Transient leukocytopenia following combination therapy for COVID-19

Background: Combination therapy with dexamethasone, remdesivir, and baricitinib has become a promising treatment for moderate or severe COVID-19; however, we have observed transient leukocytopenia in COVID-19 patients who received combination therapy. Methods: Twelve consecutive COVID-19 patients treated with combination therapy were included in this retrospective analysis. Blood cell counts collected at the following three time points were analyzed: before the start of therapy (period 1), within 24 h of starting therapy (period 2), and within 48 h of period 2 (period 3). Results: The leukocyte count significantly decreased in period 2 compared to period 1 and then significantly increased in period 3 without withdrawal of baricitinib. The neutrophil count transiently decreased in period 2 and recovered in period 3. Conclusions: Clinicians should be aware of transient leukocytopenia in patients with COVID-19 during the early phase of combination therapy. (C) 2021 The Japanese Respiratory Society. Published by Elsevier B.V. All rights reserved.

Automated summary

This study retrospectively analyzed the changes in white blood cell counts in 12 COVID-19 patients who received combination therapy. It was found that the white blood cell count significantly decreased after the start of treatment and then significantly increased 48 hours later.