Immunologic and Clinical Investigation of Baricitinib Effect on Severe COVID-19 Hospitalized Patients: A Systematic Review

Abstract

Due to the high prevalence and mortality of the COVID-19 pandemic worldwide, the beneficial effects of effective antiviral and anti-inflammatory drugs used in other diseases, especially rheumatic diseases, were observed in the treatment of COVID-19. The aim of this study determining the immunological and clinical effect of baricitinib on hospitalized patients with severe COVID-19 pneumonia: a systematic review. Material and Methods: Methods/Design: Clinical and laboratory parameters of eight cases including cohort studies and five randomized clinical trials between the barcitinib group and the control group were analyzed on the first day of hospitalization and days 7, 14 and 28 during hospitalization.. Results: According to the meta-analysis result of eight included cohort studies with 2088 patients, the Pooled Risk Ratios were 0.46 (P<0.001) for mortality, 6.14 (P< 0.001) for discharge and the mean differences were 76.78 (P< 0.001) for PaO2/FiO2 ratio, -47.32 (P= 0.02) for CRP, in the baricitinib group vs. control group on the seventh or fourteenth day of the treatment compared to the first day. Based on meta-analysis result of five RCT studies with 11825 patients, the pooled RR were 0.84 (P= 0.001) for mortality, 1.07 (P= 0.014) for patients recovery and the mean differences were -0.80 (P<0.001) for hospitalization days, -0.51(P= 0.33) for time to recovery, in the baricitinib group vs. control group.