Correlation of tocilizumab vs baricitinib with secondary bacterial and fungal infections in patients with COVID-19.

PURPOSE: The study's objective was to determine whether tocilizumab or baricitinib has a higher risk of bacterial and fungal infections secondary to coronavirus disease 2019 (COVID-19) infection.

METHODS

This single-site, retrospective chart review of 150 patients at a 433-bed community teaching hospital aimed to investigate the rate of secondary bacterial or fungal infections following COVID-19 infection in patients treated with tocilizumab or baricitinib from March 2020 to June 2022. Secondary endpoints included the time to hospital discharge, the rate of all-cause mortality, and the number of ventilator-free days.

RESULTS

Among the patients included in the study, the average age was 56.7 years, 55.3% were male, and 72.0% were unvaccinated. Tocilizumab (46.7%) was initiated more frequently than baricitinib (22.7%) in the intensive care units. For the primary endpoint of post-COVID-19 secondary infections, the baricitinib group had a lower rate (21.3%) than the tocilizumab group (34.7%) (P = 0.101). With respect to the secondary endpoints, the median hospital length of stay, rate of mortality, and number of ventilator days were higher in the tocilizumab group.

CONCLUSION

This study found no significant differences in the incidence of secondary infections and time to secondary infections between patients treated with baricitinib and tocilizumab.