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G), degree of fibrosis (F), previous treatments, basal viral load (BVL), treatment duration, viral load at 12 weeks post-treatment, adherence and adverse effects (AEs). Effectiveness was evaluated according to SVR12. Results Ninety-one patients (57.1% men) received treatment with DAAs, with a mean age of 55.6±10.4 years; 20 (22%) were coinfected with HIV, and 55 (60,4%) had BVL >800 000 UI/mL. The genotype distribution was: 29 (31.9%) G1a, 28 (30.8%) G1b, 1 (1.1%) G2, 15 (16.5%) G3 and 18 (19.8%) G4. Degree of fibrosis: 27 F0-F1, 16 F1, 10 F2, 15 F3, 2 F3-F4 and 14 F4; 7 (7.7%) patients were without data (WD). There were 75 (82.4%) naive patients; 6 had received treatment with DAAs (2 with two different lines). Treatment distribution was: 36 (39.6%) glecaprevir/pibrentasvir, 28 for 8 weeks and 8 for 12 weeks; 29 (31.9%) elbasvir/grazoprevir, 28 for 12 weeks and 1 for 16 weeks; 23 (25.3%) sofosbuvir/velpatasvir for 2 weeks, 2 with ribavirin; 1 (1.1%) ledipasvir/sofosbuvir for 8 weeks; 2 (2.2%) sofosbuvir/ velpatasvir/voxilaprevir for 12 weeks, both after relapse to two previous lines with DAAs. The response observed was: glecaprevir/pibrentasvir 32 SVR12, 3 WD and 1 treatment suspension because of the patient's poor clinical condition; elbasvir/grazoprevir 26 SVR12 and 3 WD; sofosbuvir/velpatasvir 17 SVR12, 3 WD, 1 died (sepsis) and 2 virological failure (VF) (both G3, 1 F3, 1 F4, 1 relapsed to DAAs); ledipasvir/sofosbuvir: 1 SRV12; sofosbuvir/velpatasvir/voxilaprevir 2 SRV12. Of the total evaluable responses (n=80), 78 (97.5%) SRV12 and 2 (2.5%) VF were observed. Conclusion and relevance Our data confirm the effectiveness of the new DAAs, with SVR12 >95%, and are consistent with clinical trials which show that patients with G3 have the worst SVR12 rates.

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Demographic, clinical and pharmacological data were retrospectively collected from residents with confirmed SARS-CoV-2 infection: comorbidities, signs and symptoms, outcome (recovery or death), therapy received for COVID-19 and concomitant antibiotic. Results Of the 231 residents who lived in the LTCF when the first resident with confirmed COVID-19 was tested, 29.4% tested positive for SARS-CoV-2 during the study period, of whom 23.5% died. All cause mortality increased by 228.7% compared with the previous 3 years. Median Charlson comorbidity index, age adjusted was 6 (IQR 4.5-7). A few confirmed cases were hospitalised (26.5%) and most of these residents died in the local hospital (68.7%). Median duration of hospitalisation was 12.5 days (IQR 3.5-19). Most of the cases (72.1%) had symptoms, often typical symptoms (fever, cough or breathlessness). More than half received any experimental treatment for COVID-19 (58.8%). Antibiotics were prescribed in 52.9%, with an increase of 47.2% in consumption compared with the same period in 2019. Conclusion and relevance We detected considerable mortality associated with COVID-19, highlighting the challenges of the implementation of a coordinated programme to control SARS-CoV2 outbreaks in LCTFs reducing hospital referral rates.

Objective To analyse the efficacy and safety of using tolvaptan and the suitability of its prescription with the criteria set forth in the pharmacotherapeutic guide of a tertiary hospital. Method A retrospective, observational study on tolvaptan prescriptions issued in the hospital since its inclusion in the pharmacotherapeutic guide in October 2010, until February 2013. Data were collected from the patient's electronic medical records and the computerassisted prescription programme. Results A total of 80 patients (52.3% males) with an average age of 68.8 (SD=14.6) years were included. The most common diagnosis for its prescription was heart failure (52.3% of cases). The initial mean for plasma sodium levels was 125.5 (SD=7.2) mEq/L. Tolvaptan use increased sodium levels to 135 mEq/L in 59.3% of patients. The median duration of treatment was 4 days (range 1-53 days). No significant differences were observed in other laboratory parameters tested. The average cost per patient was €487.80. Tolvaptan prescriptions were issued in accordance with the hospital's pharmacotherapeutic guide in 66.6% of the cases. Conclusions Treatment with tolvaptan safely and effectively increases plasma sodium levels in patients with hyponatraemia originating for various reasons, despite its approval for use by the EMA solely for cases of hyponatraemia secondary to syndrome of inappropriate antidiuretic hormone secretion.