Background: Management of COVID--19 patients during surges have been a challenge as hospitals have to deal with staff, room, and medication shortages. Among these medications is tocilizumab which is given to patients with severe/critical conditions. In Ospital ng Makati, patients are given baricitinib as alternative immunomodulator to prevent possible cytokine storm during tocilizumab shortages. The current recommendation for baricitinib is to give it in addition to dexamethasone and remdesivir for hospitalized COVID-19 patients requiring low to high-flow oxygen, and non-invasive ventilation. However, there is not enough evidence to recommend it as an alternative to tocilizumab in COVID--19 patients. This study aims to find out the real-world efficacy of baricitinib in addition to standard of care among admitted patients with severe COVID-19 pneumonia admitted in Ospital ng Makati. Methods: This is a retrospective, case control study that reviewed records of adult patients admitted at Ospital ng Makati from December 2020 to May 2021 due to severe COVID-19. Patients who were given standard of care was compared to those who were given baricitinib by measuring the duration of clinical improvement, in-hospital all-cause mortality, number of hospital stay, and progression to acute respiratory distress syndrome (ARDS) and need for mechanical ventilator. Results: The use of baricitinib led to a faster improvement time (10 vs 12 days) however did not reach level of significance (p=0.069). There was also no significant difference in the mortality, number of hospital days, and progression to ARDS between the two groups. Conclusion There is not enough evidence to recommend baricitinib as an alternative to tocilizumab in patients with severe COVID--19 infection.
COVID-19 ; Standard of Care