Pawan Kumar Singh, Vinod Kumar Sharma, Lokesh Kumar Lalwani, Dhruva Chaudhry, Manjunath B Govindagoudar, Chaudhari Pramod Sriram, Aman Ahuja
{"title":"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","authors":"Pawan Kumar Singh, Vinod Kumar Sharma, Lokesh Kumar Lalwani, Dhruva Chaudhry, Manjunath B Govindagoudar, Chaudhari Pramod Sriram, Aman Ahuja","doi":"10.4103/tjem.tjem_363_22","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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, <i>P</i> = 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, <i>P</i> < 0.001). The frequency of any adverse event was also higher in the corticosteroid group (70% vs. 23.8%, <i>P</i> = 0.003).</p><p><strong>Conclusion: </strong>JAKi can be used as immunomodulatory drugs in hypoxic OSC cases having evidence of ongoing inflammation.</p>","PeriodicalId":46536,"journal":{"name":"Turkish Journal of Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":1.1000,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a4/67/TJEM-23-149.PMC10389097.pdf","citationCount":"0","resultStr":"{\"title\":\"Role of Janus Kinase inhibitors in the management of pulmonary involvement due to Long COVID-19 disease: A case control study.\",\"authors\":\"Pawan Kumar Singh, Vinod Kumar Sharma, Lokesh Kumar Lalwani, Dhruva Chaudhry, Manjunath B Govindagoudar, Chaudhari Pramod Sriram, Aman Ahuja\",\"doi\":\"10.4103/tjem.tjem_363_22\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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, <i>P</i> = 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, <i>P</i> < 0.001). The frequency of any adverse event was also higher in the corticosteroid group (70% vs. 23.8%, <i>P</i> = 0.003).</p><p><strong>Conclusion: </strong>JAKi can be used as immunomodulatory drugs in hypoxic OSC cases having evidence of ongoing inflammation.</p>\",\"PeriodicalId\":46536,\"journal\":{\"name\":\"Turkish Journal of Emergency Medicine\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.1000,\"publicationDate\":\"2023-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a4/67/TJEM-23-149.PMC10389097.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Turkish Journal of Emergency Medicine\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.4103/tjem.tjem_363_22\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"EMERGENCY MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Turkish Journal of Emergency Medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4103/tjem.tjem_363_22","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"EMERGENCY MEDICINE","Score":null,"Total":0}
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.
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.
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.
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