Shrestha, Gentle SunderBista, BideshDhungana, AsheshPoudel, NimeshBhattarai, ShraddhaShrestha, ManjitBhandari, SandipVaidya, Binit2026-02-262026-02-262021https://hdl.handle.net/20.500.14572/4952Gentle Sunder Shrestha Department of Anaesthesiology, Tribhuvan University Teaching Hospital, Kathmandu Bidesh Bista Department of Internal Medicine, Civil Service Hospital of Nepal, Kathmandu, Nepal Ashesh Dhungana Department of Internal Medicine, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal Nimesh Poudel Department of Internal Medicine, Kathmandu Medical College and Teaching Hospital, Kathmandu, Nepal Shraddha Bhattarai Department of Critical Care Medicine, Alka Hospital Pvt. Ltd, Lalitpur, Nepal Manjit Shrestha Department of Critical Care Medicine, Alka Hospital Pvt. Ltd, Lalitpur, Nepal Sandip Bhandari Department of Anaesthesiology, Shahid Gangalal National Heart Centre, Kathmandu, Nepal Binit Vaidya Department of Rheumatology, National Center for Rheumatic Diseases, Kathmandu, NepalAbstract: Severe coronavirus disease 2019 can be associated with progressive respiratory failure. In addition to respiratory support and other supportive care, use of corticosteroids has shown to improve outcome. Despite the use of steroids, a significant proportion of patients progressively worsen. Adjunct immunomodulators have been studied in addition to steroids in these patients. Here we present a successful use of tofacitinib, a Janus Kinase inhibitor, in conjunction with dexamethasone for a patient with rapid worsening of respiratory status and with high level of serum inflammatory biomarkers.en-USCOVID-19dexamethasoneimmunomodulationArticle