Role of Janus Kinase inhibitors in the management of pulmonary involvement due to Long COVID-19 disease: A case control study.

IF 1.1 Q3 EMERGENCY MEDICINE

Turkish Journal of Emergency Medicine Pub Date : 2023-07-01 DOI:10.4103/tjem.tjem_363_22

Pawan Kumar Singh, Vinod Kumar Sharma, Lokesh Kumar Lalwani, Dhruva Chaudhry, Manjunath B Govindagoudar, Chaudhari Pramod Sriram, Aman Ahuja

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引用次数: 0

Abstract

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.

Abstract Image

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Janus激酶抑制剂在治疗COVID-19疾病肺部受累中的作用:一项病例对照研究

持续症状性冠状病毒病2019 (OSC)被定义为持续症状超过4周的急性疾病。OSC导致住院时间延长和氧依赖。我们的目的是发现Janus激酶抑制剂(JAKi)作为类固醇保留剂治疗OSC的结果。方法:在这项比较JAKi和皮质激素治疗OSC病例的单中心病例对照研究中，86例病例中有41例的数据被纳入，其中JAKi组21例，皮质激素组20例，从急性疾病4周到接下来的4周。记录临床参数及炎症指标。主要结局是比较两组在任何补氧情况下能够维持血氧饱和度≥95%的患者比例。结果:两组患者的基线临床和人口学特征相似。皮质类固醇组和JAKi组患者年龄分别为53.65±9.8岁和51.48±14.0岁。在基线时，85%的皮质类固醇组患者和85.8%的JAKi组患者需要氧气支持。两组患者最常见的症状是呼吸困难，其次是咳嗽。JAKi组中20%的患者接受巴西替尼治疗，其余患者接受托法替尼治疗。在随访时，大多数病例的c反应蛋白(CRP)和d -二聚体显著降低;然而，两组CRP和d -二聚体的变化相似。4周时脱离氧支持的患者数量在JAKi组中较高(皮质类固醇组为85%，JAKi组为95.2%，P = 0.269)，并且从氧支持中解脱的中位时间在JAKi组中显著较低(皮质类固醇组为19天，JAKi组为9天，P < 0.001)。皮质类固醇组出现任何不良事件的频率也更高(70%比23.8%，P = 0.003)。结论:JAKi可作为免疫调节药物用于有持续炎症证据的缺氧OSC患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Turkish Journal of Emergency Medicine EMERGENCY MEDICINE-

CiteScore

1.70

自引率

0.00%

发文量

审稿时长

22 weeks

期刊介绍： The Turkish Journal of Emergency Medicine (Turk J Emerg Med) is an International, peer-reviewed, open-access journal that publishes clinical and experimental trials, case reports, invited reviews, case images, letters to the Editor, and interesting research conducted in all fields of Emergency Medicine. The Journal is the official scientific publication of the Emergency Medicine Association of Turkey (EMAT) and is printed four times a year, in January, April, July and October. The language of the journal is English. The Journal is based on independent and unbiased double-blinded peer-reviewed principles. Only unpublished papers that are not under review for publication elsewhere can be submitted. The authors are responsible for the scientific content of the material to be published. The Turkish Journal of Emergency Medicine reserves the right to request any research materials on which the paper is based. The Editorial Board of the Turkish Journal of Emergency Medicine and the Publisher adheres to the principles of the International Council of Medical Journal Editors, the World Association of Medical Editors, the Council of Science Editors, the Committee on Publication Ethics, the US National Library of Medicine, the US Office of Research Integrity, the European Association of Science Editors, and the International Society of Managing and Technical Editors.