Human lives and nations’ economies have been adversely affected worldwide by the COVID-19 pandemic. The hyperinflammatory state associated with the disease may be related to mortality. Systemic glucocorticoid is the first-line therapy for cytokine storm. Various immunomodulatory drugs such as tocilizumab and baricitinib have been used in those not responding to glucocorticoid monotherapy. Amid the peak crisis of COVID-19 in India, there was an extreme paucity of medications, oxygen, and hospital beds. We describe three patients with COVID-19 who received low-dose tofacitinib (an oral Janus kinase inhibitor) in addition to moderate-dose glucocorticoid. These patients were treated at their homes, as the hospitals were short of beds. Rapid reduction in hypoxemia along with gradual resolution of other signs of the disease were observed. The results are reassuring regarding the feasibility of managing of severe COVID-19 outside the hospital setting when healthcare resources are overwhelmed by pandemic-related caseload.
Address correspondence to Ashish Sharma, Department of Rheumatology, Fortis Hospital, Room No. 2021, Sector 62, Noida, Uttar Pradesh, India 201301. E-mail: firstname.lastname@example.org
Authors’ addresses: Ashish Sharma, Fortis Hospital, Sector 62, Noida, Uttar Pradesh, India, Email: email@example.com. Mohammad Ali, Central Government Health Scheme, Parliament House Annexe, New Delhi, India, E-mail: firstname.lastname@example.org.