No abstract

Introduction: Severe acute respiratory syndrome-related coronavirus (SARS-CoV-2) infection is characterised by a viral phase and a severe pro-inflammatory phase. The inhibition of the JAK/STAT pathway limits the pro-inflammatory state in moderate to severe COVID-19. Methodology: We analysed the data obtained by an observational cohort of patients with SARS-CoV-2 pneumonia treated with ruxolitinib in 22 hospitals of Mexico. The applied dose was determined based on physician’s criteria. The benefit of ruxolitinib was evaluated using the 8-points ordinal scale developed by the NIH in the ACTT1 trial. Duration of hospital stay, changes in pro-inflammatory laboratory values, mortality, and toxicity were also measured. Results: A total of 287 patients were reported at 22 sites in Mexico from March to June 2020; 80.8% received ruxolitinib 5 mg BID and 19.16% received ruxolitinib 10 mg BID plus standard of care. At beginning of treatment, 223 patients were on oxygen support and 59 on invasive ventilation. The percentage of patients on invasive ventilation was 53% in the 10 mg and 13% in the 5 mg cohort. A statistically significant improvement measured as a reduction by 2 points on the 8-point ordinal scale was described (baseline 5.39 ± 0.93, final 3.67± 2.98, p = 0.0001). There were 74 deaths. Serious adverse events were presented in 6.9% of the patients. Conclusions: Ruxolitinib appears to be safe in COVID-19 patients, with clinical benefits observed in terms of decrease in the 8-point ordinal scale and pro-inflammatory state. Further studies must be done to ensure efficacy against mortality.

Asthma and COPD are two diseases related to eosinophils. But at present, we do not know with certainty how much these cells participate in these diseases, beyond that the treatment of the underlying cause produces the resolution of eosinophilia in a “reactive” way. Eosinophil-related diseases are a spectrum of systemic diseases such as Asthma and COPD in pneumology area. Under inflammatory conditions, the number of circulating eosinophils or tissues can increase dramatically, with rapid development of eosinophilia and we can obtain in a simple laboratory test. In general, the number of eosinophils in the blood can provide useful information and considering the differential diagnosis and for the subsequent test of patients presenting with eosinophilia. The treatment of eosinophilia currently in number of 300 cells in which is the criteria and the target to be treat. The best known and most used of all treatments for diseases related to eosinophils are corticosteroids, which decrease circulating and tissue eosinophils in a few hours, through mechanisms that include the direct activation of eosinophil program death. Targeted treatment against eosinophils could improve airway remodeling through mechanisms that are not fully known, and their effects on lung function are variable and decreasing symptoms in patients.

No abstract

is a physician specialist in pneumology and internal medicine with a Master's in health administration. He is a research author of multiple national and international articles and a speaker in the field. He has authored book notes on pulmonology for undergraduate studies and many chapters on the specialist field of pulmonology. He is a doctor dedicated to the clinic, teaching, and research. He currently works as a medical specialist in the city of Puebla, Mexico. He is certified by the Council of Pulmonology and Thorax Surgery and is a Member of the Latin American Association of Thorax (ALAT) and the European Respiratory Society (ERS). He is the author of several national and international articles, focused on his specialty and has publications in the field of asthma, COPD and pulmonary hypertension.