Targeting the inflammatory cascade with anakinra in moderate to severe COVID-19 pneumonia: case series.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a recently discovered coronavirus, is responsible for COVID-19, a newly emerged disease that has become pandemic. SARS-CoV-2 infection leads to direct tissue injury, especially of the lungs, but can also trigger an exaggerated host immune response. Indeed, the pathogeny of proinflammatory cytokine storm is now demonstrated in COVID-19.1 Besides interleukin (IL)-6 blockade,2 we and others1 hypothesised that targeting IL-1 should be a safe and effective approach to avoid mechanic ventilation in patients with moderate to severe COVID-19 pneumonia (P-MSP) hospitalised in a non-intensive care unit (ICU). About one-third of P-MSPs experience acute respiratory distress syndrome and/or ICU admission with a lethality rate of 60.5%.2 3 We observed similar outcomes in our institution and therefore proposed anti-IL-1 blocking by anakinra to nine …