Treatment for COVID-19-a cohort study from Northern Italy.

Multicentre, retrospective cohort study with multivariable Cox proportional-hazards modelling and survival-time inverse-probability-weighting, evaluating the impact of different treatments on survival of proven COVID-19 patients admitted to two Hospitals in the province of Piacenza, Italy. Use of tocilizumab and of high doses of low molecular weight heparin, but not of antivirals (either alone or in combination), azithromycin, and any corticosteroid, was independently associated with lower mortality. Our results support further clinical evaluation of high doses of low molecular weight heparin and tocilizumab as COVID-19 therapeutics.

Severe COVID-19 pneumonia in Piacenza, Italy - A cohort study of the first pandemic wave.

BACKGROUND: Piacenza is the closest city to the first coronavirus disease 2019 (COVID-19) cluster in Italy and has the highest national COVID-19 death rates per population. The objective of this study is to present characteristics and outcomes of patients admitted to medical departments of the Hospital of Piacenza during the first wave of the epidemic. METHODS: A total of 218 patients with confirmed or suspect COVID-19 and severe pneumonia were included from February 21st to May 15th, 2020. Routinely-collected clinical and laboratory data were retrospectively retrieved from electronic medical files. A Cox proportional-hazards model was fit to assess the association of treatment and other variables with death. RESULTS: Median age of patients was 68 years; 150 patients (69%) had comorbidities, mainly hypertension (107, 49%). Overall, 185 (85%) patients had acute respiratory distress syndrome (ARDS) on admission, including 103 (47%) with moderate or severe ARDS. Chest computed tomography scan showed bilateral disease in 201 (98%) and extensive lung involvement in 79 (50%) patients. Most patients received antiviral treatment (187, 86%) and corticosteroids (134, 61%). All patients received respiratory support and 64 (29%) were admitted to intensive care unit. As of June 30th, 100 patients (46%) died, 109 patients (50%) were discharged, and 9 patients (4%) were still hospitalized. In multivariable Cox analysis, age above 65 years, having more than one comorbidity, severe ARDS, low platelet counts, and high LDH levels at admission were associated with mortality, while having diarrhea at admission was associated with survival. The use of antivirals or corticosteroids was not associated with survival. CONCLUSIONS: Overall case fatality rates were high and associated with comorbidities, extensive lung involvement, ARDS at admission, and advanced age. The use of antivirals was not associated with increased survival.

Relação solo-vegetação em remanescente da floresta estacional decidual na Região Central do Rio Grande do Sul / Soil-vegetation relationship in seasonal deciduous forest remnant in the Central Region of Rio Grande does Sul, Brazil

O presente trabalho objetivou caracterizar a relação solo-vegetação em remanescente da Floresta Estacional Decidual na Região Central do Rio Grande do Sul a partir da análise da relação entre atributos edáficos e dois grupos fitossociológicos (G1 e G2). Características químicas e o percentual de argila do solo foram submetidos à análise da variância e suas relações com G1 e G2 foram avaliadas por análise de componentes principais (ACP). Para tanto, G1 e G2 foram classificados em 3 intervalos de declividade: 1-14º; 15-34º e 35-45º. Foram identificados Neossolo Litólico nas áreas declivosas e Neossolo Quartzarênico nas áreas planas. G1 na declividade 35-45º e G2 em 1-14º foram mais sensíveis à variação da qualidade química do solo. A relação dos grupos fitossociológicos com a qualidade química do solo aumentou proporcionalmente ao aumento de declividade. Relevo declivoso, pedogênese incipiente e material de origem sedimentar ressaltaram a fragilidade da área, o que valoriza a presença da floresta para a manutenção de serviços ambientais.

The present study aimed to characterize the soil-vegetation relationship in Seasonal Deciduous Forest remnant at Central Region of Rio Grande do Sul, starting from the analysis of the relationship between soil attributes and two phytosociological groups (G1 and G2). Chemical soil characteristics and clay percentage were submitted to variance analysis and relations with G1 and G2 were evaluated by Principal Components Analysis (PCA). Therefore, it was classified G1 and G2 within 3 slope intervals: 1-14°, 15-34° and 35-45°. Leptosols have been identified in high slopes and Arenosols in the plan area. G1 in 35-45° and G2 in 1-14º were more sensitive to soil chemical quality. The phytosociological groups and soil quality relationship increased proportionally with the increase on slope. The declivous relief, recent pedogenesis and sedimentary parental material highlighted the fragility of the area, which emphasizes the forest presence for the environmental services maintenance.