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

地球熱学 第21報 : 東太平洋海域の地殻熱流量

One hundred and ninety-seven new heat-flow measurements taken by Scripps Institution of Oceanography in the east Pacific Ocean off the coast of North and Central America are presented. These and three hundred and sixty-seven previous measurements taken in the eastern Pacific Ocean, east of 140°W and between 60°N and 10°S are used to describe the regional pattern of the area. A contour map is presented. The eastern Pacific Ocean is divided into three distinct regions: the area north of 25°N comprising the Mason-Raff magnetic lineations, a second region comprising the California Seamount Province, the East Pacific Rise, the Gulf of California, and the eastern Pacific Ocean basin, and finally a third area east of 100°W which encompasses the Middle America Trench, the Cocos, Galapagos and Carnegie ridges, the Galapagos Platform and the Guatemala Basin. An analysis is made of the heat-flow measurements in each area. This analysis shows that in the second and third regions, large areas exist having an average outward flow of heat greater than 3.0μcal/cm2/sec, the oceanic average is 1.58μcal/cm2/sec (Lee and Uyeda, 1965). These areas which are adjacent to equally large areas of subnormal heat-flow are in striking contrast with the uniformity of heat-flow which has recently been discovered in the northwest Pacific basin and seems to be typical of other ocean basins. It is unlikely that the distribution of these areas of high and low flow east of the East Pacific Rise can be explained by large-scale thermal convection cells in the mantle.スクリブス海洋研究所では,北米,中米沖に新たに197点の海洋底地殻熱流量の測定を行ない,従来の367点を加えて,西経140°以東の南緯10°より北緯60°におよぶ海域において地殻熱流量の地域的分布を吟味した.この結果,東太平洋は, 1) 北緯25°以北のMason-Raffの地磁気縞状帯を含む海域, 2)カルフォルニア海山地帯,東太平洋海嶺,カルフォルニア湾,東太平洋海盆等を含む海域, 3)中央アメリカ海溝,ココ,ガラパゴス,カーネギーの海嶺,ガテマラ海盆などの西経100°以東の海域の3海域に大別される. 2), 3)の海域においては,いくつもの大きな面積を占る平均3.0μcal/cm2sec以上の高熱流量帯が,同規模の世界平均(1.58μcal/cm2sec)以下の低流量帯と隣接して存在しており,北西太平洋海盆等の他の深海盆における一様な地殻熱流量の分布と著しい対照をなしている.東太平洋海嶺以東のこの高低熱流量の分布を大規模なマントル熱対流核で説明することは困難であるように思われる

Studies of the Thermal State of the Earth. The 21st Paper : Heat-Flow, Eastern Pacific

One hundred and ninety-seven new heat-flow measurements taken by Scripps Institution of Oceanography in the east Pacific Ocean off the coast of North and Central America are presented. These and three hundred and sixty-seven previous measurements taken in the eastern Pacific Ocean, east of 140°W and between 60°N and 10°S are used to describe the regional pattern of the area. A contour map is presented. The eastern Pacific Ocean is divided into three distinct regions: the area north of 25°N comprising the Mason-Raff magnetic lineations, a second region comprising the California Seamount Province, the East Pacific Rise, the Gulf of California, and the eastern Pacific Ocean basin, and finally a third area east of 100°W which encompasses the Middle America Trench, the Cocos, Galapagos and Carnegie ridges, the Galapagos Platform and the Guatemala Basin. An analysis is made of the heat-flow measurements in each area. This analysis shows that in the second and third regions, large areas exist having an average outward flow of heat greater than 3.0μcal/cm2/sec, the oceanic average is 1.58μcal/cm2/sec (Lee and Uyeda, 1965). These areas which are adjacent to equally large areas of subnormal heat-flow are in striking contrast with the uniformity of heat-flow which has recently been discovered in the northwest Pacific basin and seems to be typical of other ocean basins. It is unlikely that the distribution of these areas of high and low flow east of the East Pacific Rise can be explained by large-scale thermal convection cells in the mantle.スクリブス海洋研究所では,北米,中米沖に新たに197点の海洋底地殻熱流量の測定を行ない,従来の367点を加えて,西経140°以東の南緯10°より北緯60°におよぶ海域において地殻熱流量の地域的分布を吟味した.この結果,東太平洋は, 1) 北緯25°以北のMason-Raffの地磁気縞状帯を含む海域, 2)カルフォルニア海山地帯,東太平洋海嶺,カルフォルニア湾,東太平洋海盆等を含む海域, 3)中央アメリカ海溝,ココ,ガラパゴス,カーネギーの海嶺,ガテマラ海盆などの西経100°以東の海域の3海域に大別される. 2), 3)の海域においては,いくつもの大きな面積を占る平均3.0μcal/cm2sec以上の高熱流量帯が,同規模の世界平均(1.58μcal/cm2sec)以下の低流量帯と隣接して存在しており,北西太平洋海盆等の他の深海盆における一様な地殻熱流量の分布と著しい対照をなしている.東太平洋海嶺以東のこの高低熱流量の分布を大規模なマントル熱対流核で説明することは困難であるように思われる