Rui Nie

ABSTRACT BACKGROUND There is little information about the coronavirus disease 2019 (Covid-19) during pregnancy. This study aimed to determine the clinical features and the maternal and neonatal outcomes of pregnant women with Covid-19. METHODS In this retrospective analysis from five hospitals, we included pregnant women with Covid-19 from January 1 to February 20, 2020. The primary composite endpoints were admission to an intensive care unit (ICU), the use of mechanical ventilation, or death. Secondary endpoints included the clinical severity of Covid-19, neonatal mortality, admission to neonatal intensive care unit (NICU), and the incidence of acute respiratory distress syndrome (ARDS) of pregnant women and newborns. RESULTS Thirty-three pregnant women with Covid-19 and 28 newborns were identified. One (3%) pregnant woman needed the use of mechanical ventilation. No pregnant women admitted to the ICU. There were no moralities among pregnant women or newborns. The percentages of pregnant women with mild, moderate, and severe symptoms were 13 (39.4%),19(57.6%), and 1(3%). One (3.6%) newborn developed ARDS and was admitted to the NICU. The rate of perinatal transmission of SARS-CoV-2 was 3.6%. CONCLUSIONS This report suggests that pregnant women are not at increased risk for severe illness or mortality with Covid-19 compared with the general population. The SARS-CoV-2 infection during pregnancy might not be associated with as adverse obstetrical and neonatal outcomes that are seen with the severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV) infection during pregnancy. (Funded by the National Key Research and Development Program.)

BACKGROUND: Data on clinical, laboratory, and radiographic characteristics and risk factors for in-hospital mortality of lung cancer patients with COVID-19 are scarce. Here, we aimed to characterize the early clinical features of lung cancer patients with COVID-19 and identify risk factors associated with in-hospital mortality. METHODS: All consecutive lung cancer patients with laboratory-confirmed COVID-19 admitted to 12 hospitals in Hubei province, China, from 3 January to 6 May 2020 were included in the study. Patients without definite clinical outcomes during the period were excluded. Data on initial clinical, laboratory and radiographic findings were compared between survivors and nonsurvivors. Univariable and multivariable logistic regression analyses were used to explore the risk factors associated with in-hospital mortality. RESULTS: Of the 45 lung cancer patients (median [interquartile range] age, 66 [58-74] years; 68.9% males) included, 34 (75.6%) discharged and 11 (24.4%) died. Fever (73.3%) and cough (53.3%) were the dominant initial symptoms, and respiratory symptoms were common. Lung cancer patients also presented atypical appearances of COVID-19. In the multivariable analysis, prolonged prolongation prothrombin time (PT) (OR = 2.1, 95% CI: 1.00-4.41, P = 0.0497) and elevated high sensitivity cardiac troponin I (hs-TNI) (OR = 7.65, 95% CI: 1.24-47.39, P = 0.0287) were associated with an increased risk of in-hospital mortality. CONCLUSIONS: Lung cancer patients with COVID-19 have high in-hospital mortality. Prolonged PT and elevated hs-TNI are independent risk factors for in-hospital mortality of lung cancer patients with COVID-19. KEY POINTS: SIGNIFICANT FINDINGS OF THE STUDY: Lung cancer patients with COVID-19 have atypical early symptoms and imaging features. The prolonged prothrombin time and elevated high sensitivity cardiac troponin I are independent risk factors for in-hospital mortality of lung cancer patients with COVID-19. WHAT THIS STUDY ADDS: This study characterizes the early clinical features of lung cancer patients with COVID-19 in China, and identifies the risk factors associated with in-hospital mortality of lung cancer patients with COVID-19.

OBJECTIVE: To determine the optimum rescue time by comparison of results of rescue intracytoplasmic sperm injection (ICSI). STUDY DESIGN: A total of 112 couples of total fertilization failure, who had retrieved at least four mature oocytes, were prospectively randomized into two groups: the earlier rescue group, rescue ICSI performed between 4 and 6 hours after insemination, and the control group, rescue ICSI performed between 6 and 8 hours after insemination. RESULTS: There were no statistically significant differences in woman's age, duration of infertility, number of oocytes retrieved every cycle, and number of embryos transferred every cycle between the two groups. The normal fertilization rate of the earlier rescue group was increased compared with that of control group (63.1% vs. 55.7%, p < 0.05), whereas the abnormal fertilization rate in the earlier rescue group was decreased compared with control group (3.5% vs. 6.2%, p < 0.05). There was a trend suggesting an increase in the clinical pregnancy rate and implantation rate in the earlier rescue group compared with control group, though this failed to be significantly different. CONCLUSION: Rescue ICSI is an effective method of eliminating totalfertilization failure. Rescue ICSI performed earlier could result in a better pregnancy rate in this select group of patients.