Role of Janus Kinase inhibitors in the management of pulmonary involvement due to Long COVID-19 disease: A case control study
OBJECTIVES: Ongoing symptomatic coronavirus disease 2019 (OSC) is defined as persistent symptoms beyond 4 weeks of acute illness. OSC leads to prolonged hospitalization and oxygen dependence. We aimed to find the outcome of Janus kinase inhibitors (JAKi) as a steroid-sparing agent to treat OSC. METH...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2023-07-01
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| Series: | Turkish Journal of Emergency Medicine |
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| Online Access: | https://journals.lww.com/10.4103/tjem.tjem_363_22 |
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| author | Pawan Kumar Singh Vinod Kumar Sharma Lokesh Kumar Lalwani Dhruva Chaudhry Manjunath B. Govindagoudar Chaudhari Pramod Sriram Aman Ahuja |
| author_facet | Pawan Kumar Singh Vinod Kumar Sharma Lokesh Kumar Lalwani Dhruva Chaudhry Manjunath B. Govindagoudar Chaudhari Pramod Sriram Aman Ahuja |
| author_sort | Pawan Kumar Singh |
| collection | DOAJ |
| description | OBJECTIVES:
Ongoing symptomatic coronavirus disease 2019 (OSC) is defined as persistent symptoms beyond 4 weeks of acute illness. OSC leads to prolonged hospitalization and oxygen dependence. We aimed to find the outcome of Janus kinase inhibitors (JAKi) as a steroid-sparing agent to treat OSC.
METHODS:
In this single-center case-controlled study comparing JAKi and corticosteroids in OSC cases, data of 41 cases out of 86 were included – 21 in the JAKi group and 20 in the corticosteroid group from 4 weeks of acute illness to the next 4 weeks. Clinical parameters and inflammatory markers were recorded. The primary outcome was to compare the proportion of patients who were able to maintain oxygen saturation ≥95% with any oxygen supplementation in the two groups.
RESULTS:
The baseline clinical and demographic characteristics were similar in the two groups. The age was 53.65 ± 9.8 years and 51.48 ± 14.0 years in the corticosteroid group and JAKi group, respectively. At the baseline, 85% of patients in the corticosteroid group and 85.8% in the JAKi group were on oxygen support. The most common symptom in both groups was breathlessness followed by cough. Twenty percent of patients in the JAKi group received baricitinib and the remaining were given tofacitinib. At the time of follow-up, the majority of cases had a significant reduction in C-reactive protein (CRP) and D-dimer; however, the change in CRP and D-dimer was similar in both groups. The number of patients off oxygen support at 4 weeks was higher in the JAKi group (85% in the corticosteroid group vs. 95.2% in the JAKi group, P = 0.269), and the median time to liberation from oxygen support was significantly lower in JAKi group (19 days in corticosteroid group vs. 9 days in JAKi group, P < 0.001). The frequency of any adverse event was also higher in the corticosteroid group (70% vs. 23.8%, P = 0.003).
CONCLUSION:
JAKi can be used as immunomodulatory drugs in hypoxic OSC cases having evidence of ongoing inflammation. |
| format | Article |
| id | doaj-art-2c4625cc985d4c199e0cd29393646f7b |
| institution | Kabale University |
| issn | 2452-2473 |
| language | English |
| publishDate | 2023-07-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Turkish Journal of Emergency Medicine |
| spelling | doaj-art-2c4625cc985d4c199e0cd29393646f7b2025-02-09T08:56:53ZengWolters Kluwer Medknow PublicationsTurkish Journal of Emergency Medicine2452-24732023-07-0123314915510.4103/tjem.tjem_363_22Role of Janus Kinase inhibitors in the management of pulmonary involvement due to Long COVID-19 disease: A case control studyPawan Kumar SinghVinod Kumar SharmaLokesh Kumar LalwaniDhruva ChaudhryManjunath B. GovindagoudarChaudhari Pramod SriramAman AhujaOBJECTIVES: Ongoing symptomatic coronavirus disease 2019 (OSC) is defined as persistent symptoms beyond 4 weeks of acute illness. OSC leads to prolonged hospitalization and oxygen dependence. We aimed to find the outcome of Janus kinase inhibitors (JAKi) as a steroid-sparing agent to treat OSC. METHODS: In this single-center case-controlled study comparing JAKi and corticosteroids in OSC cases, data of 41 cases out of 86 were included – 21 in the JAKi group and 20 in the corticosteroid group from 4 weeks of acute illness to the next 4 weeks. Clinical parameters and inflammatory markers were recorded. The primary outcome was to compare the proportion of patients who were able to maintain oxygen saturation ≥95% with any oxygen supplementation in the two groups. RESULTS: The baseline clinical and demographic characteristics were similar in the two groups. The age was 53.65 ± 9.8 years and 51.48 ± 14.0 years in the corticosteroid group and JAKi group, respectively. At the baseline, 85% of patients in the corticosteroid group and 85.8% in the JAKi group were on oxygen support. The most common symptom in both groups was breathlessness followed by cough. Twenty percent of patients in the JAKi group received baricitinib and the remaining were given tofacitinib. At the time of follow-up, the majority of cases had a significant reduction in C-reactive protein (CRP) and D-dimer; however, the change in CRP and D-dimer was similar in both groups. The number of patients off oxygen support at 4 weeks was higher in the JAKi group (85% in the corticosteroid group vs. 95.2% in the JAKi group, P = 0.269), and the median time to liberation from oxygen support was significantly lower in JAKi group (19 days in corticosteroid group vs. 9 days in JAKi group, P < 0.001). The frequency of any adverse event was also higher in the corticosteroid group (70% vs. 23.8%, P = 0.003). CONCLUSION: JAKi can be used as immunomodulatory drugs in hypoxic OSC cases having evidence of ongoing inflammation.https://journals.lww.com/10.4103/tjem.tjem_363_22baricitinibjanus kinase inhibitorslong coronavirus disease 2019postcoronavirus diseasetofacitinib |
| spellingShingle | Pawan Kumar Singh Vinod Kumar Sharma Lokesh Kumar Lalwani Dhruva Chaudhry Manjunath B. Govindagoudar Chaudhari Pramod Sriram Aman Ahuja Role of Janus Kinase inhibitors in the management of pulmonary involvement due to Long COVID-19 disease: A case control study Turkish Journal of Emergency Medicine baricitinib janus kinase inhibitors long coronavirus disease 2019 postcoronavirus disease tofacitinib |
| title | Role of Janus Kinase inhibitors in the management of pulmonary involvement due to Long COVID-19 disease: A case control study |
| title_full | Role of Janus Kinase inhibitors in the management of pulmonary involvement due to Long COVID-19 disease: A case control study |
| title_fullStr | Role of Janus Kinase inhibitors in the management of pulmonary involvement due to Long COVID-19 disease: A case control study |
| title_full_unstemmed | Role of Janus Kinase inhibitors in the management of pulmonary involvement due to Long COVID-19 disease: A case control study |
| title_short | Role of Janus Kinase inhibitors in the management of pulmonary involvement due to Long COVID-19 disease: A case control study |
| title_sort | role of janus kinase inhibitors in the management of pulmonary involvement due to long covid 19 disease a case control study |
| topic | baricitinib janus kinase inhibitors long coronavirus disease 2019 postcoronavirus disease tofacitinib |
| url | https://journals.lww.com/10.4103/tjem.tjem_363_22 |
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