Introduction:Ongoing-symptomatic-COVID19(OSC) is defined as persistent symptoms beyond 4-weeks of acute illness. OSC leads to prolonged hospitalization and oxygen dependence. There is no data on use of JAK-inhibitors (JAKi) in the management of OSC.

Aims and Objective:To test the safety and efficacy of JAKi for persistent pulmonary symptoms in patients of Long COVID-19 Syndrome.

Methods:In this single-centre, case-controlled study comparing JAKi and corticosteroids in OSC, data of 41 cases out of 86 was included-21 in JAKi-group and 20 in corticosteroid-group from 4-week of acute-illness to next 4-week. Clinical and inflammatory parameters were recorded.

Results:The baseline clinical and demographics characteristics were similar in both groups. Age was 53.65±9.8 years and 51.48±14.0 years in corticosteroid-groups and JAKi-group respectively. At the baseline 85% patients in corticosteroid-group and 85.8% in JAKi-group were on oxygen support. Most common symptom was breathlessness followed by cough. 20% of patients in JAKi-group received baricitinib and remaining were given tofacitinib. At the time of follow-up majority of cases had significant reduction in CRP and D-dimer but change in CRP and D-dimer was similar in both groups. Number of patients off oxygen support at 4 weeks was similar in the two groups (85% in corticosteroid group versus 95.2% in JAKi-group, p=0.269) but median time to liberation from oxygen support was significantly lower in JAKi-group(19 days in corticosteroid-group versus 9 days in JAKi-group, p<0.001). Frequency of any-adverse-event was also higher in the corticosteroid-group (70% versus 23.8%, p=0.003).

Conclusion:JAKi can be used as immunomodulator drug in hypoxic-OSC cases.