SARS-CoV-2-associated myositis

We describe the case of a 9-year-old patient who presented with inability to walk due to lower extrem-ity pain in the follow-up of infection by SARS-CoV-2. Since the manifestations and findings of the examination were compatible with myositis, a blood test was performed that evinced elevation of cre-atine phosphokinase. The patient had a favourable outcome with symptomatic treatment. In the context of this case, we conducted a literature review of paediatric cases of myositis associated with SARS-CoV-2 infection. © 2022, Spanish Association of Primary Care Pediatrics. All rights reserved.

Advantages and challenges of e-learning in architecture: The case of Colombia and El Salvador

The recommendations of physical and social isolation established by the World Health Organization-WHO to face the COVID-19 pandemic implied the physical closure of establishments and institutions, including educational institutions. UNESCO reported a world crisis in education, in which 91% of students worldwide were deprived of their right to education. This article seeks to analyze the effects of migration to virtual education on architecture students in Colombia and El Salvador. The methodology used was a virtual survey administered to 293 students of the Universidad de la Costa (Colombia) and 142 students of the Universidad Centroamericana José Simeón Cañas (El Salvador). From the results, it is possible to affirm that, although the virtual modality has meant a great opportunity to transcend to new stages of university teaching, the economic limitations for most students in Latin America, particularly in the cases analyzed, as well as the digital gap that exists in certain areas, posed and continue to pose a profound challenge for the educational system in the context of the Covid-19 pandemic. © The author;licensee Universidad de la Costa - CUC

COVID-19 infection and acute tubulointerstitial nephritis

BACKGROUND: COVID-19 infection manifests as pneumonia associated with multiple organ failure, and death. Acute kidney injury is a risk factor for mortality. There is limited scientific literature on COVID-19 infection and allergic tubulointerstitial nephritis, its clinical course and short- and long-term prognosis. METHOD: We performed a retrospective study where medical records of 60 patients with histological diagnosis of allergic tubulointerstitial nephritis from January 2009 to November 2020. In these patients, we studied the incidence of COVID-19 infection, clinical characteristics and prognosis from March to the actual date. RESULTS: Of 60 patients with allergic tubulointerstitial nephritis, 6 (10%) patients were diagnosed with COVID-19. The first case, an 85-year-old woman with a history of metastatic melanoma treated with nivolumab and allergic tubulointerstitial nephritis by immunobiological agents in 2018, diagnosed with mild COVID-19 infection in April 2020 without deterioration of renal function in controls at 3 and 6 months of follow-up. The second case, a 51-year-old woman with a history of large B-cell lymphoma with plasmacytic differentiation and progression to multiple myeloma of lambda light chains and allergic tubulointerstitial nephritis due to chemotherapy since 2019, admitted for acute pyelonephritis and PRES syndrome secondary to first dose of bortezomib complicated with COVID-19 nosocomial pneumonia and acute pancreatitis treated with corticosteroids and broad spectrum antibiotic therapy;she died of abdominal refractory septic shock. The third patient, a 64-year-old man without prior renal impairment, was admitted for severe COVID-19 pneumonia and acute kidney injury secondary to acute tubulointerstitial nephritis of uncertain etiology that required orotracheal intubation and continuous veno-venous hemodiafiltration for a week who received methylprednisolone in bolus for 3 days and continued treatment with corticosteroid therapy with complete recovery of renal function and improvement in proteinuria at 3 months of follow-up. The fourth patient, an 82-yearold woman with acute kidney injury AKIN 3 secondary to acute allergic tubulointerstitial nephritis related to ciprofloxacin complicated with severe COVID-19 nosocomial pneumonia, who died despite ventilatory support and high-dose steroids therapy and tocilizumab. The fifth patient, a 75-year-old with a history of metastatic lung adenocarcinoma treated with immunobiological agents and allergic tubulointerstitial nephritis in 2018, admitted in march 2020 for mild COVID-19 pneumonia treated with steroids and hydroxychloroquine without deterioration of respiratory and kidney function. The sixth patient, an 86-years-old man with acute kidney injury AKIN 3 due to acute allergic tubulointerstitial nephritis secondary to proton-binding inhibitors and nosocomial COVID-19 infección with improvement of kidney function with steroids therapy only. CONCLUSION: Our 6 patients with allergic tubulointerstitial nephritis and COVID-19 infection presented different spectrum of the disease. It seems that nosocomial COVID-19 infection in patients admitted with recent diagnosis of acute allergic tubulointerstitial nephritis presented a worse clinical prognosis compared with long-term diagnosed acute tubulointerstitial nephritis. Further studies with a larger sample size are needed.

Structural and functional characterization of the replication and transcription activities of Hantaan virus polymerase

The Bunyavirales order is a large and worldwide distributed group of segmented negative sense single-stranded RNA viruses (sNSV) that includes more than 350 species (nine families). Arthropods and rodents are their natural reservoirs and humans are occasionally infected resulting in severe diseases. Particularly, the pathogenic prototype viruses Hantaan virus (HTNV, family Hantaviridae) and Crimean-Congo Haemorrhagic fever virus (CCHFV, family Nairoviridae) have increased their geographical expansion and as a consequence, also cases of human diseases. Thus, it is necessary to (i) understand their mechanism of infection and (ii) to develop effective drugs to counteract them. In this perspective, we are working on two critical steps of bunyavirus viral cycle : replication and transcription. These processes are carried out by the multifunctional viral polymerase (L). In order to decipher the molecular mechanisms of bunyavirus replication, we present the study of interactions between hantavirus L proteins and their genomic RNA and replication assays of the full-length Hantaan polymerase. By electrophoresis mobility shifts assays and fluoresce anisotropy we determined the viral sequences specifically binding the L proteins anddefined their length and measured their affinity. We could see differences in the interactions between bunyaviral families L proteins suggesting differences on their mechanisms of replication and the way they are regulated. On the other hand, we performed replication assays for HNTV and LACV L and we have obtained a different result patron. These studies on replication and transcription reactions have shown that Hantaan L is more active than LACV L in the presence or absence of N terminal TAG. Also, the expected replication products are different and we observed some reproducible abortive products.We observed an unexpected UTP transferase activity by the Hantaan L protein that seems related to the processing of its genomic RNA for preventing recognition by the cell innate immune system and maintaining genome integrity. TheseRNA-protein interactions studies, along with the replication assays, will provide the basis for subsequent biochemical and structural studies to understand the molecular mechanism uncovering these reactions. This will be crutial for the development of effective antiviral drugs.