Ruxolitinib as a treatment strategy for SARS-CoV-2 pneumonia: clinical experience in a real-world setting.

INTRODUCTION: Severe acute respiratory syndrome-related coronavirus (SARS-CoV-2) infection is characterised by a viral phase and a severe pro-inflammatory phase. The inhibition of the JAK/STAT pathway limits the pro-inflammatory state in moderate to severe COVID-19. METHODOLOGY: We analysed the data obtained by an observational cohort of patients with SARS-CoV-2 pneumonia treated with ruxolitinib in 22 hospitals of Mexico. The applied dose was determined based on physician's criteria. The benefit of ruxolitinib was evaluated using the 8-points ordinal scale developed by the NIH in the ACTT1 trial. Duration of hospital stay, changes in pro-inflammatory laboratory values, mortality, and toxicity were also measured. RESULTS: A total of 287 patients were reported at 22 sites in Mexico from March to June 2020; 80.8% received ruxolitinib 5 mg BID and 19.16% received ruxolitinib 10 mg BID plus standard of care. At beginning of treatment, 223 patients were on oxygen support and 59 on invasive ventilation. The percentage of patients on invasive ventilation was 53% in the 10 mg and 13% in the 5 mg cohort. A statistically significant improvement measured as a reduction by 2 points on the 8-point ordinal scale was described (baseline 5.39 ± 0.93, final 3.67± 2.98, p = 0.0001). There were 74 deaths. Serious adverse events were presented in 6.9% of the patients. CONCLUSIONS: Ruxolitinib appears to be safe in COVID-19 patients, with clinical benefits observed in terms of decrease in the 8-point ordinal scale and pro-inflammatory state. Further studies must be done to ensure efficacy against mortality.

Persistencia de síntomas en pacientes después de la enfermedad por coronavirus (COVID-19) en un hospital de tercer nivel de Puebla, México

BACKGROUND: In the epidemic phase of the coronavirus in Mexico a phenomenon called persistent symptoms has been described, which occur in all patients who have developed the disease, but despite its improvement in time, they present a series of diverse symptoms that do not allow them to continue their daily life normally during the resolution phase of the disease. OBJECTIVE: To determine the persistence of post-COVID-19 symptoms in a population cared at a third level hospital of Puebla.*MATERIAL AND METHOD: An observational and descriptive study of the population attended in the Pneumology outpatient clinic at Hospital Ángeles Puebla. Post-COVID 19 patients were asked a symptom questionnaire within 30-60 days after their symptoms or resolution of the symptoms under the following variables: age, sex, BMI, comorbidities, tobacco index, symptoms in acute COVID-19 infection, established treatment, days of resolution of symptoms, presence of symptoms after resolution of the disease. RESULTS: Fifty patients were included (30% women and 70% men), 84% presented persistent symptoms after the resolution of the disease, of which fatigue, headache, chest tightness and dyspnea were the main ones. CONCLUSIONS: This work demonstrates in a population the importance of symptoms after COVID-19 infection, which are of clinical relevance for the total resolution of the disease and aimed at improving the quality of life of recovered patients. (English) [ABSTRACT FROM AUTHOR] ANTECEDENTES: En la fase epidémica del coronavirus en México se ha descrito un fenómeno denominado síntomas persistentes, que se manifiestan en todos los pacientes que han padecido la enfermedad, pero que a pesar de su mejoría en tiempo manifiestan una serie de síntomas diversos que no permiten continuar de manera normal su vida cotidiana durante la fase de alivio de la enfermedad. OBJETIVO: Determinar la persistencia de síntomas pos-COVID-19 en una población atendida en un hospital de tercer nivel de Puebla. MATERIAL Y MÉTODO: Estudio descriptivo, observacional, de la población atendida en la consulta externa de Neumología en el Hospital Ángeles Puebla, efectuado del 1 de abril al 1 de julio de 2020. Se aplicó un cuestionario de síntomas a los pacientes pos-COVID-19 dentro de los 30 a 60 días posteriores a sus síntomas o alivio del cuadro bajo las siguientes variables: edad, sexo, IMC, comorbilidades, índice tabáquico, síntomas en infección aguda por COVID-19, tratamiento prescrito y días de alivio de los síntomas, existencia de síntomas posterior a la resolución de la enfermedad. RESULTADOS: Se incluyeron 50 pacientes (30% mujeres y 70% hombres), 84% tuvieron síntomas persistentes después del alivio de la enfermedad, los principales fueron: fatiga, cansancio y debilidad, cefalea, opresión torácica y disnea. CONCLUSIONES: Este trabajo demuestra en una población la importancia de los síntomas posteriores a infección por COVID-19, que son de relevancia clínica para el alivio total de la enfermedad y dirigido a mejorar la calidad de vida de los pacientes recuperados. (Spanish) [ABSTRACT FROM AUTHOR] Copyright of Medicina Interna de Mexico is the property of Colegio de Medicina Interna de Mexico and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)