Baricitinib treatment for hospitalized patients with severe COVID-19 on invasive mechanical ventilation：a propensity score-matched and retrospective analysis (preprint)

Introduction: Baricitinib is a selective inhibitor of Janus kinase (JAK)1 and JAK2, which is associated with clinical improvement in non-severe COVID-19 patients. But in severe COVID-19 patients, the efficacy of baricitinib is still controversial. Methods: A propensity score-matched and retrospective study was conducted to evaluate the efficacy of baricitinib in severe COVID-19 patients requiring invasive mechanical ventilation (IMV). Results: A total number of 46 patients treated with baricitinib were included, and 44 patients were assigned to control group by propensity score matching. The mean ages were high in both group (baricitinib group vs control group: 78.80±9.04 vs 82.57±9.27), and most were unvaccinated (65.2% vs 72.7%). Baricitinib group had a higher proportion of patients with hypertension (73.9% vs 45.5%). Control group had higher level of creatine kinase-myocardial band (247.50 vs 104.50). Patients in the baricitinib group were more likely to receive nirmatrelvir/ritonavir (41.3% vs 18.2%) and intravenous immunoglobin (15.2% vs 0). Both groups reported high all-cause 28-day mortality (73.9% vs 84.1%). The use of baricitinib didn’t reduce 28-days mortality. Conclusion: The present study revealed baricitinib didn’t reduce 28-days mortality in severe COVID-19 patients on IMV. The effectiveness of baricitinib in treating patients with severe COVID-19 on IMV needs to be further investigated through future studies.

A population-based retrospective study of the spread of COVID-19 from Wuhan to Henan province, China (preprint)

The epidemic of COVID-19 has now spread globally and affected over 110 countries. As of Mar 10th, using publicly available data and official news reports in Henan province, we tracked a total of 1272 cases and a retrospective study was conducted to investigate the related factors in COVID-19 spread and control. We confirmed 554 primary patients had travel or residential history of Wuhan in the recent 2 weeks. Secondary cases accounted for 77.9% (141/181) among all the patients aged 61 or older, in whom contacted with unconfirmed returnees from Wuhan was responsible for 27.0% (38/141). The median incubate period is 7 (IQR, 4-10) days by analyzing time information in 469 cases. For 442 patients with discharge dates, the duration from onset to cure is 19 (IQR, 15-23) days. The time from onset to seeking care at a hospital varied in age groups, and differed between primary and secondary cases. Patients visiting different hospitals affected the time from seeking care to cure. Thus, our results showed the spread of COVID-19 and factors associated with outcomes of patients in Henan province, which helps to understand the epidemiological features outside of the epidemic area and control the disease in other regions and countries.

Spread and control of COVID-19 in China and their associations with population movement, public health emergency measures, and medical resources (preprint)

ABSTRACT BACKGROUND The COVID-19 epidemic, first emerged in Wuhan during December 2019, has spread globally. While the mass population movement for Chinese New Year has significantly influenced spreading the disease, little direct evidence exists about the relevance to epidemic and its control of population movement from Wuhan, local emergency response, and medical resources in China. METHODS Spearman's correlation analysis was performed between official data of confirmed COVID-19 cases from Jan 20th to Feb 19th, 2020 and real-time travel data and health resources data. RESULTS There were 74,675 confirmed COVID-19 cases in China by Feb 19th, 2020. The overall fatality rate was 2.84%, much higher in Hubei than in other regions (3.27% vs 0.73%). The index of population inflow from Hubei was positively correlated with total (Provincial r=0.9159, p<0.001; City r=0.6311, p<0.001) and primary cases (Provincial r=0.8702, p<0.001; City r=0.6358, p<0.001). The local health emergency measures (eg, city lockdown and traffic control) were associated with reduced infections nationwide. Moreover, the number of public health employees per capita was inversely correlated with total cases (r=-0.6295, p<0.001) and infection rates (r=-0.4912, p<0.01). Similarly, cities with less medical resources had higher fatality (r=-0.4791, p<0.01) and lower cure rates (r=0.5286, p<0.01) among the confirmed cases. CONCLUSIONS The spread of the COVID-19 in China in its early phase was attributed primarily to population movement from Hubei, and effective governmental health emergency measures and adequate medical resources played important roles in subsequent control of epidemic and improved prognosis of affected individuals.