{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:02:00Z","timestamp":1787839320924,"version":"build-2784847793"},"reference-count":17,"publisher":"American Academy of Pediatrics (AAP)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,5,1]]},"abstract":"<jats:sec>\n                  <jats:title>BACKGROUND<\/jats:title>\n                  <jats:p>In November 2020, the Food and Drug Administration issued an Emergency Use Authorization for baricitinib, a Janus Kinase protein inhibitor, for hospitalized children and adults with COVID-19 requiring supplemental oxygen, but safety data for this pediatric indication is lacking.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>This retrospective case series describes patients aged younger than 21\u00a0years treated with baricitinib for severe COVID-19 between 2021 and 2022. Patient characteristics, treatments, adverse events, reasons for early discontinuation of baricitinib, durations of oxygen supplementation and hospitalization, and complications were recorded.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>There were 37 patients who received baricitinib. Median age was 16\u00a0years (range 1\u201320). All had a comorbidity (59% obesity, 5% malignancy), and 76% were cared for in the intensive care unit. All received remdesivir (median 5\u00a0days; range: 2\u201311), and 34 (92%) received corticosteroids (median 6\u00a0days; range: 1\u201310). Median duration of baricitinib was 6\u00a0days (range 3\u201314). Baricitinib was discontinued early for clinical improvement (2), and adverse events (7; 6 elevated liver enzymes [only 1 meeting discontinuation criteria), 1 thrombocytosis]). One patient had deep vein thrombosis without pulmonary embolism, 5 patients had concurrent infections (4 bacterial, 1 fungal, 2 herpes simplex virus reactivation). All adverse events were resolved. There were no deaths. Median hospitalization was 7\u00a0days (range 2\u2013108) and mechanical ventilation was 4.5\u00a0days (range 1\u201386\u00a0days). Two patients (5%) were discharged with supplemental oxygen and one with a tracheostomy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Baricitinib appears safe in children hospitalized for severe COVID-19. Most early baricitinib discontinuation for abnormal laboratory studies was secondary to provider caution.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/hpeds.2024-008245","type":"journal-article","created":{"date-parts":[[2025,4,9]],"date-time":"2025-04-09T20:03:01Z","timestamp":1744228981000},"page":"e203-e208","source":"Crossref","is-referenced-by-count":4,"title":["Safety Data for Baricitinib Use in Children With Severe SARS-CoV-2 Infection"],"prefix":"10.1542","volume":"15","author":[{"given":"Elspeth","family":"Bittle","sequence":"first","affiliation":[{"name":"1Department of Infectious Diseases, St. Jude Children\u2019s Research Hospital, Memphis, Tennessee"},{"name":"2Department of Pediatrics, Division of Infectious Diseases, Le Bonheur Children\u2019s Hospital, University of TN Health Science Center, Memphis, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Arnold","sequence":"additional","affiliation":[{"name":"2Department of Pediatrics, Division of Infectious Diseases, Le Bonheur Children\u2019s Hospital, University of TN Health Science Center, Memphis, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego R.","family":"Hijano","sequence":"additional","affiliation":[{"name":"1Department of Infectious Diseases, St. Jude Children\u2019s Research Hospital, Memphis, Tennessee"},{"name":"2Department of Pediatrics, Division of Infectious Diseases, Le Bonheur Children\u2019s Hospital, University of TN Health Science Center, Memphis, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Becky McGee","family":"Landman","sequence":"additional","affiliation":[{"name":"3Department of Pharmacy, Le Bonheur Children\u2019s Hospital, Memphis, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ted","family":"Morton","sequence":"additional","affiliation":[{"name":"4Department of Pharmacy and Pharmaceutical Services, St. Jude Children\u2019s Research Hospital, Memphis, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"Hines","sequence":"additional","affiliation":[{"name":"5Department of Pediatric Medicine, Division of Critical Care, St. Jude Children\u2019s Research Hospital, Memphis, Tennessee"},{"name":"6Department of Pediatrics, Division of Critical Care, Le Bonheur Children\u2019s Hospital, University of Tennessee Health Science Center, Memphis, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2025,4,10]]},"reference":[{"issue":"19","key":"2025072210023475500_r1","doi-asserted-by":"crossref","first-page":"1813","DOI":"10.1056\/NEJMoa2007764","article-title":"Remdesivir for the treatment of Covid-19 - final report","volume":"383","author":"Beigel","year":"2020","journal-title":"N Engl J 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placebo-controlled phase 3 trial","volume":"9","author":"Marconi","year":"2021","journal-title":"Lancet Respir Med."},{"key":"2025072210023475500_r11","doi-asserted-by":"crossref","first-page":"101489","DOI":"10.1016\/j.eclinm.2022.101489","article-title":"Baricitinib in hospitalised patients with COVID-19: A meta-analysis of randomised controlled trials","volume":"49","author":"Selvaraj","year":"2022","journal-title":"EClinicalMedicine."},{"issue":"9","key":"2025072210023475500_r12","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1056\/NEJMoa2031994","article-title":"Baricitinib plus Remdesivir for hospitalized adults with Covid-19","volume":"384","author":"Kalil","year":"2021","journal-title":"N Engl J Med."},{"key":"2025072210023475500_r13","article-title":"Underlying medical conditions associated with higher risk for severe COVID-19: information for healthcare professionals.","author":"Prevention CfDCa"},{"key":"2025072210023475500_r14","doi-asserted-by":"crossref","DOI":"10.1542\/9781610025225","volume-title":"Red Book: 2021\u20132024 Report of the Committee on Infectious Diseases.","author":"Kimberlin","year":"2021"},{"key":"2025072210023475500_r15","article-title":"Common Terminology Criteria for Adverse Events (CTCAE) v5.0","author":"Services USDoHaH"},{"issue":"10401","key":"2025072210023475500_r16","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1016\/S0140-6736(23)00921-2","article-title":"Baricitinib in juvenile idiopathic arthritis: an international, phase 3, randomised, double-blind, placebo-controlled, withdrawal, efficacy, and safety trial","volume":"402","author":"Ramanan","year":"2023","journal-title":"Lancet."},{"issue":"1","key":"2025072210023475500_r17","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1093\/bjd\/ljad096","article-title":"Efficacy and safety of baricitinib in combination with topical corticosteroids in paediatric patients with moderate-to-severe atopic dermatitis with an inadequate response to topical corticosteroids: results from a phase III, randomized, double-blind, placebo-controlled study (BREEZE-AD PEDS)","volume":"189","author":"Torrelo","year":"2023","journal-title":"Br J Dermatol."}],"container-title":["Hospital 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