Abstract Objectives Anakinra is a selective IL-1 inhibitor, which has been used in the context of secondary haemophagocytic lymphohistiocytosis. Although usually given in the s.c. form, previous anecdotal reports have emphasized its utility when given i.v. Our aim is to report our experience on the beneficial effects of anakinra i.v. in patients with SARS-CoV-2 and evidence of hyperinflammation. Methods We report four patients with severe COVID-19 infection requiring intensive care admission and ventilatory support. Results All four patients showed evidence of deterioration, with hyperferritinaemia and increasing oxygen requirements and with superadded bacterial infections. Upon commencement of anakinra i.v., there was subsequent improvement in the patients clinically, with reduction in ventilatory support and inotropic support, and biochemically, with rapid improvement in inflammatory markers. Conclusion Anakinra is safe to use i.v. in patients with COVID-19 and evidence of superadded bacterial infection. Although its utility has not been confirmed in a randomized trial, current research in the COVID-19 pandemic aims to establish the utility of immunosuppression, including IL-1 blockade, on the outcomes of patients with moderate to severe disease. Our case series supports its use in patients with severe, life-threatening COVID-19 and evidence of hyperinflammation.
【저자키워드】 COVID-19, Anakinra, hyperinflammation, haemophagocytic lymphohistiocytosis, 【초록키워드】 intensive care, COVID-19 pandemic, randomized trial, inflammatory markers, Immunosuppression, outcome, Deterioration, Research, Patient, Bacterial infection, inhibitor, utility, Bacterial infections, Admission, IL-1, Evidence, severe disease, Safe, secondary haemophagocytic lymphohistiocytosis, ventilatory support, Support, Severe COVID-19 Infection, life-threatening, blockade, selective, Oxygen requirement, Effect, objective, Result, the patient, subsequent, clinically, case sery, biochemically, reduction in, patients with COVID-19, patients with moderate, patients with SARS-CoV-2, 【제목키워드】 Safety, Evidence, intravenous, case sery,