A Phase III RUXCOVID study evaluating ruxolitinib on top of standard of care (SoC) therapy compared to SoC treatment alone in patients with COVID-19 did not meet its primary endpoint. With this news, recruitment was stopped for this study.

The purpose of this study is to determine the safety and efficacy of the drug ruxolitinib in people diagnosed with COVID-19 pneumonia by determining the number of people whose conditions worsen (requiring machines to help with breathing or needing supplemental oxygen) while receiving the drug.

This is a sub-study of the U-DEPLOY study: UHN Umbrella Trial Defining Coordinated Approach to Pandemic Trials of COVID-19 and Data Harmonization to Accelerate Discovery. U-DEPLOY helps to facilitate timely conduct of studies across the University Health Network and other centers.

Multifocal interstitial pneumonia is the most common cause of deterioration in people with COVID-19. This is attributed to a severe reaction where releases too many cytokines (proteins that play an important role in immune responses) which rush into the lungs resulting in lung inflammation and fluid buildup. This can lead to damage to the lungs and leading to breathing problems. Ruxolitinib when given early in the disease, may prevent the overproduction of cytokines which, in turn, may prevent lung damage.

Inclusion Criteria:

• COVID-19 infection diagnosed by nasopharyngeal sample
• Need for supplemental oxygen to maintain oxygen saturation > 93%
• 12 years of age or older

Exclusion Criteria:

• Neutrophils < 1 x 10^9/L
• Platelets < 50 x 10^9/L
• Serum total bilirubin >2.0 x upper limit of normal (ULN)
• Aspartate aminotransferase (AST), or alanine aminotransferase (ALT) > 5x ULN
• Creatinine clearance (CrCl) < 15 mL/minute
• Pregnant women
• Known HBV or HIV infection
• Signs and symptoms of Varicella Zoster Virus (VZV) infection
• Patients requiring invasive mechanical ventilation. Patients requiring non-invasive mechanical ventilation (e.g., BiPAP) are eligible.
• Patients who require supplemental oxygen support prior to COVID-19 infection.
• Patients who are on ruxolitinib or similiar drugs.