Abstract
Severe acute respiratory syndrome-related coronavirus (SARS-CoV-2) infection is characterised by a viral phase and a severe pro-inflammatory phase. The inhibition of the JAK/STAT pathway limits the pro-inflammatory state in moderate to severe COVID-19. We analysed the data obtained by an observational cohort of patients with SARS-CoV-2 pneumonia treated with ruxolitinib in 22 hospitals of Mexico. The applied dose was determined based on physician's criteria. The benefit of ruxolitinib was evaluated using the 8-points ordinal scale developed by the NIH in the ACTT1 trial. Duration of hospital stay, changes in pro-inflammatory laboratory values, mortality, and toxicity were also measured. A total of 287 patients were reported at 22 sites in Mexico from March to June 2020; 80.8% received ruxolitinib 5 mg BID and 19.16% received ruxolitinib 10 mg BID plus standard of care. At beginning of treatment, 223 patients were on oxygen support and 59 on invasive ventilation. The percentage of patients on invasive ventilation was 53% in the 10 mg and 13% in the 5 mg cohort. A statistically significant improvement measured as a reduction by 2 points on the 8-point ordinal scale was described (baseline 5.39 ± 0.93, final 3.67± 2.98, p = 0.0001). There were 74 deaths. Serious adverse events were presented in 6.9% of the patients. Ruxolitinib appears to be safe in COVID-19 patients, with clinical benefits observed in terms of decrease in the 8-point ordinal scale and pro-inflammatory state. Further studies must be done to ensure efficacy against mortality.
Highlights
Severe acute respiratory syndrome-related coronavirus (SARS-CoV-2) infection is characterised by a viral phase and a severe pro-inflammatory phase
The cytokine storm observed in COVID-19 is characterised by high levels of IL-2, IL-6, IL-7, IL-10, granulocyte colonystimulating factor, 10 kDa interferon-gamma-induced protein (IP-10), monocyte chemo-attractant protein-1 (MCP-1), macrophage inflammatory protein 1α (MIP1α), and tumour necrosis factor (TNF)
The data obtained from a cohort of patients with SARS-CoV-2 pneumonia treated with ruxolitinib in 22 hospitals of Mexico was analysed
Summary
Severe acute respiratory syndrome-related coronavirus (SARS-CoV-2) infection is characterised by a viral phase and a severe pro-inflammatory phase. At the end of 2019, multiple cases of severe pneumonia characterized by cough, dyspnoea, and lung damage with an unknown aetiology were reported in Wuhan, China This disease, named as coronavirus disease-19 (COVID-19), was declared a pandemic in March 2020 by the World Health Organization and the causative agent was identified to be a novel coronavirus, severe acute respiratory syndrome-related coronavirus (SARS-CoV-2) [1]. The cytokine storm observed in COVID-19 is characterised by high levels of IL-2, IL-6, IL-7, IL-10, granulocyte colonystimulating factor, 10 kDa interferon-gamma-induced protein (IP-10), monocyte chemo-attractant protein-1 (MCP-1), macrophage inflammatory protein 1α (MIP1α), and tumour necrosis factor (TNF) Based on these characteristics, different phases of COVID-19 infection have been described—the first or early phase called the ‘viral response’, transitions through a ‘pulmonary phase’ with increase in severity and inflammation, to a ‘hyper-inflammation phase’ [4,5]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
