Interrelaciones entre GSH y ascorbato en células de mamífero: Implicaciones fisiológicas y clínicas

Las vitaminas poseen diferentes papeles fisiológicos y clínicos además del de la prevención de enfennedades carenciales. Este es el caso de la vitamina C, que más allá de prevenir el escorbuto, posee actividad antioxidante bien descrita y la capacidad de ahorrar GSH. El GSH es un tripéptido ampliamente distribuido en las células de marniferos, el cual no es requerido en la dieta. El ciclo del gamma glutamilo es el responsable de la síntesis y de la degradación del GSH. Este tripéptido provee a la célula de un medio reductor a través de la acción de la glutation difulfuro reductasa. La administración de ácido ascórbico puede contribuir también al sistema reductor de las células. Existen numerosos datos científicos que apoyan el hecho de que algunas condiciones asociadas con estrés oxidativo podrían ser mejoradas por una terapia que mantuviera los niveles nonnales de GSH. Esto se puede conseguir por la administración de ésteres de GSH, aumentando la capacidad de síntesis de GSH al proporcionar los substratos, como el N-acety-L-cysteina y/o aumentando la disponibilidad de compuestos como el ascorbato que puede ahorrar GSH. Todos estos efectos podrían ser de interés clínico para el diseño de un "cocktail" adecuado que mantuviera el GSH intracelular dentro de valores nonnales para tejidos de mamíferos, en condiciones en las que el GSH estuviera disminuido.Vitamins have different physiological and clinical roles besides preventing deficiency diseases. This is the case of vitamin C that beyond preventing scurvy, it has a well known antioxidant activity and the capacity to spare GSH. GSH is a tripeptide widely distributed in marnmalian cells, which is not required in the diet. The gamma-glutamyl cycle is responsible for the synthesis and degradation of GSH. This tripeptide provides the cell with a reducing milieu that is achieved through the action of glutathione disulfide reductase. Administration of ascorbic acid may also contribute to the reducing properties of cells. There is enough scientific background to support the fact that several conditions associated with oxidative stress might be improved by therapy that maintain GSH within normal leves. This can be achieved by the administration of GSH-esters, increasing the capacity for GSH synthesis by providing substrates such as N-acetyl-L-cysteine aml/or by increasing the availibility of compounds such as ascorbate that can spare GSH. AII these facts could be of clinical interest in the design of the right "cocktail" in order to keep intracellular GSH within normal values in marnmalian tissues under those situations were GSH is depleted

Exploring the independent association of employment status to cancer survivors’ health-related quality of life

Background: Having a job has been associated with better Health-Related Quality of Life (HRQOL) in cancer survivors. However, the sociodemographic and disease-related profiles characterizing the survivors being employed and those having better HRQOL largely overlap. The present study aims to discern the degree to which employment status is independently associated with cancer survivors' HRQOL or if it mainly reflects the impact of other sociodemographic and cancer-related variables. Methods: Cross-sectional study on a heterogeneous sample of 772 working-age survivors of adult-onset cancer. An instrument specifically designed to assess HRQOL in cancer survivors and Multivariate Variance Analysis (MANOVA) were used. Results: Survival phase, cancer type, and employment status showed the main effects on cancer survivors' HRQOL. In particular, being employed (vs unemployed) had the greatest positive association with HRQOL, affecting ten of the twelve HRQOL domains considered. Also, interaction effects highlighted the role of age (younger) and marital status (single) as risk factors for a greater negative impact of variables affecting the survivor's HRQOL. Conclusions: The application of a multivariate methodology sheds new light on two relevant issues for the cancer survivor's HRQOL: (i) the existence of differences between diagnostic groups that are not attributed to other variables such as sex, and (ii) the important and independent role that employment status plays. Comprehensive cancer survivorship care should focus more on high-risk groups and include having a job as an essential aspect to consider and prompt. The fact that the employment status is susceptible to change represents a valuable opportunity to care for the wellbeing of this population

Interrelaciones entre GSH y ascorbato en células de mamífero: Implicaciones fisiológicas y clínicas

Vitamins have different physiological and clinical roles besides preventing deficiency diseases. This is the case of vitamin C that beyond preventing scurvy, it has a well known antioxidant activity and the capacity to spare GSH. GSH is a tripeptide widely distributed in marnmalian cells, which is not required in the diet. The gamma-glutamyl cycle is responsible for the synthesis and degradation of GSH. This tripeptide provides the cell with a reducing milieu that is achieved through the action of glutathione disulfide reductase. Administration of ascorbic acid may also contribute to the reducing properties of cells. There is enough scientific background to support the fact that several conditions associated with oxidative stress might be improved by therapy that maintain GSH within normal leves. This can be achieved by the administration of GSH-esters, increasing the capacity for GSH synthesis by providing substrates such as N-acetyl-L-cysteine aml/or by increasing the availibility of compounds such as ascorbate that can spare GSH. All these facts could be of clinical interest in the design of the right "cocktail" in order to keep intracellular GSH within normal values in marnmalian tissues under those situations were GSH is depleted.Las vitaminas poseen diferentes papeles fisiológicos y clínicos además del de la prevención de enfennedades carenciales. Este es el caso de la vitamina C, que más allá de prevenir el escorbuto, posee actividad antioxidante bien descrita y la capacidad de ahorrar GSH. El GSH es un tripéptido ampliamente distribuido en las células de marmíferos, el cual no es requerido en la dieta. El ciclo del gamma glutamilo es el responsable de la síntesis y de la degradación del GSH. Este tripéptido provee a la célula de un medio reductor a través de la acción de la glutation difulfuro reductasa. La administración de ácido ascórbico puede contribuir también al sistema reductor de las células. Existen numerosos datos científicos que apoyan el hecho de que algunas condiciones asociadas con estrés oxidativo podrían ser mejoradas por una terapia que mantuviera los niveles nonnales de GSH. Esto se puede conseguir por la administración de ésteres de GSH, aumentando la capacidad de síntesis de GSH al proporcionar los substratos, como el Nacety-L-cysteina y/o aumentando la disponibilidad de compuestos como el ascorbato que puede ahorrar GSH. Todos estos efectos podrían ser de interés clínico para el diseño de un "cocktail" adecuado que mantuviera el GSH intracelular dentro de valores nonnales para tejidos de mamíferos, en condiciones en las que el GSH estuviera disminuido

Wastewater nutrient removal in a mixed microalgae bacteria culture: effect of light and temperature on the microalgae bacteria competition

[EN] The aim of this study was to evaluate the effect of light intensity and temperature on nutrient removal and biomass productivity in a microalgae¿bacteria culture and their effects on the microalgae¿bacteria competition. Three experiments were carried out at constant temperature and various light intensities: 40, 85 and 125¿µE¿m¿2¿s¿1. Other two experiments were carried out at variable temperatures: 23¿±¿2°C and 28¿±¿2°C at light intensity of 85 and 125¿µE¿m¿2¿s¿1, respectively. The photobioreactor was fed by the effluent from an anaerobic membrane bioreactor. High nitrogen and phosphorus removal efficiencies (about 99%) were achieved under the following operating conditions: 85¿125¿µE¿m¿2¿s¿1 and 22¿±¿1°C. In the microalgae¿bacteria culture studied, increasing light intensity favoured microalgae growth and limited the nitrification process. However, a non-graduated temperature increase (up to 32°C) under the light intensities studied caused the proliferation of nitrifying bacteria and the nitrite and nitrate accumulation. Hence, light intensity and temperature are key parameters in the control of the microalgae¿bacteria competition. Biomass productivity significantly increased with light intensity, reaching 50.5¿±¿9.6, 80.3¿±¿6.5 and 94.3¿±¿7.9¿mgVSS¿L¿1¿d¿1 for a light intensity of 40, 85 and 125¿µE¿m¿2¿s¿1, respectivelyThis research work was possible because of Projects CTM2011-28595-C02-01 and CTM2011-28595-C02-02 [funded by the Spanish Ministry of Economy and Competitiveness jointly with the European Regional Development Fund and the Generalitat Valenciana GVA-ACOMP2013/203]. This research was also supported by the Spanish Ministry of Education, Culture and Sport via a pre doctoral FPU fellowship to the first author [FPU14/05082].Gonzalez-Camejo, J.; Barat, R.; Pachés Giner, MAV.; Murgui Mezquita, M.; Seco Torrecillas, A.; Ferrer, J. (2018). Wastewater nutrient removal in a mixed microalgae bacteria culture: effect of light and temperature on the microalgae bacteria competition. Environmental Technology. 39(4):503-515. https://doi.org/10.1080/09593330.2017.1305001S503515394Giménez, J. B., Robles, A., Carretero, L., Durán, F., Ruano, M. V., Gatti, M. N., … Seco, A. (2011). Experimental study of the anaerobic urban wastewater treatment in a submerged hollow-fibre membrane bioreactor at pilot scale. Bioresource Technology, 102(19), 8799-8806. doi:10.1016/j.biortech.2011.07.014Huang, Z., Ong, S. L., & Ng, H. Y. (2011). Submerged anaerobic membrane bioreactor for low-strength wastewater treatment: Effect of HRT and SRT on treatment performance and membrane fouling. Water Research, 45(2), 705-713. doi:10.1016/j.watres.2010.08.035Ruiz-Martinez, A., Martin Garcia, N., Romero, I., Seco, A., & Ferrer, J. (2012). Microalgae cultivation in wastewater: Nutrient removal from anaerobic membrane bioreactor effluent. Bioresource Technology, 126, 247-253. doi:10.1016/j.biortech.2012.09.022Chisti, Y. (2007). Biodiesel from microalgae. Biotechnology Advances, 25(3), 294-306. doi:10.1016/j.biotechadv.2007.02.001Rawat, I., Bhola, V., Kumar, R. R., & Bux, F. (2013). Improving the feasibility of producing biofuels from microalgae using wastewater. Environmental Technology, 34(13-14), 1765-1775. doi:10.1080/09593330.2013.826287Collet, P., Hélias, A., Lardon, L., Ras, M., Goy, R.-A., & Steyer, J.-P. (2011). Life-cycle assessment of microalgae culture coupled to biogas production. Bioresource Technology, 102(1), 207-214. doi:10.1016/j.biortech.2010.06.154Milledge, J. J. (2010). Commercial application of microalgae other than as biofuels: a brief review. Reviews in Environmental Science and Bio/Technology, 10(1), 31-41. doi:10.1007/s11157-010-9214-7Posadas, E., García-Encina, P.-A., Soltau, A., Domínguez, A., Díaz, I., & Muñoz, R. (2013). Carbon and nutrient removal from centrates and domestic wastewater using algal–bacterial biofilm bioreactors. Bioresource Technology, 139, 50-58. doi:10.1016/j.biortech.2013.04.008Podevin, M., De Francisci, D., Holdt, S. L., & Angelidaki, I. (2014). Effect of nitrogen source and acclimatization on specific growth rates of microalgae determined by a high-throughput in vivo microplate autofluorescence method. Journal of Applied Phycology, 27(4), 1415-1423. doi:10.1007/s10811-014-0468-2Meseck, S. L., Smith, B. C., Wikfors, G. H., Alix, J. H., & Kapareiko, D. (2006). Nutrient interactions between phytoplankton and bacterioplankton under different carbon dioxide regimes. Journal of Applied Phycology, 19(3), 229-237. doi:10.1007/s10811-006-9128-5Risgaard-Petersen, N., Nicolaisen, M. H., Revsbech, N. P., & Lomstein, B. A. (2004). Competition between Ammonia-Oxidizing Bacteria and Benthic Microalgae. Applied and Environmental Microbiology, 70(9), 5528-5537. doi:10.1128/aem.70.9.5528-5537.2004Tiquia-Arashiro, S. M., & Mormile, M. (2013). Sustainable technologies: bioenergy and biofuel from biowaste and biomass. Environmental Technology, 34(13-14), 1637-1638. doi:10.1080/09593330.2013.834162Jordan, B. R. (1996). The Effects of Ultraviolet-B Radiation on Plants: A Molecular Perspective. Advances in Botanical Research, 97-162. doi:10.1016/s0065-2296(08)60057-9Znad, H., Naderi, G., Ang, H. M., & Tade, M. O. (2012). CO2 Biomitigation and Biofuel Production Using Microalgae: Photobioreactors Developments and Future Directions. Advances in Chemical Engineering. doi:10.5772/32568Martínez, M. (2000). Nitrogen and phosphorus removal from urban wastewater by the microalga Scenedesmus obliquus. Bioresource Technology, 73(3), 263-272. doi:10.1016/s0960-8524(99)00121-2Xin, L., Hong-ying, H., & Yu-ping, Z. (2011). Growth and lipid accumulation properties of a freshwater microalga Scenedesmus sp. under different cultivation temperature. Bioresource Technology, 102(3), 3098-3102. doi:10.1016/j.biortech.2010.10.055Robles, Á., Durán, F., Ruano, M. V., Ribes, J., Rosado, A., Seco, A., & Ferrer, J. (2015). Instrumentation, control, and automation for submerged anaerobic membrane bioreactors. Environmental Technology, 36(14), 1795-1806. doi:10.1080/09593330.2015.1012180Reynolds, C. S. (2006). The Ecology of Phytoplankton. doi:10.1017/cbo9780511542145Küster, E., Dorusch, F., & Altenburger, R. (2005). EFFECTS OF HYDROGEN SULFIDE TO VIBRIO FISCHERI, SCENEDESMUS VACUOLATUS, AND DAPHNIA MAGNA. Environmental Toxicology and Chemistry, 24(10), 2621. doi:10.1897/04-546r.1Park, J., Jin, H.-F., Lim, B.-R., Park, K.-Y., & Lee, K. (2010). Ammonia removal from anaerobic digestion effluent of livestock waste using green alga Scenedesmus sp. Bioresource Technology, 101(22), 8649-8657. doi:10.1016/j.biortech.2010.06.142McGinn, P. J., Dickinson, K. E., Park, K. C., Whitney, C. G., MacQuarrie, S. P., Black, F. J., … O’Leary, S. J. B. (2012). Assessment of the bioenergy and bioremediation potentials of the microalga Scenedesmus sp. AMDD cultivated in municipal wastewater effluent in batch and continuous mode. Algal Research, 1(2), 155-165. doi:10.1016/j.algal.2012.05.001Mara, D. D., & Feachem, R. G. A. (2003). Unitary environmental classification of water- and excreta-related communicable diseases. Handbook of Water and Wastewater Microbiology, 185-192. doi:10.1016/b978-012470100-7/50012-1Jeffrey, S. W., & Humphrey, G. F. (1975). New spectrophotometric equations for determining chlorophylls a, b, c1 and c2 in higher plants, algae and natural phytoplankton. Biochemie und Physiologie der Pflanzen, 167(2), 191-194. doi:10.1016/s0015-3796(17)30778-3Laliberté, G., Lessard, P., de la Noüe, J., & Sylvestre, S. (1997). Effect of phosphorus addition on nutrient removal from wastewater with the cyanobacterium Phormidium bohneri. Bioresource Technology, 59(2-3), 227-233. doi:10.1016/s0960-8524(96)00144-7Pachés, M., Romero, I., Hermosilla, Z., & Martinez-Guijarro, R. (2012). PHYMED: An ecological classification system for the Water Framework Directive based on phytoplankton community composition. Ecological Indicators, 19, 15-23. doi:10.1016/j.ecolind.2011.07.003Xin, L., Hong-ying, H., Ke, G., & Jia, Y. (2010). Growth and nutrient removal properties of a freshwater microalga Scenedesmus sp. LX1 under different kinds of nitrogen sources. Ecological Engineering, 36(4), 379-381. doi:10.1016/j.ecoleng.2009.11.003Wang, L., Min, M., Li, Y., Chen, P., Chen, Y., Liu, Y., … Ruan, R. (2009). Cultivation of Green Algae Chlorella sp. in Different Wastewaters from Municipal Wastewater Treatment Plant. Applied Biochemistry and Biotechnology, 162(4), 1174-1186. doi:10.1007/s12010-009-8866-7Pancha, I., Chokshi, K., George, B., Ghosh, T., Paliwal, C., Maurya, R., & Mishra, S. (2014). Nitrogen stress triggered biochemical and morphological changes in the microalgae Scenedesmus sp. CCNM 1077. Bioresource Technology, 156, 146-154. doi:10.1016/j.biortech.2014.01.025Sarat Chandra, T., Deepak, R. S., Maneesh Kumar, M., Mukherji, S., Chauhan, V. S., Sarada, R., & Mudliar, S. N. (2016). Evaluation of indigenous fresh water microalga Scenedesmus obtusus for feed and fuel applications: Effect of carbon dioxide, light and nutrient sources on growth and biochemical characteristics. Bioresource Technology, 207, 430-439. doi:10.1016/j.biortech.2016.01.044Krustok, I., Odlare, M., Truu, J., & Nehrenheim, E. (2016). Inhibition of nitrification in municipal wastewater-treating photobioreactors: Effect on algal growth and nutrient uptake. Bioresource Technology, 202, 238-243. doi:10.1016/j.biortech.2015.12.020Chen, X., Goh, Q. Y., Tan, W., Hossain, I., Chen, W. N., & Lau, R. (2011). Lumostatic strategy for microalgae cultivation utilizing image analysis and chlorophyll a content as design parameters. Bioresource Technology, 102(10), 6005-6012. doi:10.1016/j.biortech.2011.02.061Powell, N., Shilton, A., Chisti, Y., & Pratt, S. (2009). Towards a luxury uptake process via microalgae – Defining the polyphosphate dynamics. Water Research, 43(17), 4207-4213. doi:10.1016/j.watres.2009.06.011Cabello, J., Toledo-Cervantes, A., Sánchez, L., Revah, S., & Morales, M. (2015). Effect of the temperature, pH and irradiance on the photosynthetic activity by Scenedesmus obtusiusculus under nitrogen replete and deplete conditions. Bioresource Technology, 181, 128-135. doi:10.1016/j.biortech.2015.01.034Zhu, W., Wan, L., & Zhao, L. (2010). Effect of nutrient level on phytoplankton community structure in different water bodies. Journal of Environmental Sciences, 22(1), 32-39. doi:10.1016/s1001-0742(09)60071-1Daims, H., Brühl, A., Amann, R., Schleifer, K.-H., & Wagner, M. (1999). The Domain-specific Probe EUB338 is Insufficient for the Detection of all Bacteria: Development and Evaluation of a more Comprehensive Probe Set. Systematic and Applied Microbiology, 22(3), 434-444. doi:10.1016/s0723-2020(99)80053-8Daims, H., Nielsen, J. L., Nielsen, P. H., Schleifer, K.-H., & Wagner, M. (2001). In Situ Characterization of Nitrospira-Like Nitrite-Oxidizing Bacteria Active in Wastewater Treatment Plants. Applied and Environmental Microbiology, 67(11), 5273-5284. doi:10.1128/aem.67.11.5273-5284.2001analysis of nitrifying bacteria in sewage treatment plants. (1996). Water Science and Technology, 34(1-2). doi:10.1016/0273-1223(96)00514-

Manejo antibiótico en neumonía adquirida en la comunidad en la hospitalización a domicilio: ¿Hay margen de mejora?

Introducción: La neumonía adquirida en la comunidad (NAC) es una enfermedad frecuente que puede serabordada en hospitalización a domicilio (HAD). En el presente trabajo evaluamos el margen de mejoracon el uso de antibióticos en la NAC en HAD. Métodos: Se reclutaron retrospectivamente todos los pacientes con NAC en dos hospitales españolesdesde el 01 de enero de 2018 al 30 de octubre de 2019. Se registraron variables demográficas, clínicas y sobre calidad de prescripción antibiótica. Posteriormente se construyó una variable que recogía seis indi-cadores de calidad asistencial, categorizando y comparando a los pacientes en dos grupos: buena calidadasistencial (cuatro o más indicadores realizados) o mala calidad asistencial (tres o menos indicadoresrealizados). Resultados: Obtuvimos una muestra de 260 pacientes. La solicitud de pruebas diagnósticas y la adecuacióna las guías de práctica clínica fue del 85, 4 y 85, 8%, respectivamente. Los porcentajes de realización dedesescalada (53, 7%) y terapia secuencial (57, 7%) cuando estaban indicadas fueron bajos. La duraciónmedia del tratamiento fue de 7, 3 días para el intravenoso y 9, 5 días para el total. La calidad de prescripciónfue buena en 134 (63, 2%) pacientes, siendo más frecuente en aquellos que ingresaron directamente enHAD desde urgencias. También se asoció a menor reingreso a 30 días. Conclusión: Existe un amplio margen de mejora en algunos aspectos con el uso de antimicrobianos enHAD, que podría motivar la implementación de programas de optimización del uso de antibióticos. Introduction: Community Acquired Pneumonia (CAP) is common disease that can be treated in Hospital At Home (HAH). In this paper we evaluate the room of improvement in the use of antibiotics in CAP in HH. Methods: Patients with CAP were retrospectively recruited in two Spanish hospitals from 1/1/18 to 10/30/19. Demographic, clinical and quality of antibiotic prescription variables were recorded. Subsequently, we created a new variable that collected six quality of care indicator, categorizing and comparing patients into two groups: good quality of care (4 or more indicators performed) or poor quality of care (3 or less indicators performed). Results: We recruited 260 patients. The request for diagnostic tests and the adequacy to Clinical Practice Guidelines were 85.4% and 85.8% respectively. Percentages of de-escalation (53.7%) and sequential therapy (57.7%) when indicated were low. The average length of treatment was 7.3 days for intravenous and 9.5 days for total. Quality of prescription was good in 134 (63.2%) patients, being more frequent in those who were admitted directly to HAD from the emergency room. It was also associated with less readmission at 30 days. Conclusion: There is a wide room for improvement in some fields of antimicrobials use in HAH that could stimulate the implementation of Antimicrobial Stewardship Programs

Distribution of alien tetrapods in the Iberian Peninsula

We present a dataset that assembles occurrence records of alien tetrapods (amphibians, reptiles, birds and mammals) in the Iberian Peninsula, a coherent biogeographically unit where introductions of alien species have occurred for millennia. These data have important potential applications for ecological research and management, including the assessment of invasion risks, formulation of preventive and management plans, and research at the biological community level on alien species. This dataset summarizes inventories and data sources on the taxonomy and distribution of alien tetrapods in the Iberia Peninsula, comprising known locations from published literature, expert knowledge and citizen science platforms. An expert-based assessment process allowed the identification of unreliable records (misclassification or natural dispersion from native range), and the classification of species according to their status of reproduction in the wild. Distributional data was harmonized into a common area unit, the 10 × 10 km Universal Transverse Mercator (UTM) system (n = 6,152 cells). The year of observation and/or year of publication were also assigned to the records. In total, we assembled 35,940 unique distribution records (UTM × species × Year) for 253 species (6 amphibians, 16 reptiles, 218 birds and 13 mammals), spanning between 1912 and 2020. The species with highest number of distribution records were the Mediterranean painted frog Discoglossus pictus (n = 59 UTM), the pond slider Trachemys scripta (n = 471), the common waxbill Estrilda astrild (n = 1,275) and the house mouse Mus musculus (n = 4,043), for amphibians, reptiles, birds and mammals, respectively. Most alien species recorded are native to Africa (33%), followed by South America (21%), Asia (19%), North America (12%) and Oceania (10%). Thirty-six species are classified by IUCN as threatened in their native range, namely 2 Critically Endangered (CR), 6 Endangered (EN), 8 Vulnerable (VU), and 20 species Near Threatened (NT). Species maps are provided in DataSet1, as well R code and GIS layers to update them as new records are obtained.info:eu-repo/semantics/publishedVersio

Exploring differences in stakeholders' perceptions of illegal bird trapping in Cyprus

Abstract Background Cyprus is recognised as a hotspot for illegal bird trapping in the Mediterranean basin. A consumer demand for the Eurasian blackcap (Sylvia atricapilla) is driving the use of non-selective trapping methods, resulting in the indiscriminate killing of millions of migratory birds. Efforts to tackle the issue have so far been characterised mostly by a top-down approach, focusing on legislation and enforcement. However, trapping levels are not decreasing and conflict between stakeholder groups is intensifying. Methods To understand why efforts to stop illegal bird trapping have not been effective, we used semi-structured interviews to interview 18 local bird trappers and nine representatives from the pertinent environmental non-governmental organisations (NGOs) and the governmental agencies responsible for enforcing the legislation. Results We found distinct differences between the views of the local trapping community and the environmental NGOs, particularly on why trapping is occurring and its impact on the avifauna. This disparity has contributed to misrepresentations of both sides and a high degree of conflict, which is potentially proving counterproductive to conservation interventions. In addition, it appears that trappers are a heterogeneous group, likely driven by various motivations besides profit. Conclusion We argue that stakeholders interested in reducing illegal bird trapping need to develop anti-poaching strategies that aim at minimising the disparity in the views, and subsequently the conflict, acknowledging also that trappers are not a homogenous group, as often treated

Evolution of the use of corticosteroids for the treatment of hospitalised COVID-19 patients in Spain between March and November 2020: SEMI-COVID national registry

Objectives: Since the results of the RECOVERY trial, WHO recommendations about the use of corticosteroids (CTs) in COVID-19 have changed. The aim of the study is to analyse the evolutive use of CTs in Spain during the pandemic to assess the potential influence of new recommendations. Material and methods: A retrospective, descriptive, and observational study was conducted on adults hospitalised due to COVID-19 in Spain who were included in the SEMI-COVID- 19 Registry from March to November 2020. Results: CTs were used in 6053 (36.21%) of the included patients. The patients were older (mean (SD)) (69.6 (14.6) vs. 66.0 (16.8) years; p < 0.001), with hypertension (57.0% vs. 47.7%; p < 0.001), obesity (26.4% vs. 19.3%; p < 0.0001), and multimorbidity prevalence (20.6% vs. 16.1%; p < 0.001). These patients had higher values (mean (95% CI)) of C-reactive protein (CRP) (86 (32.7-160) vs. 49.3 (16-109) mg/dL; p < 0.001), ferritin (791 (393-1534) vs. 470 (236- 996) µg/dL; p < 0.001), D dimer (750 (430-1400) vs. 617 (345-1180) µg/dL; p < 0.001), and lower Sp02/Fi02 (266 (91.1) vs. 301 (101); p < 0.001). Since June 2020, there was an increment in the use of CTs (March vs. September; p < 0.001). Overall, 20% did not receive steroids, and 40% received less than 200 mg accumulated prednisone equivalent dose (APED). Severe patients are treated with higher doses. The mortality benefit was observed in patients with oxygen saturation </=90%. Conclusions: Patients with greater comorbidity, severity, and inflammatory markers were those treated with CTs. In severe patients, there is a trend towards the use of higher doses. The mortality benefit was observed in patients with oxygen saturation </=90%