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Baricitinib reduces 30-day mortality in older adults with moderate-to-severe COVID-19 pneumonia.
- Source :
-
Journal of the American Geriatrics Society [J Am Geriatr Soc] 2021 Oct; Vol. 69 (10), pp. 2752-2758. Date of Electronic Publication: 2021 Jul 09. - Publication Year :
- 2021
-
Abstract
- Background: Older adults are at the highest risk of severe disease and death due to COVID-19. Randomized data have shown that baricitinib improves outcomes in these patients, but focused stratified analyses of geriatric cohorts are lacking. Our objective was to analyze the efficacy of baricitinib in older adults with COVID-19 moderate-to-severe pneumonia.<br />Methods: This is a propensity score [PS]-matched retrospective cohort study. Patients from the COVID-AGE and Alba-Score cohorts, hospitalized for moderate-to-severe COVID-19 pneumonia, were categorized in two age brackets of age <70 years old (86 with baricitinib and 86 PS-matched controls) or ≥70 years old (78 on baricitinib and 78 PS-matched controls). Thirty-day mortality rates were analyzed with Kaplan-Meier and Cox proportional hazard models.<br />Results: Mean age was 79.1 for those ≥70 years and 58.9 for those <70. Exactly 29.6% were female. Treatment with baricitinib resulted in a significant reduction in death from any cause by 48% in patients aged 70 or older, an 18.5% reduction in 30-day absolute mortality risk (n/N: 16/78 [20.5%] baricitinib, 30/78 [38.5%] in PS-matched controls, p < 0.001) and a lower 30-day adjusted fatality rate (HR 0.21; 95% CI 0.09-0.47; p < 0.001). Beneficial effects on mortality were also observed in the age group <70 (8.1% reduction in 30-day absolute mortality risk; HR 0.14; 95% CI 0.03-0.64; p = 0.011).<br />Conclusions: Baricitinib is associated with an absolute mortality risk reduction of 18.5% in adults older than 70 years hospitalized with COVID-19 pneumonia.<br /> (© 2021 The American Geriatrics Society.)
- Subjects :
- Age Factors
Aged
Aged, 80 and over
Antiviral Agents administration & dosage
Antiviral Agents adverse effects
Female
Hospital Mortality
Humans
Janus Kinase Inhibitors administration & dosage
Janus Kinase Inhibitors adverse effects
Male
Mortality
Outcome and Process Assessment, Health Care
SARS-CoV-2 isolation & purification
Severity of Illness Index
Spain epidemiology
Azetidines administration & dosage
Azetidines adverse effects
COVID-19 mortality
COVID-19 physiopathology
Pneumonia, Viral diagnosis
Pneumonia, Viral drug therapy
Purines administration & dosage
Purines adverse effects
Pyrazoles administration & dosage
Pyrazoles adverse effects
Sulfonamides administration & dosage
Sulfonamides adverse effects
COVID-19 Drug Treatment
Subjects
Details
- Language :
- English
- ISSN :
- 1532-5415
- Volume :
- 69
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- Journal of the American Geriatrics Society
- Publication Type :
- Academic Journal
- Accession number :
- 34235720
- Full Text :
- https://doi.org/10.1111/jgs.17357