Successful treatment of severe COVID-19 with subcutaneous anakinra as a sole treatment

Abstract

disease, may present as ground-glass opacity and consolidation in CT studies. Moreover, lung infarctions due to small vessel vasculitis can also appear as consolidation [5].While pulmonary nodules and mass lesions are not typical for COVID, GGOs with or without consolidations are highly suggestive of COVID-19 pneumonia [2]. As GPA and COVID-19 pneumonia share clinical and radiological features, discrimination based on imaging could be cumbersome. Prompt diagnosis and appropriate clinical management of COVID-19 superinfection in such cases are essential to prevent further morbidity and mortality [6]. This was the case in our patient. In such conditions, the specificity of a chest CT scan in proposing a correct diagnosis may be reduced; therefore, meticulous attention to the recent clinical presentation and also past medical records, together with the application of confirmatory laboratory tests such as RT-PCR can be problem-solving. AcknowledgementsInformed consent has been obtained from the patient.

Can Activation of NRF2 Be a Strategy against COVID-19?

“…This includes targeting IL-6 and IL-1 signaling [ 107 ]. Tocilizumab (a humanized monoclonal antibody against the IL-6 receptor) and anakinra (a recombinant human IL-1 receptor antagonist) are being repurposed and studied in COVID-19 [ 108 , 109 ]. Use of NRF2 activators represents an excellent alternative or parallel to these approaches because it is known that NRF2 inhibits IL-6 and IL-1β gene expression [ 21 ].…”

Anakinra for patients with COVID-19: a meta-analysis of non-randomized cohort studies.

“…1). Eleven studies were further excluded because of our prespecified exclusion criteria: five case reports [25][26][27][28][29]; four case-series with no comparators [15][16][17]30]; two because including patients treated with anakinra before COVID-19 infection [26,31].…”

Tocilizumab: from the rheumatology practice to the fight against COVID-19, a virus infection with multiple faces

“…Patients with COVID-19 present with features mimicking autoimmune diseases, such as fever, arthralgia, acute interstitial pneumonia, myocarditis, leukopenia, lymphopenia, thrombocytopenia, coagulopathy, and biological inflammatory changes derived from a cytokine storm, similar to HLH or MAS associated with autoimmune or inflammatory conditions [ 1 , 2 , 16 , 21 , 22 ].…”

“…With regard to anti-IL-1 therapy, anakinra has also shown benefit in patients with autoimmune diseases-associated MAS, both subcutaneously [ 18 , 19 ] and intravenously [ 16 ]. In severe COVID-19, some cases have similarly responded to the sole administration of anakinra at high doses by intravenous infusion (at 10 mg/kg/day during a mean of 9 days) [ 21 ] or by the subcutaneous route (at 100 mg/6 hours during 14 days) [ 22 ]. In addition, different clinical trials with intravenous anakinra are ongoing at this moment.…”