Possibilities of janus kinase inhibitors application in complex treatment of patients with COVID-19

Abstract

Introduction. More than 30 million cases and more than 970 thousand fatalities from COVID-19 have been registered. The effectiveness of interleukin-6 and interleukin-1 antagonists and janus kinase inhibitors in the treatment of new coronavirus infection is still being analyzed. At present, the emphasis is placed on the introduction into a wide practice of a Russian vaccine named Sputnik V.
 Purpose. To compare the effect of complex therapy with baricitinib and dexamethasone on the course of COVID-19 interstitial pneumonia.
 Materials and methods. A retrospective analysis of the medical records of 122 people hospitalized at the North-Western State Medical University named after I.I. Mechnikov was carried out. All the patients were divided into three groups: the first one 64 patients who received therapy including baricitinib; the second one 33 patients whose therapy included dexamethasone; the third one 25 patients in the comparison group.
 Results. In the first group of patients the lung damage was 25-75% (2-3 degree CT) in 78.1% of the patients, more than 75% in 14.1% of the patients, which was accompanied by severe clinical symptomatology and high laboratory activity. Against the background of the tharapy, positive dynamics of CT was observed in 48.4% of the cases. In the second group of patients the volume of pulmonary tissue damage by CT of 2-3 degrees was observed in 84.9% of the examined patients, clinical and laboratory activity corresponded to the moderate course of the disease. Against the background of the complex therapy, positive dynamics according to CT examination was observed in 18.2% of the cases. In the comparison group, positive dynamics according to CT was observed in 56% of the patients against the background of the therapy. Normalization of clinical and laboratory parameters was observed in all the patients from three study groups on the background of treatment.
 Conclusions. In the first group the majority of the patients had he highest number of comorbid pathologies and severe course of COVID-19. Normalization of clinical and laboratory parameters was observed in all the groups of patients. As a result of standard comprehensive therapy, as well as therapy involving baricitinib or dexamethasone, positive dynamics according to CT data was observed in 48.4%, 18.2% and 56% of the patients, respectively.