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Resumen Introducción La presencia de hipertensión arterial se asocia con peor pronóstico en pacientes con COVID-19, y se ha sugerido que el uso de inhibidores del eje renina-angiotensina puede influir en el pronóstico de los pacientes. Métodos Registro observacional de 921 pacientes consecutivos ingresados por infección respiratoria COVID-19 entre el 1 de marzo y el 30 abril de 2020 en el Hospital General Universitario de Ciudad Real. Se registraron datos clínicos y analíticos, intervenciones terapéuticas y desarrollo de eventos durante el ingreso hospitalario. Resultados La mediana de edad fue de 78 años y el 59,2% tenían hipertensión arterial. Aunque el perfil clínico fue más desfavorable en el grupo de pacientes con prescripción previa de IECA o ARA2 respecto al resto, los primeros presentaron menor riesgo de desarrollo del evento primario combinado (mortalidad total o necesidad de soporte ventilatorio invasivo). Asimismo, el empleo previo al ingreso o durante el mismo de estos fármacos mostró un efecto neutro sobre la mortalidad total y sobre la necesidad de ventilación mecánica invasiva. En el análisis de supervivencia no se observó mayor riesgo de presentar más precozmente ninguno de los eventos registrados. Conclusiones La prescripción previa al ingreso por infección respiratoria COVID-19 de inhibidores del eje renina-angiotensina se asoció a un menor riesgo de desarrollo del evento primario combinado y a un efecto neutro sobre la mortalidad total y sobre la necesidad de ventilación mecánica invasiva.

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BackgroundSeveral studies show the association between administration of tranexamic acid (ATX) in orthopaedic surgery and a decrease in transfusion requirement of patients. In January 2014, a protocol using this drug in knee and hip surgery was implemented in our hospital.PurposeTo analyse transfusion requirements in patients undergoing orthopaedic surgery who received ATX and their side effects.Material and methodsProspective study of all patients undergoing knee or hip surgery from 1 January 2014 to 30 June 2015. Data recorded were: name, medical record number, age, date of admission and surgery, orthopaedic surgery type, preoperative haemoglobin and variations during hospital stay, transfusion requirements, discharge date, possible contraindications for administration of ATX (specified in the protocol of the hospital) and occurrence of deep vein thrombosis (DVT) as a side effect.Patients were obtained from the Traumatology Service database, while transfusion requirements were obtained from the Haematology Service registry.ResultsOf the 272 patients undergoing one of the revised surgeries, 201 (73.9%) received ATX while the rest showed heart disease, previous stroke or blood disorders that contraindicated this use. 35.8% of patients who received it were men and 64.2% women, with an average age of 69.6 years. Most underwent knee arthroplasty (74.1%) and 25.9% hip arthroplasty. The average length of stay was 6.4 days (4–20 days) and the mean decrease in haemoglobin levels was 3.6 g/dL. In the group of patients receiving ATX, 19(9.5%) required transfusions and received a total of 33 packed red blood cells. In the group without ATX, 14 patients (19.7%) required administration of another 33 packed red blood cells. No patient developed DVT because of administration of ATX.ConclusionMost patients undergoing knee or hip surgery in our centre have met the criteria for administration of ATX, and transfusion requirements were significantly lower in this group compared with patients who did not receive the drug. So far there has been no case of DVT associated with the use of ATX, so we can consider it as a relatively safe drug and cost effective because it is a low cost drug that reduces the requirements for packed red blood cells in this selected group of patients.No conflict of interest.