Background The outbreak of Corona Virus Disease-2019 (COVID-19) has posed unprecedented pressure and threats to healthcare workers in Wuhan and the entire country. Aims To assess the effect of the COVID-19 outbreak on the sleep quality of healthcare workers in a children’s healthcare centre in Wuhan. Methods A cross-sectional, anonymized, self-reported questionnaire survey was conducted at the Children’s Healthcare Centre of Renmin Hospital, Wuhan University, Wuhan, China. The questionnaire consisted of three parts, including socio-demographic characteristics and COVID-19 epidemic-related factors, the Pittsburgh sleep quality index (PSQI), and Zung’s self-rating anxiety scale (SAS) and self-rating depression scale (SDS). Results In total, 47 out of 123 (38%) participants with PSQI scores > 7 were identified as having sleep disturbance. A logistic regression analysis showed that sleep disturbance was independently associated with being an only child (adjusted odds ratio (OR) and 95% confidence interval (CI) 3.40 (1.21–9.57), P < 0.05), exposure to COVID-19 patients (adjusted OR and 95% CI 2.97 (1.08–8.18), P < 0.05) and depression (adjusted OR and 95% CI 2.83 (1.10–7.27), P < 0.05). Conclusions We observed that, during the outbreak of COVID-19, sleep disturbance was highly prevalent among paediatric healthcare workers, and sleep disturbance was independently associated with being an only child, exposure to COVID-19 patients and depression. Therefore, more mental health services are required for front-line paediatric healthcare workers in Wuhan.

Distribution of SARS-CoV-2 virus and pathological features of multiple organs in COVID-19 patients remains unclear, which interferes with the improvement of COVID-19 diagnosis and treatment. In this article, we summarize the pathological findings obtained from systematic autopsy (37 cases) and percutaneous multiple organ biopsy (“minimally invasive autopsy”, 54 cases). These findings should shed light on better understanding of the progression of COVID-19 infection and the means of more effective intervention.

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Systematic autopsy and comprehensive pathological analyses of COVID-19 decedents should provide insights into the disease characteristics and facilitate the development of novel therapeutics. In this study, we report the autopsy findings from the lungs and lymphatic organs of twelve COVID-19 decedents that evaluated histopathological changes, immune cell signature, and inflammatory factor expression in the lungs, spleen, and lymph nodes. Here we show that the major pulmonary alternations included diffuse alveolar damage, interstitial fibrosis, and exudative inflammation featured with extensive serous and fibrin exudates, macrophage infiltration, and abundant production of inflammatory factors (IL-6, IP-10, TNFα and IL-1β). The spleen and hilar lymph nodes contained lesions with tissue structure disruption and immune cell dysregulation, including lymphopenia and macrophage accumulation. These findings provide pathological evidence that links injuries of the lungs and lymphatic organs with the fatal systematic respiratory and immune malfunction in critically ill COVID-19 patients.