Anakinra for COVID-19 Respiratory Symptoms

Inclusion Criteria

• •Male or female≥ 18 years of age
• •Written informed consent of the patient or a proxy
• •Ability for participant to comply with the requirements of the study
• •Hospitalized patient with COVID-19 defined as
• •* Positive SARS-CoV2 RT-PCR
• •* Or typical COVID-19 Radiographic infiltrates on the CT scan (peripheral ground glass without lung cavitation, lymphadenopathy, or pulmonary nodules) other non COVID-19 diagnosis ruled out.
• •Patient with respiratory symptoms and requirement of oxygen therapy as defined:
• •* Oxygen therapy \>= 4L/min to maintain Sp02\>92% and respiratory rate \>=24/min.
• •* Or patients under oxygen \>= 1L/min and presenting worsening of oxygen requirement defined by an increase of oxygen therapy \>= 2L/min to maintain Sp02\>92%.
• •Inflammatory component C-Reactive Protein ≥ 50mg/L.
• •Patients within the first 20 days from the onset of the first COVID-19 symptoms
• •Probabilistic antibiotics therapy according to local practice
• •Respiratory failure related to other cause than COVID-19
• •Patients requiring mechanical ventilation at inclusion or requiring oxygen therapy equal or more than 11 liters per min to maintain Sp02\>92%
• •Infectious diseases such as severe bacterial infections, aspergillosis, HIV, active HCV, active HBV, active tuberculosis
• •Contra indication to anti-IL1 receptor
• •* Known hypersensitivity to Anakinra
• •* Absolute neutrophil count (ANC)\< 1500/mm3
• •* Liver cirrhosis Child-Pugh Score C
• •* Live or attenuated vaccine in the past 8 weeks
• •* Pregnant or breast-feeding women
• •Patients with either legally protected status or who have been deprived of their freedom
• •Patient included in other interventional therapeutic research (e.g. = concurrent participation in French CoVID-19 is accepted)
• •Patients who have received previous treatment by anti-IL6R, anti-IL-6, anti-IL1R, anti-IL1 or anti-TNFα within 21 days preceding inclusion
• •Absence of Health Insurance
• •Existence of any life-threatening co-morbidity or any other medical condition which,in the opinion of the investigator, makes the patient unsuitable for inclusion.