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Impact of high dose of baricitinib in severe COVID-19 pneumonia: a prospective cohort study in Bangladesh.
Hasan, Md Jahidul; Rabbani, Raihan; Anam, Ahmad Mursel; Huq, Shihan Mahmud Redwanul; Polash, Mohammad Mufizul Islam; Nessa, Shahzadi Sayeeda Tun; Bachar, Sitesh C.
  • Hasan MJ; Clinical Pharmacist (Critical Care and Infectious Diseases/ Stewardship), Clinical Pharmacy Services, Department of Pharmacy, Square Hospitals Ltd., 18/F Bir Uttam Qazi Nuruzzaman Sarak, West Panthapath, Dhaka, 1205, Bangladesh. jahidul@squarehospital.com.
  • Rabbani R; Internal Medicine and Intensive Care Unit, Department of Medical Services, Square Hospitals Ltd., 18/F Bir Uttam Qazi Nuruzzaman Sarak, West Panthapath, Dhaka, 1205, Bangladesh.
  • Anam AM; High Dependency Unit (HDU), Department of Medical Services, Square Hospitals Ltd., 18/F Bir Uttam Qazi Nuruzzaman Sarak, West Panthapath, Dhaka, 1205, Bangladesh.
  • Huq SMR; Internal Medicine and Intensive Care Unit, Department of Medical Services, Square Hospitals Ltd., 18/F Bir Uttam Qazi Nuruzzaman Sarak, West Panthapath, Dhaka, 1205, Bangladesh.
  • Polash MMI; Intensive Care Unit, Department of Medical Services, Square Hospitals Ltd., 18/F Bir Uttam Qazi Nuruzzaman Sarak, West Panthapath, Dhaka, 1205, Bangladesh.
  • Nessa SST; Intensive Care Unit, Department of Medical Services, Square Hospitals Ltd., 18/F Bir Uttam Qazi Nuruzzaman Sarak, West Panthapath, Dhaka, 1205, Bangladesh.
  • Bachar SC; Department of Pharmacy, University of Dhaka, Dhaka, Bangladesh.
BMC Infect Dis ; 21(1): 427, 2021 May 07.
Article in English | MEDLINE | ID: covidwho-1219337
ABSTRACT

PURPOSE:

Hyperinflammation in severe COVID-19 infection increases the risk of respiratory failure and one of the cogent reasons of mortality associated with COVID-19. Baricitinib, a janus kinases inhibitor, can potentially suppress inflammatory cascades in severe COVID-19 pneumonia.

METHODS:

The objective of this study was to compare the clinical outcomes of high dose of baricitinib with its usual dose in patients with severe COVID-19 pneumonia. This prospective cohort study was conducted on 238 adult patients with severe COVID-19 pneumonia. Eight milligram and 4 mg of baricitinib was given orally to 122 patients in the high dose (HD) group and 116 patients the usual dose (UD) group, respectively daily for 14 days, and clinical outcomes were compared among the groups.

RESULTS:

Blood oxygen saturation level was stabilized (≥94% on room air) earlier in the HD group compared to the UD group [5 (IQR 4-5)/8 (IQR 6-9), P < 0.05]. Patients in the HD group required intensive care unit (ICU) and intubation supports more in the UD group than that in patients of the HD group [17.2%/9%, P < 0.05; 11.2%/4.1%, P > 0.05; N = 116/122, respectively]. The 30-day mortality and 60-day rehospitalization rate were higher in the UD group than the HD group [6%/3.3%, P < 0.01; 11.9%/7.6%, P > 0.05; N = 116/122, respectively].

CONCLUSION:

The daily high dose of baricitinib in severe COVID-19 results in early stabilization of the respiratory functions, declined requirements of critical care supports, reduced rehospitalization with mortality rate compared to its daily usual dose.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Purines / Pyrazoles / Sulfonamides / Azetidines / Anti-Inflammatory Agents, Non-Steroidal / COVID-19 Drug Treatment Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: Asia Language: English Journal: BMC Infect Dis Journal subject: Communicable Diseases Year: 2021 Document Type: Article Affiliation country: S12879-021-06119-2

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Purines / Pyrazoles / Sulfonamides / Azetidines / Anti-Inflammatory Agents, Non-Steroidal / COVID-19 Drug Treatment Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: Asia Language: English Journal: BMC Infect Dis Journal subject: Communicable Diseases Year: 2021 Document Type: Article Affiliation country: S12879-021-06119-2