Since the outbreak of the pandemic coronavirus disease 2019 (COVID-19), there has been an increasing need for treatment to decrease morbidity and mortality of patients presenting with severe disease symptoms. There has been increasing evidence to suggest that the pathophysiological basis is a severe inflammatory response that resembles the cytokine release syndrome. Current strategies to counteract this involve modifiers of the immune response such as interleukin (IL)-6 receptor blockers and Janus kinase (JAK) inhibitors. An example of a JAK inhibitor is baricitinib. In this case, we present a 17-year-old female admitted with severe COVID-19 symptoms, who was placed on high-flow nasal cannula and started on azithromycin and hydroxychloroquine, which were standard of care at the time. Due to the worsening of symptoms, she was given baricitinib for compassionate use. There was a rapid improvement in clinical and imaging findings, and the patient was discharged from the hospital within 8 days of admission. This study is fascinating because there are very limited studies published on the benefits of baricitinib in managing patients with severe symptoms of COVID-19 especially in the pediatric population, and the rapidity in recovery time was remarkable.
Coronavirus disease 2019 (COVID-19) is predominately an upper respiratory infectious disease caused by the Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2). Although most patients infected with COVID-19 generally present with acute respiratory distress symptoms, we are now learning that the virus can cause a multitude of disruption in physiological and pathophysiological homeostasis. Moreover, there are increasingly reported cases of thromboembolic events occurring in infected patients, resulting in widespread use of anticoagulation therapy. This case series presents seven patients who have received anticoagulation therapy over the course of the disease. Additionally, the correlation between thromboembolic complications secondary to COVID-19, prophylactic use of anticoagulation therapy and the significant pathological findings that might arise will be assessed and discussed in great details.
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