Interleukin-1 receptor antagonist anakinra in association with remdesivir in severe COVID-19: A case report.


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.





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Publication Info

Franzetti, Marco, Ugo Pozzetti, Manuela Carugati, Alessandro Pandolfo, Chiara Molteni, Paolo Faccioli, Gioacchino Castaldo, Ernesto Longoni, et al. (2020). Interleukin-1 receptor antagonist anakinra in association with remdesivir in severe COVID-19: A case report. International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases, 97. pp. 215–218. 10.1016/j.ijid.2020.05.050 Retrieved from

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Manuela Carugati

Associate Professor of Medicine

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