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Additional baricitinib loading dose improves clinical outcome in COVID-19

Authors
  • Hasan, Md Jahidul1
  • Rabbani, Raihan2
  • Anam, Ahmad Mursel3
  • Huq, Shihan Mahmud Redwanul2
  • 1 Clinical Pharmacy Services, Department of Pharmacy, Square Hospitals Ltd, 18/F Bir Uttam Qazi Nuruzzaman Sarak, West Panthapath , (Bangladesh)
  • 2 Department of Medical Services, Internal Medicine and ICU, Square Hospitals Ltd, 18/F Bir Uttam Qazi Nuruzzaman Sarak, West Panthapath, Bangladesh , (Bangladesh)
  • 3 Department of Medical Services, High Dependency Unit (HDU), Square Hospitals Ltd, 18/F Bir Uttam Qazi Nuruzzaman Sarak, West Panthapath, Bangladesh , (Bangladesh)
Type
Published Article
Journal
Open Medicine
Publisher
De Gruyter
Publication Date
Dec 05, 2020
Volume
16
Issue
1
Pages
41–46
Identifiers
DOI: 10.1515/med-2021-0010
Source
De Gruyter
Keywords
License
Green

Abstract

Pneumonia associated with coronavirus disease 2019 (COVID-19) has been accounted for high mortality rate in severe COVID-19 worldwide, and additional serious scarcity of standard and effective anti-inflammatory drug in COVID-19 pneumonia management is a big challenge. Baricitinib, a Janus kinase (JAK) inhibitor, is a promising drug in COVID-19 pneumonia. This study aims to compare the clinical outcome of moderate-to-severe COVID-19 pneumonia treated with baricitinib with or without a loading dose. This prospective case-control study enrolled 37 adult patients where 17 patients (control) received baricitinib at 4 mg oral daily dose and 20 patients (case) received an additional single 8 mg oral loading dose. The median day to gain blood oxygen saturation level ≥95% (in room air) and return in normal breathing function were lower in case group than the control group. The requirement of intensive care unit and mechanical ventilation support was higher in the control group than in the case group [29.4% (N = 17)/10% (N = 20), P < 0.05; 11.8% (N = 17)/5% (N = 20), P > 0.05), respectively]. Thus, an additional loading dose of baricitinib revealed better clinical outcome of patients with COVID-19 pneumonia.

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