El alcance de la cláusula paraguas en los Tratados Bilaterales de Inversión

Modern Bilateral Investment Treaties (BITs), contain various investment protection standards, which it extend and significance haven’t been define with exactitude neither by doctrine nor by jurisprudence. One of these is the so-called umbrella clause that have generated a debate respect the position and interpretation to be taken at the analysis of these provisions. These clauses intend to position under the protection of a BIT, obligations that a State had undertake with an investor, in such way that a rupture of these obligations amount a violation of the treaty. Various arbitral tribunals that have treated the theme have reach to different conclusions in respect to the extension of this type of provisions. On one hand, an extended interpretation accepts the effect of protecting obligations under a BIT. Such position is sustained by the ordinary interpretation of the terms in accordance with the Vienna Convention, by the analysis of the origins and purpose of such clauses and by the principles of effectiveness and pacta sunt servanda.Los modernos Tratados Bilaterales de Inversión (TBIs) contienen varios estándares de protección de inversiones cuyo alcance y significado no han sido definidos con exactitud tanto por la doctrina como por la jurisprudencia. Uno de éstos consiste en la llamada cláusula paraguas; la cual ha provocado un intenso debate respecto a la posición e interpretación que se debe adoptar al analizar una disposición de este tipo. Estas cláusulas, buscan colocar bajo la protección de un TBI obligaciones que el Estado haya adquirido con el inversor, de tal manera que una ruptura de estas obligaciones constituya una violación del tratado. Varios tribunales arbitrales que han abordado el tema han llegado a conclusiones distintas respecto al alcance de este tipo de disposiciones. Por un lado, se encuentra una interpretación amplia que acepta el efecto de colocar bajo la protección de un TBI las obligaciones. Dicha posición se sustenta en la interpretación ordinaria de los términos conforme lo establece la Convención de Viena, en el análisis del origen y propósito de estas disposiciones y en los principios de efectividad y pacta sunt servanda

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio