk Samsung Medical CenterSeoul 03181South Korea

BACKGROUND In Korea,infliximab was approved for use in children with ulcerative colitis(UC)in October 2012.AIM To compare the clinical course of UC before and after the introduction of biological agents,and to compare with the IBSEN study.METHODS Patients under 18 years of age,who were diagnosed with UC and followed from January 2003 to October 2020,were included in the study.Group A(n=48)was followed for at least 2 years between January 2003 and October 2012,and Group B(n=62)was followed for at least 2 years between November 2012 and October 2020.We compared endoscopic remission,drug composition,relapse rate,steroidfree period,and the quality of life of each group.We plotted the clinical course of the included patients using the pediatric UC activity index score,and compared our patients with those in the IBSEN study.RESULTS After 2 years of treatment,colonoscopy evaluation revealed different outcomes in the two treatment groups.Remission was confirmed in 14 patients(29.2%)of Group A,and in 31 patients(50.0%)of Group B(P<0.012).The median cumulative corticosteroid-free period was 3.0 years in Group A and 4.4 years in Group B.Steroid-free period of Group B was significantly longer than that of Group A(P<0.001).There was a statistically significant difference between the two groups in evaluation of the relapse rate during the observation period(P<0.001).The plotted clinical course graphs of Group A showed similar proportions to the graphs in the IBSEN study.However,in Group B,the proportion of patients corresponding to curve 1(remission or mild severity after initial high activity)was high at 76%(47/62).CONCLUSION The incidence of relapse has decreased and the steroid-free period has increased after the introduction of the biological agent.The clinical course also showed a different pattern from that of IBSEN study.The active use of biological agents may change the long-term disease course in moderate to severe pediatric UC.

关键词： Colitis Ulcerative Children Infliximab Relapse Steroid

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Nationwide Trends in the Prevalence of Cigarette and E-cigarette Smoking among Korean Adults between 2014-2021:A Representative Serial Study of 1.2 Million Individuals

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Biomedical and Environmental Sciences 2023年第10期36卷 996-998页

作者： Minji kim Wonyoung Cho Jinseok Lee yong sung Choi Seung Geun Yeo Young Joo Lee Sang Youl Rhee Chanyang Min Dong Keon yon Center for Digital Health Medical Science Research InstituteKyung Hee University Medical CenterKyung Hee University College of MedicineSeoulSouth Korea Department of Regulatory Science Kyung Hee UniversitySeoulSouth Korea Department of Biomedical Engineering Kyung Hee UniversityYonginSouth Korea Department of Pediatrics Kyung Hee University Medical CenterKyung Hee University College of MedicineSeoulSouth Korea Department of Otolaryngology-Head&Neck Surgery Kyung Hee University Medical CenterKyung Hee University College of MedicineSeoulSouth Korea Department of Obstetrics and Gynecology Kyung Hee University College of MedicineSeoulSouth Korea Department of Endocrinology and Metabolism Kyung Hee University College of MedicineSeoulKorea

Both cigarette and e-cigarette use cause respiratory tract damage and related health outcomes,and potentially increase the risk of coronavirus disease 2019(COVID-19)-related symptoms[1].Since the COVID-19 pandemic,loc... 详细信息

关键词： respiratory damage legal

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Differences in Pandemic-Related Factors Associated with Alcohol and Substance Use among Korean Adolescents:Nationwide Representative Study

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Biomedical and Environmental Sciences 2023年第6期36卷 542-548页

作者： Hyunju yon Sangil Park Jung U Shin Ai Koyanagi Louis Jacob Lee Smith Chanyang Min Jinseok Lee Rosie Kwon Guillaume Fond Laurent Boyer Sunyoung kim Namwoo kim Sang Youl Rhee Jae Il Shin Dong Keon yon Ho Geol Woo Department of Medicine Kyung Hee University College of MedicineSeoulRepublic of Korea Department of Neurology Kyung Hee University Medical CenterSeoulRepublic of Korea Department of Dermatology CHA Bundang Medical CenterCHA University School of MedicineSeongnamRepublic of Korea Research and Development Unit Parc Sanitari Sant Joan de DeuCIBERSAMISCIIIBarcelonaSpain Catalan Institution for Research and Advanced Studies(ICREA) Pg.Lluis CompanysBarcelonaSpain Department of Physical Medicine and Rehabilitation Lariboisière-Fernand Widal HospitalAP-HPUniversity Paris CitéParisFrance Centre for Health Performance and WellbeingAnglia Ruskin UniversityCambridgeUK Center for Digital Health Medical Science Research InstituteKyung Hee University Medical CenterKyung Hee University College of MedicineSeoulRepublic of Korea Department of Biomedical Engineering Kyung Hee UniversityYonginRepublic of Korea Assistance Publique-Hôpitaux de Marseille(AP-HM) Aix-Marseille UniversityCEReSSHealth Service Research and Quality of Life CenterMarseilleFrance FondaMental Foundation CreteilFrance Department of Family Medicine Kyung Hee University College of MedicineSeoulRepublic of Korea Department of Psychiatry Seoul St.Mary's HospitalThe Catholic University of KoreaCollege of MedicineSeoulRepublic of Korea Department of Endocrinology and Metabolism Kyung Hee University School of MedicineSeoulRepublic of Korea Department of Pediatrics Yonsei University College of MedicineSeoulRepublic of Korea Department of Pediatrics Kyung Hee University College of MedicineSeoulRepublic of Korea

The coronavirus disease 2019(COVID-19)pandemic has raised concerns about the mental health and social well-being of youth,including its potential to increase or exacerbate substance use behaviors[1].Among adolescents,the COVID-19pandemic has resulted in limited face-to-face school contact and thus missed milestones in preventing alcohol and substance use.

关键词： Alcohol raised alcohol

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Cutaneous ciliated cyst on the anterior neck in young women: A case report

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World Journal of Clinical Cases 2020年第19期8卷 4481-4487页

作者： yon Hee kim Jihyoun Lee Department of Pathology Soonchunhyang University Seoul HospitalSeoul 04401South Korea Department of Surgery Soonchunhyang University Seoul HospitalSeoul 04401South Korea

BACKGROUND A cutaneous ciliated cyst(CCC)is a rare,benign tumor in young female adults,which is usually found on the lower extremities.CASE SUMMARY We found an uncommon location of CCC in the anterolateral cervical area and reviewed the literature.A 20-year-old female complained of a well-defined,painless,palpable mass that started several years ago.The mass was tense and movable and located at the anterolateral aspect of the neck.Imaging showed a non-enhancing round mass.Surgical excision biopsy was performed,and the cystic mass was revealed to be a CCC.CONCLUSION The rare location of CCC can be found in anterior neck area,which should be another diagnostic option for mass on anterior neck.

关键词： Head and neck neoplasms Female Young adult Subcutaneous mass Mixed tumor Mullerian Case report

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Late recurrence of papillary thyroid cancer from needle tract implantation after core needle biopsy: A case report

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World Journal of Clinical Cases 2021年第1期9卷 218-223页

作者： yon-Hee kim In-Ho Choi Jong-Eun Lee Zisun kim Sun-Wook Han sung-Mo Hur Jihyoun Lee Department of Pathology Soonchunhyang University Seoul HospitalSeoul 04401South Korea Department of Surgery Soonchunhyang University Cheonan HospitalCheonan 31151South Korea Department of Surgery Soonchunhyang University Bucheon HospitalBuchoen 14584South Korea Department ofSurgery Soonchunhyang University Seoul HospitalSeoul 04401South Korea

BACKGROUND Papillary thyroid cancer(PTC)has good prognosis so that the local recurrence or distant metastasis can occur later on the lifetime follow up.In this study,we report recurrence of PTC in subcutaneous area combined with lymph node metastasis.A suspicion of needle tract implantation after core needle biopsy was found.CASE SUMMARY A 66-year-old female patients who underwent right thyroid lobectomy for PTC complained of palpable nodule on anterior neck area.The location of the palpable nodule was not associated with her postoperative scar.After excision of the skin tumor,it was diagnosed as recurrence of PTC.Furthermore,results of subsequent imaging showed lymph node metastasis on her right cervical area.According to the previous medical records,the patient received core needle biopsy through the neck of the patient midline and hematoma was noted after the procedure.The time interval from the first diagnosis to local recurrence or metastasis to the skin and lymph nodes was ten years.As treatment,the patient underwent lymph node dissection in the right and completion thyroidectomy for radioisotope treatment.CONCLUSION Needle tract implantation can occur after core needle biopsy.Further studies are needed to compare core-needle biopsy and fine-needle aspiration.

关键词： Thyroid cancer Papillary Neoplasm seeding Biopsy Large-core needle Neoplasm recurrence Local Case report Image-guided biopsy

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Antifi brotic effects of green tea on in vitro and in vivo models of liver fibrosis

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World Journal of Gastroenterology 2009年第41期15卷 5200-5205页

作者： Hye Kyung kim Taik-Hoon Yang Hong-yon Cho Department of Food and Biotechnology Hanseo University Seosan Chungnam 356-706 South Korea Department of Food and Bio-technology College of Science and Technology Korea University Jochiwon Chungnam 339-700 South Korea

AIM: To examine the protective effect of green tea extract (GT) on hepatic fi brosis in vitro and in vivo in dimethylnitrosamine (DMN)-induced rats.METHODS: HSC-T6, a rat hepatic stellate cell line, was used as an in vitro assay system. Cell proliferation, collagen content, and type 1 collagen expression were examined in activated HSC-T6 cells. Collagen was determined by estimating the hydroxyproline content. In rats with DMN-induced hepatic fi brosis, serum aspartate aminotransferase and alanine aminotransferase concentrations, liver hydroxyproline and lipid peroxides were determined. Pathologic changes were examined by hematoxylin & eosin staining.RESULTS: GT administration prevented the development of hepatic fibrosis in the rat model of DMN-induced liver fi brosis. These results were confi rmed both by liver histology and by quantitative measurement of hepatic hydroxyproline content, a marker of liver collagen deposition. Accordingly, inhibition of proliferation, reduced collagen deposition, and type 1 collagen expression were observed in activated HSC-T6 cells following GT treatment. These results imply that GT reduced the proliferation of activated HSC and down regulated the collagen content and expression of collagen type 1, thereby ameliorating hepatic fibrosis.CONCLUSION: This study demonstrates that greentea administration can effectively improve liver fibrosis caused by DMN, and may be used as a therapeutic option and preventive measure against hepatic f ibrosis.

关键词：肝纤维化绿茶提取物体外体内天冬氨酸转氨酶模型二甲基亚硝胺胶原含量

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National trends in alcohol and substance use among adolescents from 2005 to 2021:a Korean serial cross‑sectional study of one million adolescents

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World Journal of Pediatrics 2023年第11期19卷 1071-1081页

作者： Sangil Park Hyunju yon Chae Yeon Ban Hyoin Shin Seounghyun Eum Seung Won Lee Youn Ho Shin Jung UShin Ai Koyanagi Louis Jacob Lee Smith Chanyang Min AbdullahÖzgür Yeniova So Young kim Jinseok Lee Vlasta Hadalin Rosie Kwon Min Ji Koo Guillaume Fond Laurent Boyer Sunyoung kim Jong Woo Hahn Namwoo kim Eléa Lefkir Victoire Bondeville Sang Youl Rhee Jae Il Shin Dong Keon yon Ho Geol Woo Department of Neurology Kyung Hee University Medical Center23 Kyungheedae‑roDongdaemun‑guSeoul 02447South Korea Department of Medicine Kyung Hee University College of MedicineSeoulSouth Korea Department of Precision Medicine Sungkyunkwan University School of MedicineSuwonSouth Korea Department of Pediatrics CHA Gangnam Medical CenterCHA University School of MedicineSeoulSouth Korea Department of Dermatology CHA Bundang Medical CenterCHA University School of MedicineSeongnamSouth Korea Research and Development Unit Parc Sanitari Sant Joan de DeuCIBERSAMISCIIIBarcelonaSpain Catalan Institution for Research and Advanced Studies(ICREA) Pg.Lluis CompanysBarcelonaSpain Faculty of Medicine University of Versailles Saint-Quentin-en-YvelinesMontigny‑le‑BretonneuxFrance Centre for Health Performance and WellbeingAnglia Ruskin UniversityCambridgeUK Center for Digital Health Medical Science Research InstituteKyung Hee University Medical CenterKyung Hee University College of MedicineSeoulSouth Korea Division of Gastroenterology Department of Internal MedicineFaculty of MedicineTokat Gaziosmanpaşa UniversityTokatTurkey Department of Otorhinolaryngology‑Head&Neck Surgery CHA Bundang Medical CenterCHA University School of MedicineSeongnamSouth Korea Department of Biomedical Engineering Kyung Hee UniversityYonginSouth Korea Faculty of Medicine University of LjubljanaLjubljanaSlovenia Department of Biomedical Engineering University of MichiganAnn ArborMIUSA Department of Human Biology University of TorontoTorontoONCanada AP-HM Aix-Marseille UniversityCEReSS-Health Service Research and Quality of Life CenterMarseilleFrance FondaMental Foundation CreteilFrance Department of Family Medicine Kyung Hee University College of MedicineSeoulSouth Korea Department of Pediatrics Seoul National University Bundang HospitalSeongnamSouth Korea Department of Neuropsychiatry Seoul National University HospitalSeoulSouth Korea Faculty of Medicine University of Rennes 1RennesFrance Department

Background Although previous studies have provided data on early pandemic periods of alcohol and substance use in adolescents,more adequate studies are needed to predict the trends of alcohol and substance use during recent periods,including the mid-pandemic period.This study investigated the changes in alcohol and substance use,except tobacco use,throughout the pre-,early-,and mid-pandemic periods in adolescents using a nationwide serial cross-sectional survey from South Korea.Methods Data on 1,109,776 Korean adolescents aged 13–18 years from 2005 to 2021 were obtained in a survey operated by the Korea Disease Control and Prevention Agency.We evaluated adolescents’alcohol and substance consumption prevalence and compared the slope of alcohol and substance prevalence before and during the COVID-19 pandemic to see the trend changes.We define the pre-COVID-19 period as consisting of four groups of consecutive years(2005–2008,2009–2012,2013–2015,and 2016–2019).The COVID-19 pandemic period is composed of 2020(early-pandemic era)and 2021(midpandemic era).Results More than a million adolescents successfully met the inclusion criteria.The weighted prevalence of current alcohol use was 26.8%[95%confidence interval(CI)26.4–27.1]from 2005 to 2008 and 10.5%(95%CI 10.1–11.0)in 2020 and 2021.The weighted prevalence of substance use was 1.1%(95%CI 1.1–1.2)from 2005 to 2008 and 0.7%(95%CI 0.6–0.7)between 2020 and 2021.From 2005 to 2021,the overall trend of use of both alcohol and drugs was found to decrease,but the decline has slowed since COVID-19 epidemic(current alcohol use:βdiff 0.167;95%CI 0.150–0.184;substance use:βdiff 0.152;95%CI 0.110–0.194).The changes in the slope of current alcohol and substance use showed a consistent slowdown with regard to sex,grade,residence area,and smoking status from 2005 to 2021.Conclusion The overall prevalence of alcohol consumption and substance use among over one million Korean adolescents from the early and mid-stage(2020–2021)of the COVID-19 pandemic showed a slower decline than expect

关键词： Alcohol Adolescent Corona virus disease 2019 South Korea Substance use

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Estimated prevalence and trends in smoking among adolescents in South Korea,2005-2021:a nationwide serial study

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World Journal of Pediatrics 2023年第4期19卷 366-377页

作者： Hyoin Shin Sangil Park Hyunju yon Chae Yeon Ban Stephen Turner Seong Ho Cho Youn Ho Shin Jung U.Shin Ai Koyanagi Louis Jacob Lee Smith Chanyang Min Young Joo Lee So Young kim Jinseok Lee Rosie Kwon Min Ji Koo Guillaume Fond Laurent Boyer Jong Woo Hahn Namwoo kim Sang Youl Rhee Jae Il Shin Ho Geol Woo Hyeowon Park Hyeon Jin kim Yoonsung Lee Man S.kim Eléa Lefkir Vlasta Hadalin Jungwoo Choi Seung Won Lee Dong Keon yon Sunyoung kim Department of Medicine Kyung Hee University College of MedicineSeoulSouth Korea Department of Neurology Kyung Hee University College of MedicineSeoulSouth Korea Maternity and Child Health Division NHS Grampian AberdeenAberdeenUK Division of Allergy-Immunology University of South Florida Morsani College of MedicineTampaFLUSA Department of Pediatrics CHA Gangnam Medical CenterCHA University School of MedicineSeoulSouth Korea Department of Dermatology CHA Bundang Medical CenterCHA University School of MedicineSeongnamSouth Korea Research and Development Unit Parc Sanitari Sant Joan de DeuCIBERSAMISCIIIBarcelonaSpain Catalan Institution for Research and Advanced Studies(ICREA) Pg.Lluis CompanysBarcelonaSpain Faculty of Medicine University of Versailles Saint-Quentin-en-YvelinesMontigny-Le-BretonneuxFrance Centre for Health Performance and WellbeingAnglia Ruskin UniversityCambridgeUK Center for Digital Health Medical Science Research InstituteKyung Hee University Medical CenterKyung Hee University College of Medicine23 Kyungheedae-RoDongdaemun-GuSeoul02447South Korea Department of Obstetrics and Gynecology Kyung Hee University College of MedicineSeoulSouth Korea Department of Otorhinolaryngology-Head and Neck Surgery CHA Bundang Medical CenterCHA University School of MedicineSeongnamSouth Korea Department of Biomedical Engineering Kyung Hee UniversityYonginSouth Korea Department of Biomedical Engineering University of MichiganAnn ArborMIUSA Department of Human Biology University of TorontoTorontoONCanada AP-HM Aix-Marseille Univ.CEReSS—Health Service Research and Quality of Life CenterMarseilleFrance FondaMental Foundation CreteilFrance Department of Pediatrics Seoul National University College of MedicineSeoulSouth Korea Department of Neuropsychiatry Seoul National University College of MedicineSeoulSouth Korea Department of Endocrinology and Metabolism Kyung Hee University School of MedicineSeoulSouth Korea Department of Pediatrics Yonsei University College of

Background Although smoking is classified as a risk factor for severe COVID-19 outcomes,there is a scarcity of studies on prevalence of smoking during the COVID-19 pandemic.Thus,this study aims to analyze the trends of prevalence of smoking in adolescents over the COVID-19 pandemic period.Methods The present study used data from middle to high school adolescents between 2005 and 2021 who participated in the Korea Youth Risk Behavior Web-based Survey(KYRBS).We evaluated the smoking prevalence(ever or daily)by year groups and estimated the slope in smoking prevalence before and during the pandemic.Results A total of 1,137,823 adolescents participated in the study[mean age,15.04 years[95%confidence interval(CI)15.03-15.06];and male,52.4%(95%CI 51.7-53.1)].The prevalence of ever smokers was 27.7%(95%CI 27.3-28.1)between 2005 and 2008 but decreased to 9.8%(95%CI 9.3-10.3)in 2021.A consistent trend was found in daily smokers,as the estimates decreased from 5.4%(95%CI 5.2-5.6)between 2005 and 2008 to 2.3%(95%CI 2.1-2.5)in 2021.However,the downward slope in the overall prevalence of ever smokers and daily smokers became less pronounced in the COVID-19 pandemic period than in the pre-pandemic period.In the subgroup with substance use,the decreasing slope in daily smokers was significantly more pronounced during the pandemic than during the pre-pandemic period.Conclusions The proportion of ever smokers and daily smokers showed a less pronounced decreasing trend during the pandemic.The findings of our study provide an overall understanding of the pandemic's impact on smoking prevalence in adolescents.

关键词： Adolescent COVID-19 Daily smokers Ever smokers Pandemic Smoking

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