Combination Therapy for Patients Hospitalized with COVID-19

Patients with severe COVID-19 have dysregulated inflammatory responses and elevated cytokine levels. Baricitinib, a Janus kinase inhibitor, blocks cytokine signaling and may also have anti–SARS-CoV-2 activity. To assess whether adding baricitinib to remdesivir improves outcomes, 1033 patients hospitalized with COVID-19 were randomized to receive baricitinib plus remdesivir (combination therapy) or remdesivir alone in the ACTT-2 trial.

Among all patients, median time to recovery was 7 days (combination therapy) or 8 days (remdesivir). In the 216 requiring high-flow oxygen or noninvasive ventilation at enrollment, median time to recovery was 10 days (combination) or 18 days (remdesivir). New use of oxygen or mechanical ventilation was less lik…