SARS-COVID-19 is known to manifest with a wide variety of symptoms, most of which are respiratory. Myalgias are a common symptom of COVID-19, but cases of severe virus-induced inflammatory muscle injury leading to rhabdomyolysis and polymyositis have also been reported. Here, we present and discuss a case of a 56-year-old woman who presented with an initial presentation of COVID-19 infection with inflammatory polymyositis leading to rhabdomyolysis. The patient was first treated for rhabdomyolysis with aggressive fluid resuscitation with intravenous normal saline without improvement in symptoms. She was then started on high-dose intravenous methylprednisolone for presumed immune-mediated polymyositis. An MRI of the bilateral lower extremities and a biopsy of the left thigh confirmed inflammatory myositis. After the initiation of steroids, liver function tests and creatinine kinase levels trended down, and symptoms improved. The patient was discharged with a prednisone taper and completely recovered at a follow-up six months later. Post-COVID severe musculoskeletal involvement, including polymyositis or rhabdomyolysis, is rare, with only a few other cases published so far. Viral myositis, supported by myopathological evidence, should be considered carefully in patients with a recent COVID-19 infection after ruling out more common causes of myositis. Some proposed mechanisms include direct infection of the muscle or an environmental event triggering autoimmunity. Treatment generally involves corticosteroids that are gradually tapered.

暂无摘要。

This is a response to Dr. Somovilla del Saz\'s letter to the editor regarding Marchand et al.\'s article, \"Risk of all-cause and cardiac-related mortality after vaccination against COVID-19: A meta-analysis of self-controlled case series studies.\" The response is on behalf of all authors clarifying misconceptions about the work.

BACKGROUND: Cancer is a risk factor for developing severe COVID19. Additionally, SARS-CoV2 has a special tropism for renal cells and complications like thrombosis or cytokine storm could be enhanced by standard treatments in kidney cancer (i.e., antiangiogenics or immunotherapy). Thus, understanding the impact of COVID19 in patients with this tumor is key for their correct management.
METHODS: We designed a retrospective case-control study comparing the outcome of three groups of advanced kidney cancer patients on systemic treatment: cohort A (developed COVID19 while on antiangiogenics), cohort B (developed COVID19 while on immunotherapy) and cohort C (non-infected). Matching factors were age, gender, and treatment.
RESULTS: 95 patients were recruited in 16 centers in Spain from September 2020 to May 2021. Finally, 85 were deemed as eligible (23 cohort A, 21 cohort B, 41 cohort C). Patients with COVID required more dose interruptions (25 vs. six) and hospitalizations (10 vs. none) than those without COVID (both p = 0.001). No difference between cohorts A and B was observed regarding hospitalization or length of stay. No ICU admission was registered and one patient in cohort B died due to COVID19. Regarding cancer evolution, three patients in cohort A presented progressive disease after COVID19 compared to two in cohort B. One case in cohort B, initially deemed as stable disease, achieved a partial response after COVID19.
CONCLUSIONS: Kidney cancer patients who developed COVID19 while on systemic therapy required more treatment interruptions and hospitalizations than those non-infected. However, no significant impact on cancer outcome was observed. Also, no difference was seen between cases on antiangiogenics or immunotherapy.

This case report details a 43-year-old female diagnosed with the collapsing variant of focal segmental glomerulosclerosis (FSGS) post-infection with coronavirus disease 2019 (COVID-19). The patient contracted COVID-19 after returning from a trip to Florida and initially presented to the emergency department with gastrointestinal symptoms. Thereafter, the patient was diagnosed with COVID-19 and was admitted for acute kidney injury and worsening COVID-19 infection. FSGS is a glomerulopathy that consists of glomerular scarring that leads to nephrotic syndrome, secondary to podocyte effacement. FSGS has many causes, as well as distinct variants, but is noted to have an association with some viruses, most notably HIV and cytomegalovirus (CMV). Although the association between FSGS and HIV or CMV is well established, the evidence is minimal in regard to other viruses. This case report serves to highlight the potential association of COVID-19 with FSGS.

This case report describes the sudden presentation and successful cessation of psychiatric symptoms following the first administration of the Moderna mRNA vaccine against the SARS-CoV-2 virus during early 2021. The process of discovery of symptoms is described, along with an empirical procedure which identified St. John\'s wort as the mediating agent. Implications for self-medication of mild depression are discussed. Hypericin, a constituent agent in St. John\'s wort, interacts with the SARS-CoV-2 spike protein. Sensitization to hypericin following vaccine administration is consistent with the observed symptoms.

The recent worldwide SARS-CoV-2 (COVID-19) pandemic has reshaped the way people live, how they access goods and services, and how they perform various activities. For public transit, there have been health concerns over the potential spread to transit users and transit service staff, which prompted transportation agencies to make decisions about the service, e.g., whether to reduce or temporarily shut down services. These decisions had substantial negative consequences, especially for transit-dependent travelers, and prompted transit users to explore alternative transportation modes, e.g., bikeshare. However, local governments and the public in general have limited information about whether and to what extent bikeshare provides adequate accessibility and mobility to those transit-dependent residents. To fill this gap, this study implemented spatial and visual analytics to identify how micro-mobility in the form of bikesharing has addressed travel needs and improved the resilience of transportation systems. The study analyzed the case of San Francisco in California, USA, focusing on three phases of the pandemic, i.e., initial confirmed cases, shelter-in-place, and initial changes in transit service. First, the authors implemented unsupervised machine learning clustering methods to identify different bikesharing trip types. Moreover, through spatiotemporally matching bikeshare ridership data with transit service information (i.e., General Transit Feed Specification, GTFS) using the tool called OpenTripPlanner (OTP), the authors studied the travel behavior changes (e.g., the proportion of bikeshare trips that could be finished by transit) for different bikeshare trip types over the three specified phases. This study revealed that during the pandemic, more casual users joined bikeshare programs; the proportion of recreation-related bikeshare trips increased; and routine trips became more prevalent considering that docking-station-based bikeshare trips increased. More importantly, the analyses also provided insights about mode substitution, because the analyses identified an increase in dockless bikeshare trips in areas with no or limited transit coverage.

During the first and second waves of the pandemic, Quebec was among the Canadian provinces with the highest COVID-19 mortality rates. Facing particularly large COVID-19 outbreaks in its facilities, an integrated health and social services center in the province of Quebec (Canada), developed resilience strategies. To explore these diverse responses to the crisis, we conducted a case study analysis of a Quebec integrated health and social services center, building on a conceptualization of resilience strategies using \"configurations\" of effects, strategies, and impacts. Qualitative data from 14 indepth interviews conducted in the summer and fall of 2020 with managers and frontline practitioners were analyzed through the lens of situations of \"anticipation,\" \"reaction,\" or \"inaction.\" The findings were discussed in three results dissemination workshops, two with practitioners and one with managers, to discern lessons they learned. Three major configurations emerged: 1) reorganization of services and spaces to accommodate more COVID-19 patients; 2) management of contamination risks for patients and professionals; and 3) management of personal protective equipment (PPE), supplies, and medications. Within these configurations, the responses to the crisis were strongly shaped by the 2015 health care system reforms in Quebec and were constrained by organizational challenges that included a centralized model of governance, a history of substantial budget cuts to longterm care facilities, and a systematic lack of human resources.

Introduction. During the Coronavirus-19 (Covid-19) pandemic, a significant increase in the frequency of complications in the form of venous thrombosis was observed. However, there is also the other side of the coin - an increase in the tendency to bleeding in the course of COVID19. Case Report. We present the case of a patient hospitalised in the COVID-19 Isolation Ward due to severe pneumonia in the course of SARS-CoV2 infection. She developed respiratory failure requiring a non-invasive mechanical ventilation. In addition, pulmonary embolism was diagnosed, the treatment with low molecule heparin was initiated. Soon, the patient developed a huge haematoma of the posterior compartment of the thigh causing deformation and dysfunction of the limb and resulting with acute haemorrhagic anaemia. Conclusion. Our article is a contribution to the discussion on the need to pay attention to the possibility of haemorrhagic complications in the course of anticoagulant treatment due to venous thrombosis in COVID-19 patients.

Vaccine-induced immune thrombotic thrombocytopenia (VITT) is a rare but detrimental syndrome that has been most commonly reported after the administration of vaccination for the prevention of viral infections. VITT often presents with thrombosis at unusual sites such as cerebral venous sinuses, portal, splanchnic or hepatic veins, in association with thrombocytopenia and elevated anti-platelet factor 4 (aPF-4) antibodies. We describe the case of a young male patient who developed thrombocytopenia, cerebral sinus venous thrombosis, and intracerebral bleed 12 days after receiving the Ad26.COV2.S (Janssen/Johnson&Johnson) COVID-19 vaccine.