CREUTZFELDT-JAKOB DISEASE: ACCELERATED BY COVID?

TYPE: Late Breaking TOPIC: Chest Infections INTRODUCTION: Creutzfeld Jakob Disease (CJD) is a collective group of rare neurodegenerative diseases characterized by rapidly progressing cognitive decline, deficits in cortical function (aphasia, apraxia, agnosia), myoclonic jerks and extrapyramidal symptoms with a mortality of 100%. CASE PRESENTATION: We present a 72-year-old female who initially presented with aphasia, dyscalculia, right hemiparesis and dysgraphia.Upon arrival, she was hemodynamically stable and labs were remarkable for a positive COVID PCR test. CT head and CT angiogram was within normal limits. MRI was nonspecific. EEG showed left temporal lateralized periodic discharges (PLDs) at 1 Hz with a triphasic morphology and Lumbar puncture disclosed a protein of 79 mg/dL, glucose 65 mg/dL, WBC 1, HSV 1 and 2 PCR, cryptococcus, gram stain/culture AFB, and cytology were all negative. With concern for autoimmune encephalitis she was empirically started on IVIG without improvement. Paraneoplastic and autoimmune evaluation resulted pan negative. 14-3-3 CSF protein assay reported positive and diagnosis CJD was made. After goals of care discussion with the family, she was discharged home with hospice. DISCUSSION: Sporadic type (sCJD) accounts for about 85% of cases and occurs after somatic mutation in the gene for PrP protein. Rapid neurocognitive decline and cortical function deficits with negative infectious, autoimmune, and paraneoplastic workups should prompt further evaluation for CJD. CSF protein 14-3-3 has a sensitivity of 92%–96% for sCJD. EEG showing of a 1/second periodic triphasic sharp wave complex is present in 1/3 cases. CONCLUSIONS: Most recently, there have been some case reports indicating that the systemic immune response in COVID-19 could accelerate the clinical course of sCJD, however, a potential causal link remains unclear. DISCLOSURE: No significant relationships. KEYWORD: CJD

Specific Learning Disorders and Special Educational Needs during COVID-19 Pandemic; Pilot Survey Study Performed in Local District Schools in Italy.

Specific Learning Disorders (SLD) are a group of heterogeneous health deficits frequently diagnosed in early childhood that cause difficulties in general intellectual functioning. In the last decades in Italy new laws have been developed to give practical guidelines for the best education plans for children with SLD. BACKGROUND: The aim of our study was to determine the efficacy of the educational treatment on SLD in Primary and Secondary schools in the Italian city of Barletta. We acquired valuable data to evaluate Special Education Needs during COVID-19. METHODS: Our study was conducted from April to June 2021, during the second "lockdown" period in Italy. A fact-finding survey was conducted to schools with a questionnaire provided to the teachers to acquire data on the SEN applied in the management of distance learning for children. RESULTS: The study involved 15 male and 6 female pupils with SLD in Primary Schools and 18 male and 6 female in Secondary Schools. The schools participating in the study organized distance learning programs with a support teacher with a 1:1 ratio. Data showed that all children with SLD needed a support teacher. CONCLUSIONS: The findings of this pilot study suggest that distance learning programs are able to achieve adequate educational goals, despite the difficulties of the lockdown period.