IL-6 serum levels predict severity and response to tocilizumab in COVID-19: An observational study

Background: Patients with coronavirus disaese 2019 (COVID-19) can develop a cytokine release syndrome that eventually leads to acute respiratory distress syndrome requiring invasive mechanical ventilation (IMV). Because IL-6 is a relevant cytokine in acute respiratory distress syndrome, the blockade of its receptor with tocilizumab (TCZ) could reduce mortality and/or morbidity in severe COVID-19. Objective: We sought to determine whether baseline IL-6 serum levels can predict the need for IMV and the response to TCZ. Methods: A retrospective observational study was performed in hospitalized patients diagnosed with COVID-19. Clinical information and laboratory findings, including IL-6 levels, were collected approximately 3 and 9 days after admission to be matched with preadministration and postadministration of TCZ. Multivariable logistic and linear regressions and survival analysis were performed depending on outcomes: need for IMV, evolution of arterial oxygen tension/fraction of inspired oxygen ratio, or mortality. Results: One hundred forty-six patients were studied, predominantly males (66%); median age was 63 years. Forty-four patients (30%) required IMV, and 58 patients (40%) received treatment with TCZ. IL-6 levels greater than 30 pg/mL was the best predictor for IMV (odds ratio, 7.1; P < .001). Early administration of TCZ was associated with improvement in oxygenation (arterial oxygen tension/fraction of inspired oxygen ratio) in patients with high IL-6 (P = .048). Patients with high IL-6 not treated with TCZ showed high mortality (hazard ratio, 4.6; P = .003), as well as those with low IL-6 treated with TCZ (hazard ratio, 3.6; P = .016). No relevant serious adverse events were observed in TCZ-treated patients. Conclusions: Baseline IL-6 greater than 30 pg/mL predicts IMV requirement in patients with COVID-19 and contributes to establish an adequate indication for TCZ administrationThis study was funded by Spanish Ministry of Economy, Industry and Competitiveness (MINECO) and Instituto de Salud Carlos III (grant nos. RD16/0011/0012 and PI18/ 0371 to I.G.A., grant no. PI19/00549 to A.A., and grant no. SAF2017-82886-R to F.S.-M.) and co-funded by the European Regional Development Fund. The study was also funded by ‘‘La Caixa Banking Foundation’’ (grant no. HR17-00016 to F.S.-M.) and ‘‘Fondos Supera COVID19’’ by Banco de Santander and CRUE. None of these sponsors have had any role in study design; in the collection, analysis, and interpretation of data; in the writing of the report; and in the decision to submit the article for publicatio

Biomass combustion with in situ CO2 capture by CaO in a 300 kWth circulating fluidized bed facility

This paper reports experimental results from a new 300 kWth calcium looping pilot plant designed to capture CO2 “in situ” during the combustion of biomass in a fluidized bed. This novel concept relies on the high reactivity of biomass as a fuel, which allows for effective combustion around 700 °C in air at atmospheric pressure. In these conditions, CaO particles fed into the fluidized bed combustor react with the CO2 generated during biomass combustion, allowing for an effective CO2 capture. A subsequent step of regeneration of CaCO3 in an oxy-fired calciner is also needed to release a concentrated stream of CO2. This regeneration step is assumed to be integrated in a large scale oxyfired power plant and/or a larger scale post-combustion calcium looping system. The combustor-carbonator is the key reactor in this novel concept, and this work presents experimental results from a 300 kWth pilot to test such a reactor. The pilot involves two 12 m height interconnected circulating fluidized bed reactors. Several series of experiments to investigate the combustor-carbonator reactor have been carried out achieving combustion efficiencies close to 100% and CO2 capture efficiencies between 70 and 95% in dynamic and stationary state conditions, using wood pellets as a fuel. Different superficial gas velocities, excess air ratios above stoichiometric requirements, and solid circulating rates between combustor-carbonator and combustor-calciner have been tested during the experiments. Closure of the carbon and oxygen balances during the combustion and carbonation trials has been successful. A simple reactor model for combustion and CO2 capture in the combustor-carbonator has been applied to aid in the interpretation of results, which should facilitate the future scaling up of this process concept.This work was partially funded under the MENOS CO2 project (CDTI, Spanish Ministry of Economy and Competitivity). M.E. Diego acknowledges the award of a fellowship Grant under the CSIC JAE Programme, co-funded by the European Social Fund.Peer reviewe

Captura de CO2: tecnologías para una captación a gran escala

Con la publicación de este cuarto volumen nuestra plataforma completa la serie de monografías elaboradas por sus expertos sobre las tecnologías de captura, transporte, almacenamiento y usos del CO2 (tecnologías CAC). La captura, primera de las fases y sobre la que profundiza este libro, es la etapa que da sentido a las demás y, por tanto, la que condiciona toda su gestión posterior. Se trata, además, del área que más desarrollo ha experimentado durante estos últimos años, en los que sus tres líneas de trabajo fundamentales (pre-combustión, post-combustión y oxicombustión) han sido ampliamente estudiadas y desarrolladas. Ello hace posible que al día de hoy se encuentren preparadas para dar el salto a la escala comercial. Pero, como cabría esperar en un área con elevado potencial de innovación, se han iniciado ya los trabajos en tecnologías de segunda y tercera generación, tales como la de carbonatación-calcinación o el empleo de membranas, que están llamadas a rebajar aún más el coste asociado a la gestión de la tonelada de CO2 evitada. Existe un consenso internacional en que la demanda mundial energética, a pesar de las fluctuaciones económicas de los últimos años, seguirá aumentando y también en que una parte sustancial de la misma, ya sea en generación de electricidad o en su empleo por un abanico amplio de industrias, continuará siendo cubierta por energía fósil. Consecuentemente, el desarrollo y uso de las tecnologías CAC es irrenunciable. En resumen, este documento se presenta como lectura de referencia para quien desee conocer en profundidad unas tecnologías que hoy ya se muestran fundamentales. Por nuestra parte, continuamos trabajando para que su implantación en nuestro país ayude al cumplimiento de los compromisos de reducción de emisiones que España adopte en cada momento y para que asimismo se logre el beneficio del desarrollo económico e industrial de un sector del CO2 competitivo.Peer reviewe