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Intracerebral bleeding after janus-kinase inhibitor baricitinib for COVID-19.
Brain Hemorrhages. 2021 Jul 05 [Online ahead of print]BH

Abstract

Objectives

Intracerebral hemorhaghe/bleeding (ICH) after an infection with SARS-CoV-2 (COVID-19) treated with the Janus-kinase inhibitor baricitinib has not been reported.Case presentation: a 86yo Caucasian female suddenly developed aphasia with a systolic blood pressure of 220 mmHg. Cerebral imaging revealed an ICH in the left temporal lobe without mass effect and no need for neurosurgical intervention. Her previous history was positive for arterial hypertension, hyperlipidemia, heart failure, renal insufficiency, hyperuricemia, macula degeneration, lumbalgia, and glaucoma bilaterally. Additionally, she had experienced an infection with SARS-CoV-2 with onset 44 days earlier having been treated with ceftriaxone (2g/d for 7d), dexamethasone (6mg for 6d), and bariticinib (2mg for 6d).

Conclusions

Though ICH was time-linked to COVID-19, a causal relation could not be unequivocally established. Whether baricitinib increased the bleeding risk remains speculative. As long as causalities between ICH and baricitinib remain unproven, it should be given with caution and only under close blood pressure monitoring.

Authors+Show Affiliations

Klinik Landstrasse, Messerli Institute, Vienna, Austria.Disciplina de Neurociência., Universidade Federal de São Paulo/Escola Paulista de Medicina (UNIFESP/EPM), Rua Pedro de Toledo, 697 - Vila Clementino, São Paulo, SP, 04039-00, Brazil.

Pub Type(s)

Case Reports

Language

eng

PubMed ID

34250455

Citation

Finsterer, Josef, and Fulvio A. Scorza. "Intracerebral Bleeding After Janus-kinase Inhibitor Baricitinib for COVID-19." Brain Hemorrhages, 2021.
Finsterer J, Scorza FA. Intracerebral bleeding after janus-kinase inhibitor baricitinib for COVID-19. Brain Hemorrhages. 2021.
Finsterer, J., & Scorza, F. A. (2021). Intracerebral bleeding after janus-kinase inhibitor baricitinib for COVID-19. Brain Hemorrhages. https://doi.org/10.1016/j.hest.2021.06.005
Finsterer J, Scorza FA. Intracerebral Bleeding After Janus-kinase Inhibitor Baricitinib for COVID-19. Brain Hemorrhages. 2021 Jul 5; PubMed PMID: 34250455.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intracerebral bleeding after janus-kinase inhibitor baricitinib for COVID-19. AU - Finsterer,Josef, AU - Scorza,Fulvio A, Y1 - 2021/07/05/ PY - 2021/06/20/received PY - 2021/06/29/accepted PY - 2021/7/12/entrez PY - 2021/7/13/pubmed PY - 2021/7/13/medline KW - COVID-19 KW - Cerebral bleeding KW - Coagulation KW - Hypertension KW - Hypocoagulability KW - SARS-CoV-2 KW - Thrombocytes JF - Brain hemorrhages JO - Brain Hemorrhages N2 - Objectives: Intracerebral hemorhaghe/bleeding (ICH) after an infection with SARS-CoV-2 (COVID-19) treated with the Janus-kinase inhibitor baricitinib has not been reported.Case presentation: a 86yo Caucasian female suddenly developed aphasia with a systolic blood pressure of 220 mmHg. Cerebral imaging revealed an ICH in the left temporal lobe without mass effect and no need for neurosurgical intervention. Her previous history was positive for arterial hypertension, hyperlipidemia, heart failure, renal insufficiency, hyperuricemia, macula degeneration, lumbalgia, and glaucoma bilaterally. Additionally, she had experienced an infection with SARS-CoV-2 with onset 44 days earlier having been treated with ceftriaxone (2g/d for 7d), dexamethasone (6mg for 6d), and bariticinib (2mg for 6d). Conclusions: Though ICH was time-linked to COVID-19, a causal relation could not be unequivocally established. Whether baricitinib increased the bleeding risk remains speculative. As long as causalities between ICH and baricitinib remain unproven, it should be given with caution and only under close blood pressure monitoring. SN - 2589-238X UR - https://www.unboundmedicine.com/medline/citation/34250455/Intracerebral_bleeding_after_janus-kinase_inhibitor_baricitinib_for_COVID-19. L2 - https://linkinghub.elsevier.com/retrieve/pii/S2589-238X(21)00033-4 DB - PRIME DP - Unbound Medicine ER -
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