{
  "abstract": "Background\n\nBaricitinib was shown to reduce the mortality of COVID-19 patients, but real world data about baricitinib in combination with nirmatrelvir/ritonavir for the treatment of elderly patients with severe or critical COVID-19 were limited. The aim of the study was to determine the effects and hospital-acquired infections occurrence after combined medication in these patients.Methods\n\nWe included severe or critical COVID-19 patients treated at Beijing Chaoyang Hospital from December 2022 to February 2023. We investigated duration of hospital stay, factors associated with reduced mortality risk, IL-6 levels and the characteristics of hospital-acquired infections in patients treated with baricitinib with nirmatrelvir/ritonavir.Results\n\nThe median age of the 117 included patients was 79 (interquartile range [IQR]: 70-85) years. Thirty-six patients received baricitinib with nirmatrelvir/ritonavir, 16 of whom died. The factors associated with reduced mortality were the administration of baricitinib with nirmatrelvir/ritonavir (hazard ratio [HR]: 0.405 (95% CI: 0.183-0.90), p = 0.026)). The IL-6 levels were 0.75 (IQR: 0.55-1.82) log₁₀ pg/mL before or within 2 days of baricitinib administration, and it was 1.45 (IQR: 0.94-2.07) log₁₀ pg/mL after baricitinib administration for 6 to 8 days. A mixed-effects model showed a statistically significant effect of Time on IL-6 levels (F(1, 20.757) = 6.299, p = 0.020). The fixed effects estimates indicated that each one-day increase during the treatment period, IL-6 levels increased by an average of 0.081 units (B = 0.081, SE = 0.032, t (20.757) = 2.510, p = 0.020, 95% CI (0.014, 0.148)). In patients treated with baricitinib, carbapenem-resistant Acinetobacter baumannii (2), carbapenem-resistant Klebsiella pneumoniae (2), and K. pneumoniae (2) were more common pathogens detected in the respiratory tract. Carbapenem-resistant K. pneumoniae (1), Enterococcus faecium (1), and Staphylococcus epidermidis (1) were detected in blood. Enterococcus faecium (2) and K. pneumoniae (1) were identified via urine culture.Conclusion\n\nBaricitinib combined with nirmatrelvir/ritonavir was associated with lower mortality in elderly patients with severe or critical COVID-19 in the real world. Carbapenem-resistant A.baumanniiand carbapenem-resistant K. pneumoniae were more common pathogens detected in the respiratory tract in these patients.Clinical trial number\n\nNot applicable.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Infectious Diseases and Clinical Microbiology, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, No. 8 Gongti South Road, Beijing, 100020, China.",
    "Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, No. 8 Gongti South Road, Beijing, 100020, China.",
    "Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, No. 8 Gongti South Road, Beijing, 100020, China. yonghang2004@sina.com.",
    "Department of Infectious Diseases and Clinical Microbiology, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, No. 8 Gongti South Road, Beijing, 100020, China. didcm2006@mail.ccmu.edu.cn."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 9,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Ling Xu"
    },
    {
      "affs": [
        0
      ],
      "name": "Yongzhe Liu"
    },
    {
      "affs": [
        0
      ],
      "name": "Ran Li"
    },
    {
      "affs": [
        0
      ],
      "name": "Chen Ma"
    },
    {
      "affs": [
        0
      ],
      "name": "Jun Liu"
    },
    {
      "affs": [
        0
      ],
      "name": "Boyuan Yang"
    },
    {
      "affs": [
        1
      ],
      "name": "Kewu Huang"
    },
    {
      "affs": [
        2
      ],
      "name": "Hangyong He"
    },
    {
      "affs": [
        3
      ],
      "name": "Li Gu"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/32sy4xkxjgwyt.bib",
  "cited_by": 0,
  "doi": "10.1186/s12879-026-14144-2",
  "fulltext_url": "https://europepmc.org/articles/PMC13721712",
  "id": "32sy4xkxjgwyt",
  "issns": [
    "1471-2334"
  ],
  "landing_url": "https://europepmc.org/article/MED/42958072",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Research"
    ],
    [
      "openalex",
      "2725|COVID-19 Clinical Research Studies"
    ]
  ],
  "openalex": "W7172137016",
  "pdf_url": "https://europepmc.org/articles/PMC13721712?pdf=render",
  "pmcid": "PMC13721712",
  "pmid": "42958072",
  "published": "2026-08-01",
  "publisher": "BMC",
  "ris": "https://research.draconitic.com/paper/32sy4xkxjgwyt.ris",
  "sources": [
    {
      "first_seen": "2026-11-01T00:20:47Z",
      "native_id": "MED:42958072",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42958072"
    },
    {
      "first_seen": "2026-11-03T12:22:21Z",
      "native_id": "PMC13721712",
      "source": "pmc",
      "url": "https://doi.org/10.1186/s12879-026-14144-2"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2725|COVID-19 Clinical Research Studies",
      "subfield": "infectious-disease"
    }
  ],
  "title": "Effects and infection risks of baricitinib in combination with nirmatrelvir/ritonavir in elderly patients with severe or critical COVID-19: a retrospective observational cohort study.",
  "title_text": "Effects and infection risks of baricitinib in combination with nirmatrelvir/ritonavir in elderly patients with severe or critical COVID-19: a retrospective observational cohort study.",
  "type": "peer-reviewed",
  "updated_at": "2026-11-03T12:22:21Z",
  "url": "https://research.draconitic.com/paper/32sy4xkxjgwyt",
  "venue": "BMC infectious diseases",
  "versions": []
}