High Dose Intravenous Anakinra Treatment is Safe and Effective in Severe and Critical Covid-19 Patients: A Propensity Score Matched Study in a Single Center

Background: In COVID-19 severe disease course such as need of intensive care unit (ICU) as well as development of mortality is mainly due to cytokine storm. In this study, we aimed to evaluate the high dose intravenous anakinra treatment response and outcome in patients with severe and critically ill COVID-19 compared to standard of care. Method: This retrospective observational study was carried out at a tertiary referral center. The study population consisted of two groups as follows; the patients receiving high dose intravenous anakinra (anakinra group) between 01.09.2021 and 01.02.2022 and the patients treated with standard of care (SoC, control group) as historical control group who were hospitalized between 01.07.2022 and 01.09.2022. Results: After the propensity score 1:1 matching 79 patients in anakinra and 79 patients in SoC matched and included into the analysis. Mean±SD patient age was 67.4±16.7 and 67.1±16.3 years in anakinra and SoC group, respectively (p=0.9). Male gender was 38 (48.7%) in anakinra and 36 (46.2%) SoC (p=0.8). Overall, ICU admission was in 14.1% (n=11) and 30.8% (n=24) (p=0.013; OR: 6.2), intubation in 12.8% (n=10) and 16.7% (n=13) patients (p=0.5), 14.1% (n=11) and 32.1% (n=25) patients died in anakinra and control group, respectively (p=0.008; OR: 7.1) Conclusion: In our study mortality was lower in patients receiving anakinra compared to SoC. Intravenous high dose anakinra is safe and effective treatment in patients with severe and critical COVID-19.Funding: None to declare. Declaration of Interest: Authors declare no conflictsEthical Approval: Local ethics committee approval and participant consent were obtained forthis study (date and number: 24.02.2022 and 2022/04-09).