Objective We aimed to analyze clinical outcomes from patients with severe COVID-19 pneumonia that received either baricitinib plus dexamethasone or dexamethasone monotherapy. Methodology We performed a retrospective comparative study. Data from hospitalized patients with severe COVID-19 pneumonia (saturation <93%, bilateral pulmonary infiltrates) that were treated with baricitinib plus dexamethasone or dexamethasone were collected. Our primary objective was to compare overall mortality and secondly to compare progression to mechanical ventilation and over infection rates. Results A total of 793 patients were assessed for inclusion criteria, 596 were excluded and 197 were analyzed for primary outcome: 123 in the baricitinib plus dexamethasone group and 74 in the dexamethasone monotherapy group. The mean age was 59.9 years (SD ± 14.5) and 62.1% (123/197) were male. 42.9% (85/197) of the cases required ICU admission and 25.8% (51/197) underwent invasive mechanical ventilation (IMV). Overall thirty-day mortality was 27.9% (55/197); Mortality was significantly lower in the baricitinib plus dexamethasone group compared to the dexamethasone monotherapy group (20.3% vs 40.5%, P =<.05). There was no difference in hospital acquired infections between both groups. Conclusion Thirty-day mortality was significantly lower in patients with COVID-19 pneumonia treated with baricitinib plus dexamethasone versus dexamethasone monotherapy. No difference was observed in progression to invasive mechanical ventilation and hospital acquired infections.

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Coronaviruses have been well known for causing common cold syndrome in healthy people. Two beta-coronaviruses that emerged from animal reservoirs, severe acute respiratory syndrome coronavirus (SARS-CoV), and Middle East respiratory syndrome coronavirus caused global epidemics in 2002 and 2012. In December 2019, a cluster of pneumonia cases in the city of Wuhan in the province of Hubei, China, with an unknown etiology was reported by Chinese authorities. The full genomic sequence of the novel coronavirus was released by January 2020 and it was designated the 2019 novel coronavirus by the World Health Organization (WHO). Later, the International Committee on the Taxonomy of Viruses named it SARS-CoV-2 and the WHO designated this new disease as COVID-19. By June 22, 2020, there were 8,860,331 confirmed cases globally, and a total of 465,740 deaths. At present, there is no approved vaccine against SARS-CoV-2 and no specific medication for treatment, although some drugs have shown some in vitro activity and promising outcomes regarding mortality in recent clinical trials. As of today, the most effective mechanism in prevention is avoidance of exposure and basic respiratory hygiene. Caution is warranted due to the great amount of available information rapidly obtained, and the fact that there is scientific uncertainty. Answers will be found with well-designed studies that require time and patience.