• Clinicians should c onsider using these drugs only if neither baricitinib nor IL -6 receptor blockers (tocilizumab or sarilumab) are available.
• The GDG emphasiz ed the need f or more trial evidence to better inform the recommendations

Practical Info Route, dosage and duration: We refer to the table o f trial characteristics (ruxolitinib and tofacitinib) to guide the administr ation of these ag ents, in the absenc e of other available information. Timing: Ruxolitinib or tofacitinib (like IL-6 receptor blockers) should be initiated with s ystemic corticosteroids; specific timing during hospitalization or the c ourse of illness is no t specified.

Resources and other considerations Resource implications, equity and human rights The GDG no ted that, given the recommendation against use o f ruxolitinib or tofacitinib, efforts to ensure access to drugs should focus on those tha t are currently recommended. Acceptability and feasibility As ruxolitinib and tofacitinib are administered orally twice daily, this treatment should be eas y to ac cept for hospitalized patients with severe and critical COVID-19. In patients unable to sw allow whole table ts, they can be dispersed in w ater to take orally or via nasogastric tube ( see Practical info).