Spread of a SARS-CoV-2 variant through Europe in the summer of 2020

[EN] Following its emergence in late 2019, the spread of SARS-CoV-21,2 has been tracked by phylogenetic analysis of viral genome sequences in unprecedented detail3,4,5. Although the virus spread globally in early 2020 before borders closed, intercontinental travel has since been greatly reduced. However, travel within Europe resumed in the summer of 2020. Here we report on a SARS-CoV-2 variant, 20E (EU1), that was identified in Spain in early summer 2020 and subsequently spread across Europe. We find no evidence that this variant has increased transmissibility, but instead demonstrate how rising incidence in Spain, resumption of travel, and lack of effective screening and containment may explain the variant’s success. Despite travel restrictions, we estimate that 20E (EU1) was introduced hundreds of times to European countries by summertime travellers, which is likely to have undermined local efforts to minimize infection with SARS-CoV-2. Our results illustrate how a variant can rapidly become dominant even in the absence of a substantial transmission advantage in favourable epidemiological settings. Genomic surveillance is critical for understanding how travel can affect transmission of SARS-CoV-2, and thus for informing future containment strategies as travel resumes.S

Factores predictores de la respuesta a la terapia de inducción con ciclofosfamida en nefritis lúpica proliferativa Predictive factors of response to cyclophosphamide-based induction therapy for proliferative lupus nephritis

El daño renal adiciona significativa morbilidad y mortalidad a los pacientes afectados por lupus eritematoso sistémico (LES). Se estudiaron 38 enfermos con LES con nefritis lúpica proliferativa para determinar el porcentaje de ellos que logran buena respuesta con la terapia de inducción con ciclofosfamida endovenosa y los factores que permitan predecir la respuesta a la misma. Estos sujetos fueron atendidos entre enero de 1997 y diciembre del 2006, período durante el cual recibieron terapia de inducción con 6 dosis de pulsos mensuales de ciclofosfamida. Se realizó un estudio longitudinal de evaluación pronóstica. Se obtuvo respuesta con la terapia de inducción en 27 pacientes, el 71,1 %: completa en 24 casos y parcial en 3. Las variables analizadas, tanto sociodemográficas como clínicas e histológicas, presentes antes de iniciar el tratamiento, no mostraron asociación significativa en predecir la respuesta al mismo, incluidas dentro de estas las pruebas de función renal y los índices de actividad y de cronicidad histológica. Se concluyó que la ciclofosfamida es eficaz en la terapia de inducción de la nefritis lúpica proliferativa, pero no se identificaron factores que permitan predecir los casos que no lograran respuesta con la misma.Renal damage brings significant additional morbidity and mortality to patients with systemic erythematous lupus (SEL). Thirty eight patients with SEL and proliferative lupus nephritis were studied to determine what percentage of them has good response to intravenous cyclophosphamide-based induction therapy and the factors that allow predicting that response. These subjects were seen in the period from January 1997 to December 2006 and received induction therapy based on 6 doses of cyclophosphamide pulses every month. A longitudinal prognostic evaluation study was undertaken. Response to induction therapy was seen in 27 patients (71.1%) that was complete in 24 cases and partial in 3 patients. The analyzed variables comprising socio-demographic, clinical and histological ones, already existing before the treatment, were not significantly associated to response prediction including renal function test and renal activity, and histological chronicity indexes. It was concluded that cyclophosphamide is effective in induction therapy for proliferative lupus nephritis; however, the predictive factors for cases that will not respond to it remained unknown