Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial

Background: Many patients with COVID-19 have been treated with plasma containing anti-SARS-CoV-2 antibodies. We aimed to evaluate the safety and efficacy of convalescent plasma therapy in patients admitted to hospital with COVID-19. Methods: This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]) is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. The trial is underway at 177 NHS hospitals from across the UK. Eligible and consenting patients were randomly assigned (1:1) to receive either usual care alone (usual care group) or usual care plus high-titre convalescent plasma (convalescent plasma group). The primary outcome was 28-day mortality, analysed on an intention-to-treat basis. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936. Findings: Between May 28, 2020, and Jan 15, 2021, 11558 (71%) of 16287 patients enrolled in RECOVERY were eligible to receive convalescent plasma and were assigned to either the convalescent plasma group or the usual care group. There was no significant difference in 28-day mortality between the two groups: 1399 (24%) of 5795 patients in the convalescent plasma group and 1408 (24%) of 5763 patients in the usual care group died within 28 days (rate ratio 1·00, 95% CI 0·93–1·07; p=0·95). The 28-day mortality rate ratio was similar in all prespecified subgroups of patients, including in those patients without detectable SARS-CoV-2 antibodies at randomisation. Allocation to convalescent plasma had no significant effect on the proportion of patients discharged from hospital within 28 days (3832 [66%] patients in the convalescent plasma group vs 3822 [66%] patients in the usual care group; rate ratio 0·99, 95% CI 0·94–1·03; p=0·57). Among those not on invasive mechanical ventilation at randomisation, there was no significant difference in the proportion of patients meeting the composite endpoint of progression to invasive mechanical ventilation or death (1568 [29%] of 5493 patients in the convalescent plasma group vs 1568 [29%] of 5448 patients in the usual care group; rate ratio 0·99, 95% CI 0·93–1·05; p=0·79). Interpretation: In patients hospitalised with COVID-19, high-titre convalescent plasma did not improve survival or other prespecified clinical outcomes. Funding: UK Research and Innovation (Medical Research Council) and National Institute of Health Research

Effects of Corrosion and Ribs on Low Cycle Fatigue Behavior of Reinforcing Steel Bars S400

The results of an experimental study for assessing the degradation of the fatigue properties of reinforcing steel bars grade S400 caused by exposure to laboratory salt spray corrosion environment are presented. For this purpose, low cycle fatigue (LCF) tests were carried out. Furthermore, the effect of ribs on the fatigue strength was recorded. Results are indicative of the catalytic impact of corrosion on LCF behavior. Since two important degradation factors such as corrosion and LCF are functions of time, it appears that the reliability of steel S400 is also time dependant. Additionally, the presence of ribs on material's surface affects significantly the fatigue behavior by reducing energy dissipation and duration of test

Lifetime robustness of a RC bridge pier under corrosion considering bridge importance

A probabilistic approach to lifetime robustness of deteriorating bridges is presented. The role of the environmental damage on structural robustness is investigated by comparing the performance indicators in the original state, in which the structure is intact, and in a perturbed state, in which a damage scenario is applied. The robustness criterion is formulated by taking the importance of the structure into account. The proposed approach is applied to a reinforced concrete bridge pier with box cross-section exposed to corrosion. The results demonstrate the effectiveness of the proposed approach and show the role of the importance of the structure in the assessment of lifetime robustness