Baricitinib in patients with severe pneumonia due to COVID-19 in Veracruz, Mexico

Abstract

Background: Patients affected by COVID-19 pneumonia who present severe symptoms with manifest hypoxemia and cytokine storm have a high mortality rate, which is why therapies focused on reducing inflammation and improving lung function have been used, being one of them Baricitinib Material and methods: Patients who presented data of severe pneumonia due to COVID-19 with data of severe hypoxemia and cytokine storm were selected, from June to August 2020, to whom the SaO2/FiO2 ratio is measured at the beginning, intermediate and end of treatment. Results: We included data from 30 patients, 22 (73%) men, with a median age of 58.5 years. 77% had comorbidities: hypertension (43%), obesity (30%), diabetes (27%). The medians of D-Dimer 982ng/mL, Ferritin 1,375ng/mL and CRP 10mg/dL. 97% patients had treatment: azithromycin (77%), ivermectin (53%) and dexamethasone (47%). The initial pulseoximetry (SaO2) with room air had a median of 80.5% and the median SaO2/FiO2 (SAFI) was 134; 90% had moderate ARDS and 10% had severe ARDS. All received Baricitinib 4 mg/day by 14 days. SaO2 at 7 days had a median of 93.0% and the median SAFI was 310; the median SaO2 at 14 days was 95% and the median SAFI was 452. In comparative analysis, baseline SaO2/SAFI was significantly lower compared to 7 and 14 days (p = 0.001 for both comparisons). 90% patients improved and 10% died. Conclusion: Baricitinib therapy in these patients presented good results by improving clinical status and pulmonary failure, with patients being cared for at home and avoiding mechanical ventilation.