Outcomes in COVID-19 Patients with Pneumonia Treated with High-Flow Oxygen Therapy and Baricitinib—Retrospective Single-Center Study

Abstract

Background. The aim of the study was to assess the effect of baricitinib on 28-day all-cause mortality and the progression of respiratory failure in patients needing transfer to the intensive care unit (ICU) with COVID-19 pneumonia treated with high-flow oxygen therapy. Methods. This retrospective study included hospitalized patients with COVID-19 pneumonia treated with high-flow oxygen non-invasive ventilation receiving standard of care (SOC) or SOC in addition to baricitinib. Data on patients’ characteristics, pro-inflammatory markers, D dimer, and National Early Warning Score 2 (NEWS2) values were collected and compared between groups. The primary endpoint was 28-day all-cause in-hospital mortality and the secondary outcome was transfer to the ICU. Results. The study included 125 patients. The primary outcome was observed in 44.8% of them: 27% in the baricitinib group vs. 62% in the SOC group, p < 0.001. Transfer to the ICU ward was significantly lower in the baricitinib group: 29% vs. 81%, p < 0.001. A significant improvement was observed when the baricitinib group was compared to SOC in procalcitonin, CRP, D-dimer, neutrophil-to-lymphocyte ratio values, and NEWS2. Conclusion. Treatment with baricitinib in addition to SOC was associated with reduced mortality and a lower prevalence of transfer to the ICU in hospitalized patients with COVID-19 pneumonia treated with high-flow oxygen non-invasive therapy.

High-Flow Nasal Cannula oxygen therapy in COVID-19: retrospective analysis of clinical outcomes – single center experience

“…The use of baricitinib was associated with the better survival (HR 0.39, 95% CI 0.21–0.72) in the multivariate COX proportional analysis when adjusted for other covariates. These findings are consistent with the results of the COV-BARRIER study ( 46 ), A retrospective single-center study ( 47 ) comparing outcomes in patients treated with HFNC also reported a significantly lower 28-day all-cause mortality rate in patients treated with baricitinib compared to the standard care group. The vaccinal status is well known as a predictor of outcomes in patients with COVID 19 ( 48–50 ), and in our study, it also emerged as a significant negative predictor of mortality.…”