Abstract
The outbreak of a current public health coronavirus 2019 disease is a causative agent of a serious acute respiratory syndrome and even death. COVID-19 has exposed to multi-suggested pharmaceutical agents to control this global disease. Baricitinib, a well-known antirheumatic agent, was one of them. This article reviews the likely pros and cons of baricitinib in attenuation of COVID-19 based on the mechanism of drug action as well as its pharmacokinetics. The inhibitory effect of baricitinib on receptor mediated endocytosis promoter, AKK1, and on JAK-STAT signaling pathway is benefacial in inhibition of both viral assembling and inflammation. Also, its pharmacokinetic has encouraged the physicians toward the drug selection for COVID-19 treatment. On the other hand, most of baricitinib side effects are dose-dependent. In conclusion, targeting of AAK1 and JAK1/2 using baricitinib has predicted to be potential and effective with minimal side effects in management COVID-19 infected patients for a short therapeutic dosing period. Laboratory monitoring should be considered for some parameters. However, experimental trials are mandatory for a long-term treatment with a lower dose of baricitinib to evaluate its effectiveness and safety in patients with moderate COVID-19 infection.
Highlights
The present coronavirus disease 2019 is a leading cause of a serious acute respiratory syndrome which has been announced as a pandemic on March 11, 2020 by the World Health Organization
Experimental trials are mandatory for a long-term treatment with a lower dose of baricitinib to evaluate its effectiveness and safety in patients with moderate COVID-19 infection
What are the objectives of this review? This review is needed in order to establish the benefits and harms of clinically relevant outcomes of baricitinib in people infected with novel coronavirus COVID-19
Summary
The present coronavirus disease 2019 is a leading cause of a serious acute respiratory syndrome which has been announced as a pandemic on March 11, 2020 by the World Health Organization. COVID-19 pathogenesis Coronavirus 2019 enters host respiratory epithelial cells through receptor-mediated endocytosis mechanism using a protein expressed on its own spike, a surface viral glycoprotein, to bind to the host angiotensin converting enzyme 2 (ACE-2) receptor, a cell membrane bound aminopeptidase receptor which expressed fundamentally in mature lung type II alveolar cells (6) and further in oral cavity mucosa (7). It is expressed by heart, proximal tubular cells of kidneys, and blood vessels. Modes of baricitinib action and its pharmacokinetics rationalize the reasons behind its suggestion to be a potential choice in COVID-19 treatment
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