Coronavirus disease 2019 (COVID-19) pandemic may exert adverse impacts on sleep among populations, which may raise awareness of the burden of sleep disturbance, and the demand of intervention strategies for different populations. We aimed to summarize the current evidence for the impacts of COVID-19 on sleep in patients with COVID-19, healthcare workers (HWs), and the general population. We searched PubMed and Embase for studies on the prevalence of sleep disturbance. Totally, 86 studies were included in the review, including 16 studies for COVID-19 patients, 34 studies for HWs, and 36 studies for the general population. The prevalence of sleep disturbance was 33.3%–84.7%, and 29.5–40% in hospitalized COVID-19 patients and discharged COVID-19 survivors, respectively. Physiologic and psychological traumatic effects of the infection may interact with environmental factors to increase the risk of sleep disturbance in COVID-19 patients. The prevalence of sleep disturbance was 18.4–84.7% in HWs, and the contributors mainly included high workloads and shift work, occupation-related factors, and psychological factors. The prevalence of sleep disturbance was 17.65–81% in the general population. Physiologic and social-psychological factors contributed to sleep disturbance of the general population during COVID-19 pandemic. In summary, the sleep disturbance was highly prevalent during COVID-19 pandemic. Specific health strategies should be implemented to tackle sleep disturbance.

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there are few reports on the lymph nodes of entrance point to recurrent laryngeal nerve (Ln-epRLn) in patients with papillary thyroid carcinoma (PTC). Thus, we investigated the clinical significance of LN-epRLN and implications it may have. An observational analysis of 878 consecutive patients with PTC who underwent thyroidectomy from April 2016 to March 2017 was conducted. We explored the surrounding tissue of laryngeal entry point, during routine central lymph node dissection (CLND). The lymph node specimens were sent separately for routine histopathological examination. Thereafter, complications and follow-ups were recorded. LN-epRLNs were found in 73 of the 878 patients, with the metastatic rate of 3.76%. Univariate and multivariate analysis showed central lymph node metastases can serve as independent predictors for LN-epRLN metastasis. In summary, we confirmed the significance of LN-epRLN in metastasis and recurrence, which required precise anatomy and thorough CLND. In PTC patients, especially in suspicious presence of central cervical lymph node metastasis, attention should be given to excising the nodal tissue at the laryngeal entry point. Papillary thyroid carcinoma (PTC) is the most common type of endocrine malignancy yet 1. Advocates of partial central lymph node dissection (CLND) cite the reduction in risks of postoperative complications 2. Taken collectively, studies 3-5 showed that the most common metastases and local recurrences of PTC nodal disease were in the central neck compartment. Additionally, recurrent malignancy after partial CLND may require a second surgery, which is considered more hazardous than a primary operation. Reoperation on patients with regional recurrence at the laryngeal entry point would pose challenges due to its complexity 6. Variations in the extent of adhesions around the lymph nodes of entrance point to recurrent laryngeal nerve (LN-epRLN)and neck muscle remnants make identification of the recurrent laryngeal nerve (RLN) and parathyroid glands more difficult compared to primary operation, and risks of certain postoperative complications, such as RLN palsy or hypoparathyroidism, are significantly higher 7. In this study, we evaluated a series of patients who underwent thyroidectomies with the aim of highlighting LN-epRLN metastasis in PTC patients. Methods A total of 878 consecutive PTC patients received initial thyroidectomy at Shanghai Ruijin Hospital between April 2016 and March 2017. A prophylactic or therapeutic CLND was routinely performed in PTC patients. Exclusion criteria: those who underwent previous thyroid surgery; possess pathological types of thyroid carcinomas other than PTC; gross extrathyroidal extension invading the surrounding tissue of entrance point to RLN. According to the guidance of the 2018 Tumour Node Metastasis (TNM) staging system of American Joint Committee on Cancer/International Union Against Cancer (AJCC/UICC) 8 , we identified all the sample as T 1-3 N 0-1a M 0 PTC. All patients involved in this study gave their informed consent, and the...