e383 damage. Interestingly, in the context of other coronaviruses, NLRP3 activa tion has been shown to trigger cytokine storms. 5 This observation suggests that there is an interplay between SARS-CoV2, autophagy, and cytokine release, and we propose that in future trials, combining anakinra with autophagy inhibitors should be avoided in patients with COVID-19 and evidence of hyperinflammation. It is also reasonable to hypothesise that a combination of anakinra and an autophagy activator should be explored. Although the mechanism needs to be studied further, enhancing autophagy might help to decrease IL-1β production and limit inflammatory cell influx and production of other cytokines, thereby working synergistically with immunomodulatory agents in attenuating the cytokine storm.We declare no competing interests.

No abstract

No abstract

No abstract