Baricitinib treatment for hospitalized patients with severe COVID-19 on invasive mechanical ventilation：a propensity score-matched and retrospective analysis

Abstract

Introduction: Baricitinib is a selective inhibitor of Janus kinase (JAK)1 and JAK2, which is associated with clinical improvement in non-severe COVID-19 patients. But in severe COVID-19 patients, the efficacy of baricitinib is still controversial. Methods: A propensity score-matched and retrospective study was conducted to evaluate the efficacy of baricitinib in severe COVID-19 patients requiring invasive mechanical ventilation (IMV). Results: A total number of 46 patients treated with baricitinib were included, and 44 patients were assigned to control group by propensity score matching. The mean ages were high in both group (baricitinib group vs control group: 78.80±9.04 vs 82.57±9.27), and most were unvaccinated (65.2% vs 72.7%). Baricitinib group had a higher proportion of patients with hypertension (73.9% vs 45.5%). Control group had higher level of creatine kinase-myocardial band (247.50 vs 104.50). Patients in the baricitinib group were more likely to receive nirmatrelvir/ritonavir (41.3% vs 18.2%) and intravenous immunoglobin (15.2% vs 0). Both groups reported high all-cause 28-day mortality (73.9% vs 84.1%). The use of baricitinib didn’t reduce 28-days mortality. Conclusion: The present study revealed baricitinib didn’t reduce 28-days mortality in severe COVID-19 patients on IMV. The effectiveness of baricitinib in treating patients with severe COVID-19 on IMV needs to be further investigated through future studies.