Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes COVID-19 (coronavirus disease 2019), which is associated with high morbidity and mortality, especially in elder patients. Acute respiratory distress syndrome (ARDS) is a life-threatening complication of COVID-19 and has been linked with severe hyperinflammation. Dexamethasone has emerged as standard of care for COVID-19 associated respiratory failure. In a non-randomized prospective phase II multi-center study, we asked whether targeted inhibition of Janus kinase-mediated cytokine signaling using ruxolitinib is feasible and efficacious in SARS-CoV-2- induced ARDS with hyperinflammation. Sixteen SARS-CoV-2 infected patients requiring invasive mechanical ventilation for ARDS were treated with ruxolitinib in addition to standard treatment. Ruxolitinib treatment was well tolerated and 13 patients survived at least the first 28 days on treatment, which was the primary endpoint of the trial. Immediate start of ruxolitinib after deterioration was associated with improved outcome, as was a lymphocyte-to-neutrophils ratio above 0.07. Together, treatment with the janus-kinase inhibitor ruxolitinib is feasible and might be efficacious in COVID-19 induced ARDS patients requiring invasive mechanical ventilation. The trial has been registered under EudraCT-No.: 2020-001732-10 and NCT04359290.

严重急性呼吸系统综合症冠状病毒 2 (SARS-CoV-2) 导致 COVID-19（冠状病毒病 2019），它与高发病率和死亡率有关，尤其是在老年患者中。急性呼吸窘迫综合征 (ARDS) 是 COVID-19 危及生命的并发症，并与严重的过度炎症有关。地塞米松已成为 COVID-19 相关呼吸衰竭的护理标准。在一项非随机前瞻性 II 期多中心研究中，我们询问了使用鲁索替尼靶向抑制 Janus 激酶介导的细胞因子信号传导在 SARS-CoV-2 诱导的伴有过度炎症的 ARDS 中是否可行和有效。除了标准治疗外，16 名 SARS-CoV-2 感染患者需要接受有创机械通气以治疗 ARDS。Ruxolitinib 治疗耐受性良好，13 名患者至少在治疗的前 28 天存活，这是试验的主要终点。恶化后立即开始使用鲁索替尼与改善结果相关，淋巴细胞与中性粒细胞的比率高于 0.07。总之，使用 janus 激酶抑制剂鲁索替尼进行治疗是可行的，并且可能对需要有创机械通气的 COVID-19 诱导的 ARDS 患者有效。该试验已在 EudraCT-No.: 2020-001732-10 和 NCT04359290 下注册。使用 janus 激酶抑制剂鲁索替尼进行治疗是可行的，并且可能对需要有创机械通气的 COVID-19 诱导的 ARDS 患者有效。该试验已在 EudraCT-No.: 2020-001732-10 和 NCT04359290 下注册。使用 janus 激酶抑制剂鲁索替尼进行治疗是可行的，并且可能对需要有创机械通气的 COVID-19 诱导的 ARDS 患者有效。该试验已在 EudraCT-No.: 2020-001732-10 和 NCT04359290 下注册。