Background The COVID-19 outbreak challenges the Spanish health system since March 2020. Some available therapies (antimalarials, antivirals, biological agents) were grounded on clinical case observations or basic science data. The aim of this study is to describe the characteristics and impact of different therapies on clinical outcomes in a cohort of severe COVID-19 patients. Methods In this retrospective, single-center, observational study, we collected sequential data on adult patients admitted to Hospital Universitario Quironsalud Madrid. Eligible patients should have a microbiological (positive test on RT-PCR assay from a nasal swab) or an epidemiological diagnosis of severe COVID-19. Demographic, baseline comorbidities, laboratory data, clinical outcomes, and treatments were compared between survivors and non-survivors. We carried out univariate and multivariate logistic regression models to assess potential risk factors for in-hospital mortality. Findings From March 10th to April 15th, 2020, 607 patients were included. Median age was 69 years [interquartile range, {IQR} 22; 65% male). The most common comorbidities were hypertension (276 [46·94%]), diabetes (95 [16·16%]), chronic cardiac (133 [22·62%]) and respiratory (114 [19·39%]) diseases. 141 patients (23·2%) died. In the multivariate model the risk of death increased with older age (odds ratio, for every year of age, 1·15, [95% CI 1·11 - 1·2]), tocilizumab therapy (2·4, [1·13 - 5·11]), C-reactive protein at admission (1·07, per 10 mg/L, [1·04 - 1·10]), d -dimer > 2·5 μg/mL (1·99, [1·03 - 3·86]), diabetes mellitus (2·61, [1·19 - 5·73]), and the PaO 2 /FiO 2 at admission (0·99, per every 1 mmHg, [0·98 - 0·99]). Among the prescribed therapies (tocilizumab, glucocorticoids, lopinavir/ritonavir, hydroxychloroquine, cyclosporine), only cyclosporine was associated with a significant decrease in mortality (0·24, [0·12 - 0·46]; p <0·001). Interpretation In a real-clinical setting, inhibition of the calcineurin inflammatory pathway, NF-κΒ, could reduce the hyperinflammatory phase in COVID-19. Our findings might entail relevant implications for the therapy of this disease and could boost the design of new clinical trials among subjects affected by severe COVID-19. Funding Hospital Universitario Quironsalud Madrid. Own fundings for COVID-19 research.

This manuscript compares the electrochemically controlled adsorption of hydroquinone-derived adlayers and their reductive desorption from nanometer-sized Pt(111) domains present on the surface (i) of model stepped single-crystal electrodes and (ii) of preferentially oriented Pt nanoparticles. The results obtained using a stepped surface series, i.e., Pt(S)[(n - 1)(111)x(110)], suggest that in the presence of 2 mM H(2)Q((aq)) the electrochemically detected desorption-adsorption process takes place selectively from ordered Pt(111) domains present as terraces, while being precluded at other available surface sites, i.e., Pt(110) steps, where adsorption takes place irreversibly. This domain-selective electroanalytical detection scheme is employed later to selectively monitor desorption-adsorption of hydroquinone-derived adlayers from ordered, nanometer-scaled Pt(111) domains on the surface of preferentially oriented Pt nanoparticles, confirming the existence of well-ordered (111) domains on the surface of the Pt nanoparticles. A good correlation is noted between the electrochemical behavior at well-ordered Pt(hkl) surfaces and at preferentially oriented Pt nanoparticles. Key learnings and potential applications are discussed. The results demonstrate the technical feasibility of performing domain-selective decapping of nanoparticles by handle of an externally controlled parameter, i.e., the applied potential.