Use of Baricitinib in Combination With Remdesivir and Steroid in COVID-19 Treatment: A Multicenter Retrospective Study

Introduction Hospitalized patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can develop severe complications. Baricitinib, a Janus kinase (JAK) JAK1/JAK2 inhibitor used to treat rheumatoid arthritis, has been proposed to prevent intracellular uptake of SARS-CoV-2 by targeting the angiotensin-converting enzyme 2 (ACE2) receptor, suppressing cytokine storm. We evaluated the effects of baricitinib on coronavirus disease 2019 (COVID-19) patient survival. Methods We conducted a retrospective study of 100 COVID-19 patients hospitalized in Southern California, United States, throughout September 2021. Univariate analysis of study variables was conducted with bivariate analysis of their relationships using chi-square and t-test with p-value <0.05 considered significant. Kaplan-Meier survival analysis was performed to compare outcomes of COVID-19 patients treated with baricitinib and those that were not. Results Our study included a patient population with a mean age of 62 years. Twenty-four percent of our patients were admitted to the intensive care unit (ICU), 16% were placed on mechanical ventilation, and 27% were expired. Patients receiving baricitinib were more likely to be admitted to the ICU and receive concomitant remdesivir therapy. Use of baricitinib increased median survival (p = 0.045). Conclusion Baricitinib administered with remdesivir and dexamethasone was shown to increase the survival of hospitalized patients with COVID-19. More studies are required to evaluate the benefits of conjunctive therapy with baricitinib, remdesivir, and dexamethasone. Though our study shows increased survival in patients receiving therapy, our study is limited by small sample size and there was not enough data to confirm whether baricitinib therapy decreased disease progression. Further studies are required.