Cytokine storm syndrome (CSS) represents a severe complication in COVID-19. Anakinra, an Il-1 receptor antagonist, may orchestrate the excessive inflammation. We report the use of anakinra (100 mg/d) in COVID-19. Under therapy, clinical stabilization occurred. After discontinuation of the biological, bacterial superinfection with sepsis occurred. On December 31, 2019, the number of hospitalized patients with severe pneumonia suddenly increased in the Chinese city of Wuhan (Hubei Province). Soon after the first cases, on January 7, 2019, Chinese health authorities reported that the outbreak was caused by a novel coronavirus, named coronavirus SARS-CoV-2. 1 Epidemiologic data indicated that person-to-person transmission of SARS-CoV-2 was occurring, and the resulting disease was named coronavirus Disease 2019 (COVID-19). 1 Despite rigid containment and