Study of the effect of Baricitinib on the Course of COVID-19

Abstract

The aim of the study was to determine the effect of the inhibitor of janus kinase – baricitinib ("Olumiant") on the course of COVID-19. This drug baricitinib is able to suppress the systemic inflammatory response, which is one of the common causes of death in COVID-19, is an urgent problem of the study. The study was carried out in the Regional Specialized Budget Infectious Diseases Hospital of Stavropol (Russian Federation, Stavropol Region). In a multivariate analysis, it was shown that the use of baricitinib was associated with a decrease in the frequency of the primary endpoint of death/need for invasive lung ventilation. The use of baricitinib was quite safe, but in some patients there was an increase in the level of transaminases. No cases of hypercoagulation have been reported while taking baricitinib. It was found that patients with a normal BMI are more sensitive to therapy than those who are overweight.75% of patients in the first group had a temperature above 38.0oC. However, against the background of taking the standard treatment regimen and baricitinib, it was noted that the temperature stabilized during the day and did not rise again. Against the background of taking baricitinib, the elimination of the phenomena of respiratory failure and the refusal of an oxygen mask occurred 3.1 times more often than without baricitinib. The authors concluded that the use of baricitinib can be considered as an additional therapy for moderate forms of pneumonia in patients over 65 years or in patients with concomitant chronic diseases in order to suppress the reactions of systemic inflammation and the development of serious respiratory and other system lesions caused by COVID-19.

The Effect of Longitudinal Gastric Resection in Morbid Obesity Surgery on the Course of Insulin-Dependent Diabetes and Gastroesophageal Reflux Disease

“…The rate of excess body weight loss also varies from 50 to 70% of the initial weight for 12 months, however, cases of extremely rapid weight loss after longitudinal gastric resection have become increasingly recorded (2020-2021). A case of longitudinal gastric resection was registered in March 2021, when the patient lost 120% of the planned body weight loss within 6 months after surgery (but it is necessary to take into account the fact of repeated longitudinal gastric resection on the second day after the first operation due to suture failure and prolonged postoperative recovery) [12][13][14][15].…”

Current Use of Baricitinib in COVID-19 Treatment and Its Future: An Updated Literature Review

“…The mortality associated with cases of critically ill COVID-19 patients complicated by various comorbidities has been staggering. Baricitinib proves to be a worthy contender in reducing mortality in these severely ill patients by down-regulating inflammatory mediators implicated by COVID-19 pathophysiology two days after the start of treatment and reducing cytokine and chemokine production [2][3][4]. A randomized placebocontrolled trial conducted by Ely et al shows that mortality is decreased upon treatment with baricitinib in patients without any spiking rates of infections, clots, or cardiovascular events [2].…”

“…The severity of COVID-19 can be attributed to the pervasive way it attacks multiple organ systems in the body. One of the recognized clinical manifestations of COVID-19 infections is bilateral pneumonia associated with ARDS [ 3 ]. Internally, this ARDS triggers an excessive immune reaction called a cytokine storm [ 4 ].…”

“…According to Hu et al, this storm generates hyperinflammatory cytokine cells and chemical mediators and is indicative of the severity of the infection and probability of death from the disease. The development of oral, reversible, and selective Janus kinase (JAK) 1/JAK 2 inhibitors like baricitinib has served as a treatment for individuals with long-standing rheumatoid arthritis (RA) and has the capability to suppress systemic inflammatory responses, thereby minimizing the risk of a cytokine storm [ 3 ]. In the study by Quek et al, a justification was suggested for its usage in COVID-19 as it inhibits the JAK signal transducer and activator of transcription (JAK-STAT) signaling pathway, which is exploited by many cytokines and plays an important role in cytokine release syndrome [ 5 ].…”

“…Baricitinib is a JAK1/2 inhibitor; an immunomodulator with anticytokine properties that stifles immunologic response making it useful for diseases associated with excessive cytokine release, like COVID-19 and RA [ 2 , 3 ]. It also prevented viral endocytosis by specifically targetting host proteins [ 2 ].…”