In patients without hypoxia we do not recommend Baricitinib (Strong recommendation)
Definition of mild illness:
- Symptomatic (any acute COVID-19 related symptoms)
- AND respiratory rate <24/min
- WITHOUT pneumonia or hypoxia
Definition of moderate illness:
- Pneumonia (clinical or radiological)
- AND respiratory rate ≤30/min
- AND SpO2 ≥94% on room air
In hypoxic patients Baricitinib may be given to patients already on corticosteroids but not on Tocilizumab (conditional recommendation).
A conditional recommendation is one for which the desirable effects probably outweigh the undesirable effects (weak recommendation FOR an intervention) or undesirable effects probably outweigh the desirable effects (weak recommendation AGAINST an intervention) but appreciable uncertainty exists. This implies that not all will be best served by this recommendation and decisions can be made by the patient and caregiver based on patient values, resources and setting with a clear understanding of the ensuing harms and benefits.
Definition of moderate illness
- Pneumonia (clinical or radiological) OR hypoxia (SpO2 <94% in adults with no underlying lung disease)
- AND respiratory rate ≤30/min
- AND SpO2 ≥90% on room air
Definition of severe illness:
Pneumonia with ANY ONE of the following:
- respiratory rate >30/min
- severe respiratory distress
- SpO2 <90% on room air
- NO invasive or non-invasive respiratory support needed
Definition of critical illness:
- Requirement for high-level respiratory support: noninvasive ventilation, high-flow oxygen (≥20 litres per minute) or invasive mechanical ventilation
• OR acute respiratory distress syndrome (PaO2/FiO2 ratio of <300)
• OR sepsis
• OR shock