Caring for patients in a new pandemic: the necessity and challenges of observational research.

Thomas, David L

People with COVID-19 can develop pneumonia and severe inflammatory response with excessive cytokine release known as the cytokine storm. The Janus kinase inhibitor baricitinib used to treat rheumatoid arthritis reduces inflammation by modifying the cytokine pathway. In this issue of the JCI, Bronte and Ugel et al. performed an observational longitudinal study to evaluated the use of baricitinib in 20 patients with COVID-19. Treated subjects showed reduced levels of plasma interleukin (IL)-6, tumor necrosis factor (TNF), IL-1β and phosphorylated STAT3 and swift lymphocyte restoration. Notably, these patients had a dramatically favorable clinical outcome. While bias can plague uncontrolled research, this study has biological credibility and warrants randomized control studies.