Treatment
Tofacitinib was administered at a dose 10 mg twice daily on day 1,
followed by 5 mg twice daily on day 2-5. The dosage was reduced to 5 mg
once daily in patients with eGFR less than 60 ml/min/1.73
m2. The dosage and duration of treatment were chosen
based on the approved dosage of tofacitinib for rheumatoid arthritis. We
felt that more intensive immunosuppression, that is, the administration
of tofacitinib at a higher dose or for a longer course would be
unnecessary and could be hazardous for patients with an active viral
infection. Certain side effects of tofacitinib, including infections due
to bacterial or viral pathogens, lymphopenia and venous thromboembolic
events are particularly relevant for hospitalised patients with COVID-19
[13].
All patients received standard of care treatment from the time of
hospital admission according to the Russian COVID-19 guidelines.
Standard of care treatment was administered at the physician’s
discretion and included oxygen supply if needed (target oxygen
saturation at least 93%), hydroxychloroquine (400 mg twice on day 1,
followed by 200 mg twice per day on days 2–5), azithromycin,
lopinavir-ritonavir (400/100 mg twice daily), and low molecular weight
heparin according to bodyweight and kidney function. Intravenous
administration of dexamethasone was also permitted at a dose not
exceeding 16 mg daily.