Publication

Abstract :

Background: 

Baricitinib is a Janus-kinase inhibitor with known anti-inflammatory effects with beneficial outcomes in COVID-19 management. We aim to assess the efficacy and all-cause mortality among moderate-to-severe COVID-19 patients who received baricitinib as an add-on to the standard of care.

Methods: 

The retrospective case–control study recruited moderate-to-severe COVID-19 patients receiving baricitinib therapy for at least 72 h as cases from April 2021 to October 2021. Age- and severity-matched COVID-19 patients receiving standard of care without baricitinib served as control. The clinical and demographic data of the study groups were collected. Study outcomes evaluated included all-cause mortality, clinical improvement as assessed by the WHO Ordinal Scale scores, multiorgan dysfunction syndrome, thrombotic events, and secondary infections.

Results: 

Among 527 moderate-to-severe COVID-19 patients in the study period, 75 patients each were recruited into the case and control groups who fulfilled the study eligibility criteria. The average age was found to be 60.82 ± 13.03 and 61 ± 13.48 years in case and control groups, respectively. All-cause mortality was 42.7% (64), with 27 (36%) and 37 (49.3%) deaths in the case and control groups, respectively (P = 0.09). Kaplan–Meier survival analysis revealed the survival distributions to be significantly different between case and control groups (Log-rank: P =0.048). Clinical improvement was observed in 35 (47%) and 28 (37.7%) patients among cases and controls, respectively (P = 0.32).

Conclusion: 

The study demonstrated improved clinical outcomes, including mortality reduction and higher proportion of patients attaining clinical improvement as measured by at least 1-point improvement of the WHO ordinal scale, though a statistical significance was not observed.