J Korean Med Sci.  2023 Dec;38(47):e408. 10.3346/jkms.2023.38.e408.

Nationwide Trends in Non-COVID-19 Infectious Disease Laboratory Tests in the Era of the COVID-19 Pandemic in Korea

• Kim SB
• Kim YE
• Bang T
• Hong M
• Radnaabaatar M
• Huh K
• Hong KH
• Jung J

• KMID: 2548807
• DOI: http://doi.org/10.3346/jkms.2023.38.e408

Abstract

The coronavirus disease 2019 pandemic has brought significant changes to infectious disease management globally. This study explored changes in clinical microbiological testing trends and their implications for infectious disease incidence and medical utilization during the pandemic. We collected nationwide claims for monthly clinical microbiology tests from January 2018 to March 2022 using the National Health Insurance Service database. Seasonal autoregressive integrated moving average models were employed to make predictions for each disease based on the baseline period (January 2018 to January 2020). The results showed a significant decrease in general bacterial and fungal cultures, respiratory infectious diseaserelated, and inflammatory markers, while the representatives of tests for vector-borne diseases, healthcare-associated infections, and chronic viral infections remained stable. The study highlights the potential of clinical microbiological testing trends as an additional surveillance tool and offers implications for future infectious disease management and surveillance strategies in pandemic settings.

Keyword

Clinical Laboratory Testing; Epidemiological Monitoring; Pandemics

Figure

• 

  Fig. 1 Monthly changes in the number of tests before and after COVID-19, with a two-year forecast presented without COVID-19. (A) IgM, Mycoplasma; (B) Urine antigen, Legionella; (C) PCR, Tuberculosis; (D) IGRA for Tuberculosis; (E) ESR; (F) CRP; (G) ASO, Quantitative; (H) Procalcitonin; (I) Culture and AST; (J) Culture and AST including anaerobes; (K) Gram stain; (L) Antibody, Leptospira; (M) Antibody, Scrub typhus; (N) Antibody, Hantavirus; (O) HBsAg; (P) Antibody, HCV; (Q) Antibody, HIV; (R) PCR, CMV; (S) PCR, EBV; (T) Toxin, Clostridioides difficile; (U) Urease test for Helicobacter pylori.COVID-19 = coronavirus disease 2019, PCR = polymerase chain reaction, IGRA = interferon gamma release assay, ESR = erythrocyte sedimentation rate, CRP = C-reactive protein, ASO = anti-streptolysin O, AST = antimicrobial susceptibility test, HBsAg = hepatitis B virus surface antigen, HCV = hepatitis C virus, HIV = human immunodeficiency virus, CMV = human cytomegalovirus, EBV = Epstein-Barr virus.

Reference

1. Downey LE, Gadsden T, Vilas VD, Peiris D, Jan S. The impact of COVID-19 on essential health service provision for endemic infectious diseases in the South-East Asia region: a systematic review. Lancet Reg Health Southeast Asia. 2022; 1:100011. PMID: 35769109.

2. Min KD, Kang H, Lee JY, Jeon S, Cho SI. Estimating the effectiveness of non-pharmaceutical interventions on COVID-19 control in Korea. J Korean Med Sci. 2020; 35(35):e321. PMID: 32893522.

3. Yang B, Huang AT, Garcia-Carreras B, Hart WE, Staid A, Hitchings MD, et al. Effect of specific non-pharmaceutical intervention policies on SARS-CoV-2 transmission in the counties of the United States. Nat Commun. 2021; 12(1):3560. PMID: 34117244.

4. Geng MJ, Zhang HY, Yu LJ, Lv CL, Wang T, Che TL, et al. Changes in notifiable infectious disease incidence in China during the COVID-19 pandemic. Nat Commun. 2021; 12(1):6923. PMID: 34836947.

5. Wang P, Xu Y, Su Z, Xie C. Impact of COVID-19 pandemic on influenza virus prevalence in children in Sichuan, China. J Med Virol. 2023; 95(1):e28204. PMID: 36217691.

6. Huh K, Kim YE, Ji W, Kim DW, Lee EJ, Kim JH, et al. Decrease in hospital admissions for respiratory diseases during the COVID-19 pandemic: a nationwide claims study. Thorax. 2021; 76(9):939–941. PMID: 33782081.

7. Huh K, Jung J, Hong J, Kim M, Ahn JG, Kim JH, et al. Impact of nonpharmaceutical interventions on the incidence of respiratory infections during the coronavirus disease 2019 (COVID-19) outbreak in Korea: a nationwide surveillance study. Clin Infect Dis. 2021; 72(7):e184–e191. PMID: 33150393.

8. Yun HE, Ryu BY, Choe YJ. Impact of social distancing on incidence of vaccine-preventable diseases, South Korea. J Med Virol. 2021; 93(3):1814–1816. PMID: 33079384.

9. Kim DH, Nguyen TM, Kim JH. Infectious respiratory diseases decreased during the COVID-19 pandemic in South Korea. Int J Environ Res Public Health. 2021; 18(11):6008. PMID: 34205018.

10. Shi HJ, Kim NY, Eom SA, Kim-Jeon MD, Oh SS, Moon BS, et al. Effects of non-pharmacological interventions on respiratory viruses other than SARS-CoV-2: analysis of laboratory surveillance and literature review from 2018 to 2021. J Korean Med Sci. 2022; 37(21):e172. PMID: 35638198.

11. Kang JM, Kim YE, Huh K, Hong J, Kim DW, Kim MY, et al. Reduction in Kawasaki disease after nonpharmaceutical interventions in the COVID-19 era: a nationwide observational study in Korea. Circulation. 2021; 143(25):2508–2510. PMID: 34092115.

12. Wang X, Xu H, Chu P, Zeng Y, Tian J, Song F, et al. Effects of COVID-19-targeted nonpharmaceutical interventions on children’s respiratory admissions in China: a national multicenter time series study. Int J Infect Dis. 2022; 124:174–180. PMID: 36241166.