Real-life use of high-dose anakinra in patients with COVID-19 treated with remdesivir

Aim: Aim of this study was to evaluate the effect of anakinra (ANK) addition to remdesivir (RDV) on all-cause 28-day mortality in patients hospitalized with COVID-19. Patients & methods: ANK was administered intravenously at a dose of 5 mg/kg every 12 h in patients with severe respiratory failure and pronounced inflammatory status. 58 patients were treated with RDV + ANK, 219 patients with RDV. Results: The estimate of mortality at 28 days was 17.2% in the RDV + ANK group and 21.4% in the RDV group. Median time to death was 14 days in the RDV + ANK group and 19 in the RDV group. Conclusion: Despite severe respiratory failure and pronounced inflammatory status, patients who received RDV + ANK had similar mortality compared with patients who received RDV. In this study, we looked at hospitalized patients with COVID-19 pneumonia who were given different treatments. These included a combination therapy, an antiviral medication only or an antiviral and anti-inflammatory. Almost all patients received treatment with corticosteroids, another common anti-inflammatory medication that is currently part of standard COVID-19 treatment. Patients treated with the antiviral and anti-inflammatory showed more severe pneumonia compared with patients who received just the antiviral, probably reflecting the physicians' choice to give an anti-inflammatory to patients with a more serious clinical condition. Nevertheless, the mortality rate was similar in the two groups. The combination therapy of the antiviral and anti-inflammatory might improve mortality in COVID-19 patients with severe pneumonia to be comparable to mortality in patients with less severe clinical presentations.