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
At the early stage of public health emergencies, when the conventional medical reserves prepared are insufficient, and productivity could temporarily not meet the surge in demand, donations can be used to cover excess demand for medical supplies to a large extent. This paper explicitly considers the allocation problem of limited medical reserves during a public health emergency, incorporating uncertainty in demand and donated supplies and the priorities of health care centers. The problem is formulated as a two-stage stochastic program that regards the donated supplies as an efficient recourse action, aiming to minimize the total losses. The optimal allocation strategy of limited medical reserves and donations is obtained by solving the model using Gurobi solver. Finally, the effectiveness of the proposed approach is verified by a series of computational results, which show that the solutions of our method not only benefit the emergency demand fulfill rate but reduce the total losses as well.
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