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%

Sewage sludge based catalysts for catalytic wet air oxidation of phenol: preparation, characterisation and catalytic performance

In this study the use of novel CWAO catalysts, namely potentially low cost, sewage sludge derived activated carbons was explored. Two types of municipal sludge were used: dewatered raw filter cake and dewatered mesophilic anaerobically digested sludge. The carbons were produced by: carbonisation; physical activation (steam or CO2) and chemical activation (K2CO3). Hydrochloric acid washing of some of the carbons was also investigated. The carbons were characterised in terms of their surface area, contact pH, propensity towards metal leaching, surface chemistry (via FTIR), ash content and inorganic elemental composition. Their CWAO performance was assessed at 160 ◦C and a partial oxygen pressure of 4.2 bar (25 bar of air) within a stirred batch reactor containing a 5 g/L phenol solution. All the carbons exhibited catalytic activity, with the K2CO3 activated and HCl washed carbons attaining a phenol and TOC removal that matched the performance of an activated carbon specifically manufactured for oxidative wastewater treatment applications. A strong correlation was found between surface area and phenol or TOC conversion, suggesting that surface area is a primary requisite for their performance in the first batch cycle. Thus, the oxidation of phenol is thought to proceed via a free radical driven mechanism. The active sites necessary to facilitate this mechanism, whether present as surface functional groups or active metals (e.g., Fe), were detected on all of the sludge based activated carbons. However, no clear correlation between phenol conversion and these active sites could be established.Peer ReviewedPostprint (published version