Background In December, 2019, coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in Wuhan, China. The number of affected pregnant women is increasing, but scarce information is available about the clinical features of COVID-19 in pregnancy. This study aimed to clarify the clinical features and obstetric and neonatal outcomes of pregnant patients with COVID-19. MethodsIn this retrospective, single-centre study, we included all pregnant women with COVID-19 who were admitted to Tongji Hospital in Wuhan, China. Clinical features, treatments, and maternal and fetal outcomes were assessed.Findings Seven patients, admitted to Tongji Hospital from Jan 1, to Feb 8, 2020, were included in our study. The mean age of the patients was 32 years (range 29-34 years) and the mean gestational age was 39 weeks plus 1 day (range 37 weeks to 41 weeks plus 2 days). Clinical manifestations were fever (six [86%] patients), cough (one [14%] patient), shortness of breath (one [14%] patient), and diarrhoea (one [14%] patient). All the patients had caesarean section within 3 days of clinical presentation with an average gestational age of 39 weeks plus 2 days. The final date of followup wasFeb 12, 2020. The outcomes of the pregnant women and neonates were good. Three neonates were tested for SARS-CoV-2 and one neonate was infected with SARS-CoV-2 36 h after birth.Interpretation The maternal, fetal, and neonatal outcomes of patients who were infected in late pregnancy appeared very good, and these outcomes were achieved with intensive, active management that might be the best practice in the absence of more robust data. The clinical characteristics of these patients with COVID-19 during pregnancy were similar to those of non-pregnant adults with COVID-19 that have been reported in the literature.

Colorectal cancer (CRC) has emerged as a major public health concern in China during the last decade. In this study, we investigated the disease burden posed by CRC and analyzed temporal trends in CRC incidence and mortality rates in this country. We collected CRC incidence data from the Cancer Incidence in Five Continents, Volume XI dataset and the age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR) of CRC by sex and age, from the 2016 Global Burden of Diseases Study. We used the average annual percentage change (AAPC) to quantify temporal trends in CRC incidence and mortality from 1990 to 2016 and found the ASIR of CRC increased from 14.25 per 100,000 in 1990 to 25.27 per 100,000 in 2016 (AAPC = 2.34, 95% confidence interval [CI] 2.29, 2.39). Cancer cases increased from 104.3 thousand to 392.8 thousand during the same period. The ASIR increased by 2.76% (95% CI 2.66%, 2.85%) and 1.70% (95% CI 1.64%, 1.76%) per year in males and females, respectively. The highest AAPC was found in people aged 15–49 years (2.76, 95% CI 2.59, 2.94). Cancer deaths increased from 81.1 thousand in 1990 to 167.1 thousand in 2016, while the ASMR remained stable (−0.04, 95% CI −0.13, 0.05), A mild increase (AAPC = 0.42, 95% CI 0.34, 0.51) was found among males and a significant decrease (AAPC = −0.75, 95% CI −0.90, −0.60) was found among females. Between 2016 and 2025, cancer cases and deaths are expected to increase from 392.8 and 167.1 thousand in 2016 to 642.3 (95% CI 498.4, 732.1) and 221.1 thousand (95% CI 122.5, 314.8) in 2025, respectively. Our study showed a steady increase in the CRC incidence in China over the past three decades and predicted a further increase in the near future. To combat this health concern, the prevention and management of known risk factors should be promoted through national polices. Greater priority should be given to CRC prevention in younger adults, and CRC screening should be widely adopted for this population.

The coronavirus disease 2019 (COVID-19) pandemic remains threatening to women and children, but clinical evidence regarding women during pregnancy, puerperium and lactation is limited. We assessed clinical and immunologic features of and breastfeeding advice provided to mother–infant pairs. This observational analysis was conducted in a tertiary-care centre in Wuhan, China. Pregnant patients with laboratory-confirmed COVID-19 who delivered during hospitalization were enrolled. Clinical characteristics and serial specimens of the mother–infant pairs were examined, supplemented with follow-ups regarding recovery and breastfeeding. Fourteen pregnant patients had live births and recovered well; four patients continued breastfeeding while taking precautions. No neonatal infections were observed. No infants developed COVID-19 during breastfeeding. Common maternal symptoms were fever (11/14, 78.1%) and cough (6/14, 42.9%). A pregnancy-specific symptom was abnormal foetal movement, which was noticed by three patients (21.4%). The mean virus shedding time was 9 days (standard deviation, 6 days; range, 1–22 days). The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) genome was not detected in breast milk or maternal vaginal secretions. Immunologic assay revealed seroconversion of IgM on day 8 after onset and IgG on day 28. Both IgM and IgG antibodies to SARS-CoV-2 were detected in breast milk, cord blood and neonatal serum. The study results suggest that passive acquisition of antibodies against SARS-CoV-2 is available by ingesting breast milk. Breastfeeding has a low risk of transmitting SARS-CoV-2 or escalating maternal disease, so continuing breastfeeding with prudent precautions is encouraged.