Interleukin-1 receptor antagonist anakinra in association with remdesivir in severe COVID-19: A case report
Marco Franzetti, Ugo Pozzetti, Manuela Carugati, Alessandro Pandolfo, Chiara Molteni, Paolo Faccioli, Gioacchino Castaldo, Ernesto Longoni, Valentina Ormas, Enrico Iemoli, Stefania Piconi
Abstract
We report the first successful treatment with the IL-1 receptor antagonist anakinra, in association with the most promising and available antiviral therapy, of a severe case of novel coronavirus disease 2019 (COVID-19). We describe the diagnosis, clinical course, and management of the case, including the respiratory failure at presentation, the progression to a scenario characterized by profound inflammatory dysregulation similar to that observed during macrophage activation syndrome, and the clinical improvement after treatment with the IL-1 receptor antagonist anakinra. This case highlights the high tolerability and the interesting immunomodulatory profile of the IL-1 receptor antagonist anakinra in the setting of severe COVID-19 associated with remdesivir therapy. Further studies are needed to confirm the safety and efficacy of this combination strategy in the treatment of this emerging infection.