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%

Gênese de ferri-argilãs em horizontes B texturais de uma seqüência de solos sobre diabásio em Piracicaba (SP) Ferriargillan genesis in argillic B horizons of a soil sequence over diabase in Piracicaba

Numa sequência de solos sobre diabásio localizada no campus da USP em Piracicaba a formação de ferri-argilãs e os processos de adensamento foram estudados. Foram realizados estudos morfológicos, micromorfológicos, de microscopia eletrônica de varredura e microanálise em amostras retiradas de três trincheiras localizadas nesta sequência. A presença de ferri-argilãs de iluviação foi observada nos horizontes B textural e na alterita principalmente preenchendo a porosidade mamelonar, policôncava e fissural provocando o adensamento dos mesmos. Evidências de hidromorfia temporária sugeriram que este processo estaria provocando a desestabilização das ligações ferro-argila facilitando assim a mobilização e redistribuição do ferro e da argila.<br>The formation of ferriargillans and densing processes were studied on a soil sequence over diabase situated in Piracicaba (SP) Brazil. Morphological, micromorphological, scanning electron microscopic and microanalytical studies were performed on samples taken from three trenches within the sequence. The presence of illuvial ferriargillans was observed mainly in the argillic B horizons and the saprolite, which filled the mamelonar, polyconcave and planar voids which led to their densing. Evidence of temporary hydromorphy suggested that this process would affect the stability of the iron oxide-clay interactions which would promote the mobilization and redistribution of iron and clay