The National Institutes of Health has updated its COVID-19 Treatment Guidelines with new information following the FDA emergency use authorization of baricitinib. Baricitinib was recently authorized in combination with remdesivir in hospitalized adults and children aged ≥2 years with COVID-19 who require supplemental oxygen, invasive mechanical ventilation, or extracorporeal membrane oxygenation. A recent article in the NEJM found administering the drug in combination with remdesivir improved time to recovery (10 days vs 18 days control) in patients receiving high-flow oxygen or noninvasive ventilation. According to an NIH statement, after reviewing the available evidence for baricitinib, the NIH's COVID-19 Treatment Guidelines Panel determined the following: There are insufficient data for the Panel to recommend either for or against the use of baricitinib in combination with remdesivir for the treatment of COVID-19 in hospitalized patients in cases where corticosteroids can be used instead.In the rare circumstances where corticosteroids cannot be used, the Panel recommends using baricitinib in combination with remdesivir for the treatment of COVID-19 in hospitalized, nonintubated patients who require oxygen supplementation (BIIa).The Panel recommends against the use of baricitinib in the absence of remdesivir, except in a clinical trial (AIII).There are insufficient data for the Panel to recommend either for or against the use of baricitinib in combination with corticosteroids for the treatment of COVID-19. Since both agents are potent immunosuppressants, there is potential for an additive risk of infection.More data are needed to clarify the role of baricitinib in the management of COVID-19. Healthcare providers are encouraged to discuss participation in baricitinib clinical trials with their patients. Read the full guidelines (12/14/20 revision) here.