We read with great interest in a recent article by Liu, et al. 1 on the clinical and CT findings of pregnant patients and children with COVID-19. It is clinically oriented, and of great value to the medical workers on the frontline. It revealed that the clinical symptoms of pregnant women were atypical, despite unavailable data about pregnancy outcome in the study. We mainly focused on the pregnancy outcome in patients with COVID-19. It seems that SARS-CoV-2 would be more friendly than its members of the coronavirus family, 2 such as SARS-CoV-1 and MERS-CoV, which caused severe maternal and neonatal complications. 3 Currently, it is too early yet to explicitly determine the effects of SARS-CoV-2 on pregnant women and their fetuses. 4 Here we explored the impact on pregnancy in patients with COVID-19 from multiple medical centers outside Wuhan, China.We retrospectively analyzed data from 8 pregnant patients who were laboratory-confirmed from January 24 to February 19, 2020. A detailed analysis of clinical features was shown in Table 1 . The age range was 27-33 years. Two (20%) patients had uterine scarring and one patient was twin pregnancy. Five patients (62.5%) developed mild symptoms; three patients (37.5%) showed severe or critical illness requiring ICU admission, one of which undergone ECMO support; four patients (50%) were performed emergency deliveries because of fetal distress or premature rupture of the membrane (PROM). Specially, patient 6 with twin pregnancy had preeclampsia with high blood pressure of 180/100 mmHg and later developed into eclampsia; patient 7 presented with mild symptoms at first and her condition deteriorated rapidly within 6 h after admission, with severe complications including septic shock, septic cardiomyopathy, ARDS, MODS, requiring intubation and mechanical ventilation. Six livebirths and one stillbirth were analyzed. Half of the

Children hospitalized for coronavirus disease 2019 (COVID-19): A multicenter retrospective descriptive study Dear editor: We read with interest the article by Dr. Song R and colleagues in the Journal of Infection titled "Clinical and epidemiological features of COVID-19 family clusters in Beijing, China." 1 , published online in April 2020. The authors presented the epidemiological and clinical features of the clusters of four families and found that SARS-CoV-2 is transmitted quickly in the form of family clusters. Children in the families generally showed milder symptoms. As of April 28, 2020, the coronavirus disease 2019 (COVID-19) caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been responsible for more than 3.05 million confirmed cases around the world. Early evidence showed that children seemed to be escaping the worst effects of the SARS-Cov-2. 2 However, a recent study indicated children with SARS-CoV-2 infection could be detected in early January 2020 in Wuhan. 3 Another study reported that children are as susceptible to COVID-19 as adults. 4 As the number of children infected with COVID-19 gradually increases, the disease has been documented in infants, children and adolescents, however, limited reports analyzed pediatric patients with COVID-19. Although a recent review has summarized the clinical features and management of infected children, 5 the spectrum of disease of children outside Wuhan are still limited. Therefore, we included 46 children (≤18 years of age) hospitalized with positive real-time fluorescence polymerase chain reaction (RT-PCR) results of throat swabs were included from four tertiary-care hospitals in Guangdong, Hunan, and Hubei Provinces, China between January 20, 2020 and March 9, 2020. Demographic data and clinical features are summarized in Table 1. Details of the laboratory, chest radiological findings and treatment are provided in Supplementary Tables 1-2 and Figure 1. All 46 children cases were non-severe by clinical examination. 29 children (63%) were male, with a median age of 8 years (interquartile range, 4-14 years; range, 7 months to 18 years). 32 children (70%) had at least one infected family member, indicating pediatric patients acquired infections mainly through close contact with their parents or other family members who lived in Wuhan, or had visited there. Unlike adults, no children in this study had comorbidities. 22 children (48%) were asymptomatic at the onset. The most common clinical symptoms were dry cough [12 children (26%)] and fever [eight children (17%)] accompanied by other upper respiratory symptoms, such as nasal congestion and runny nose. Our children cases had no gastrointestinal symptoms, such as nausea, vomiting, and diarrhea. No children had leukopenia and lymphopenia. 20 children (43%) had chest imaging abnormalities, such as unilateral nodular or patchy ground-glass opacities. Recent studies questioned the role of chest CT in the diagnosis of COVID-19 because of biologic

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Abstract. The aim of the present study was to investigate the effect of heart rate (HR) on the diagnostic accuracy of 256-slice computed tomography angiography (CTA) in the detection of coronary artery stenosis. Coronary imaging was performed using a Philips 256-slice spiral CT, and receiver operating characteristic (ROC) curve analysis was conducted to evaluate the diagnostic value of 256-slice CTA in coronary artery stenosis. The HR of the research subjects in the study was within a certain range (39-107 bpm). One hundred patients suspected of coronary heart disease underwent 256-slice CTA examination. The cases were divided into three groups: Low HR (HR <75 bpm), moderate HR (75≤ HR <90 bpm) and high HR (HR ≥90 bpm). For the three groups, two observers independently assessed the image quality for all coronary segments on a four-point ordinal scale. An image quality of grades 1-3 was considered diagnostic, while grade 4 was non-diagnostic. A total of 97.76% of the images were diagnostic in the low-HR group, 96.86% in the moderate-HR group and 95.80% in the high-HR group. According to the ROC curve analysis, the specificity of CTA in diagnosing coronary artery stenosis was 98.40, 96.00 and 97.60% in the low-, moderate-and high-HR groups, respectively. In conclusion, 256-slice coronary CTA can be used to clearly show the main segments of the coronary artery and to effectively diagnose coronary artery stenosis. Within the range of HRs investigated, HR was found to have no significant effect on the diagnostic accuracy of 256-slice coronary CTA for coronary artery stenosis.