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%

Phylogenetic analysis and antibiotic activity of bacteria isolated from the surface of two co-occurring macroalgae from the Baltic Sea

Bacteria associated with Fucus vesiculosus and Delesseria sanguinea, two macroalgae from the Kiel Fjord were investigated seasonally over two years by cultivation-based methods. A total of 166 bacterial strains were isolated from the macroalgae, affiliated to seven classes of bacteria (Actinobacteria, Bacilli, Alphaproteobacteria, Betaproteobacteria, Gammaproteobacteria, Cytophagia and Flavobacteria). According to 16S rRNA gene sequence similarities they were arranged in 82 phylotypes of>99.0% sequence identity. Assuming that chemical factors rule the bacteriamacroalga and bacteriabacteria interactions on algal surfaces, we tested the antibiotic activity of the bacterial isolates not only against a panel of four standard test organisms (Bacillus subtilis, Candida glabrata, Escherichia coli and Staphylococcus lentus) but also four macroalga-associated microorganisms: Algicola bacteriolytica and Pseudoalteromonas elyakovii (macroalgal pathogens), and Bacillus algicola and Formosa algae (strains associated with algal surfaces). Organic extracts of more than 51% of the isolates from the two macroalgae inhibited the growth of at least one of the tested microorganisms. As much as 46% and 45% of the isolates derived from F. vesiculosus and D. sanguinea, respectively, showed antimicrobial activity against the set of macroalga-associated bacteria, compared with 13 and 19% against a standard set of microorganisms. High antibacterial activity against macroalgal pathogens and bacterial competitors support the assumption that complex chemical interactions shape the relationships of bacteria associated with macroalgae and suggest that these bacteria are a rich source of antimicrobial metabolites