In 2020, the global spread of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection (also known as COVID-19) has led to pandemic health issues with significant changes in individual and community practices. Preterm birth could be one of the risks in pregnant mothers who are infected by the SARS-CoV-2. Preterm births contribute upto 10% of all births and incur significant impact on the child health and cost to the health care system. However, the association of city lockdown during COVID-19 pandemic with the rate of preterm births is unclear. In a cohort study, we examined the association of city lockdown during the COVID-19 pandemic with the births at different gestations in three different cities. Compared with the pre-pandemic epoch, the associative relationships ranged from a decrease in all births, all births across all preterm gestations and to preterm births in moderately and late preterm gestations. We concluded that there were variable associative relationships of city lockdown during COVID-19 pandemic with preterm births. This could be related to the differences in health, societal and cultural factors, which will inspire further studies in this area.

Background: Myocardial injury is a life-threatening complication of coronavirus disease 2019 (COVID-19). Pre-existing health conditions and early morphological alterations may precipitate cardiac injury and dysfunction after contracting the virus. The current study aimed at assessing potential risk factors for COVID-19 cardiac complications in patients with pre-existing conditions and imaging predictors. Methods and Results: The multi-center, retrospective cohort study consecutively enrolled 400 patients with lab-confirmed COVID-19 in six Chinese hospitals remote to the Wuhan epicenter. Patients were diagnosed with or without the complication of myocardial injury by history and cardiac biomarker Troponin I/T (TnI/T) elevation above the 99th percentile upper reference limit. The majority of COVID-19 patients with myocardial injury exhibited pre-existing health conditions, such as hypertension, diabetes, hypercholesterolemia, and coronary disease. They had increased levels of the inflammatory cytokine interleukin-6 and more in-hospital adverse events (admission to an intensive care unit, invasive mechanical ventilation, or death). Chest CT scan on admission demonstrated that COVID-19 patients with myocardial injury had higher epicardial adipose tissue volume ([EATV] 139.1 (83.8-195.9) vs. 92.6 (76.2-134.4) cm2; P = 0.036). The optimal EATV cut-off value (137.1 cm2) served as a useful factor for assessing myocardial injury, which yielded sensitivity and specificity of 55.0% (95%CI, 32.0-76.2%) and 77.4% (95%CI, 71.6-82.3%) in adverse cardiac events, respectively. Multivariate logistic regression analysis showed that EATV over 137.1 cm2 was a strong independent predictor for myocardial injury in patients with COVID-19 [OR 3.058, (95%CI, 1.032-9.063); P = 0.044]. Conclusions: Augmented EATV on admission chest CT scan, together with the pre-existing health conditions (hypertension, diabetes, and hyperlipidemia) and inflammatory cytokine production, is associated with increased myocardial injury and mortality in COVID-19 patients. Assessment of pre-existing conditions and chest CT scan EATV on admission may provide a threshold point potentially useful for predicting cardiovascular complications of COVID-19.

Background: The COVID-19 pandemic is a major public health issue and challenge to health professionals. In similar epidemics, nurses experienced more distress than other providers. Methods: We surveyed both on-duty nurses caring for infected patients and second-line nurses caring for uninfected patients from Hubei and other provinces throughout China. Results: We received completed surveys from 1,364 nurses from 22 provinces: 658 front-line and 706 second-line nurses. The median (IQR) GHQ-28 score of all nurses was 17 (IQR 11-24). The overall incidence of mild-to-moderate distress (GHQ score > 5) was 28%; that for severe distress (GHQ score > 11) was 6%. The incidence of mild-to-moderate distress in the second-line nurses was higher than that in the front-line nurses (31 vs. 25%; OR, 0.74; 95 CI, 0.58-0.94). Living alone (OR, 0.62; 95% CI, 0.44-0.86) and feeling supported (OR, 0.82, 95% CI, 0.74-0.90) independently predicted lower anxiety. Conclusions: During the COVID-19 pandemic, the psychological problems of all nurses were generally serious. The interviewed second-line nurses face more serious issues than the front-line nurses.

Aim: To characterize the impact of the German strategy for containment of Coronavirus SARS-CoV-2 (social distancing and lockdown) on the training, other habitual physical activity, and sleep in highly trained kayakers and canoeists. Method: During the 4 weeks immediately prior to and following the beginning of the German government\'s strategy for containment of Coronavirus SARS-CoV-2 on March 23, 2020, 14 highly trained athletes (VO2peak: 3,162 ± 774 ml/min; 500-m best time: 117.9 ± 7.9 s) wore a multi-sensor smartwatch to allow continuous assessment of heart rate, physical activity, and sleep duration. Result: In comparison to before lockdown, the overall weekly training time and the average length of each session of training during the lockdown decreased by 27.6% (P = 0.02; d = 0.91) and 15.4% (P = 0.36; d = 0.36), respectively. At the same time, the number of sessions involving specific (i.e., canoeing and kayaking) and non-specific (i.e., running, cycling) training, respectively, did not change (P = 0.36-0.37; d = 0.34-0.35). The number of sessions involving strength (+17.4%; P = 0.03; d = 0.89) or other types of training (+16.7%; P = 0.06; d = 0.75) increased during the lockdown with 2.8-17.5% more training time involving a heart rate <60%, 82-88, 89-93, or 94-100% of individual peak heart rate (HRpeak) (P = 0.03-0.86; d = 0.07-1.38), and 4.3-18.7% less time with a heart rate of 60-72 or 73-83% HRpeak (P = < 0.001-0.0.26; d = 0.44-2.24). The daily duration of sleep was ~30 min (6.7%) longer during the lockdown (P < 0.001; d = 1.53) and the overall time spent lying down was 17% greater (P < 0.001; d = 2.26); whereas sitting time (-9.4%; P = 0.003; d = 1.23), the duration of light (15 min; -7.3%; P = 0.04; d = 0.83), and moderate (-18.6%; P = 0.01; d = 1.00) physical activity other than training (-9.4%; P = 0.22; d = 0.00) were all lower during lockdown. Conclusion: The present data revealed that following the German lockdown for containment of the Coronavirus SARS-CoV-2, highly trained kayakers and canoeists spent less overall time training each week (-27.6%) with, on average, shorter training sessions (-15.1%) and less light-to-moderate physical activity outside of training. Moreover, they performed more strength training sessions per week, and all engaged in more training at intensities >82 and <60% of HRpeak and spent longer periods lying down and sleeping during the lockdown.

Ever since SARS-CoV-2 began infecting people by the end of 2019, of whom some developed severe pneumonia (about 5%), which could be fatal (case fatality ~3.5%), the extent and speed of the COVID-19 outbreak has been phenomenal. Within 2.5 months (by March 18, 2020) over 191,127 COVID-19 patients have been identified in 161 countries. By then, over 700 pediatric patients were confirmed to have COVID-19 in China, with only about 58 diagnosed elsewhere. By now, there are thousands of children and adolescents infected. Chinese pediatricians would like to share their experience on how these patients were managed in China and the key recommendations that had guided them in meeting the evolving challenges. A group of experts were summoned by the Chinese Pediatric Society and Editorial Board of Chinese Journal of Pediatrics to extract informative data from a survey on confirmed COVID-19 pediatric patients in China. Consensus on diagnosis, management, and prevention of pediatric COVID-19 were drawn up based on the analysis of such data plus insights gained from the past SARS and MERS coronavirus outbreaks. Relevant cumulating experiences from physicians managing adult patients, expedited reports on clinical and scientific COVID-19 and SARS-CoV-2 data, and the National Health Committee guidelines on COVID-19 management were integrated into this proposal.

Asthma is a prevalent pediatric disease causing important health, economic, and emotional burdens around the world. Asthma attacks can be controlled with standardized management, but no cure exists for the disease. Many attacks are triggered by respiratory tract infections and children with basic airway diseases are at high risk for developing severe or critical illnesses. The new COVID-19 pandemic threatens to disrupt children\'s asthma control management and we have set out to summarize the main factors that need to be considered by pediatricians treating children with asthma at times like these. We discuss the intrinsic nature of asthma and its treatment, and the effects of irregular treatment giving recommendations such as the use of the WeChat platform and WeChat Official Accounts for follow-ups to improve children\'s asthma compliance during the pandemic. We also cover the COVID-19 protection strategies, and the importance of stress reduction, a balanced diet, exercise, and the avoidance of known attack triggers for maintaining good control of asthma during the pandemic.