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00925njm 22002777a 4500 dc de la Calle, Cristina author Lopez-Medrano, Francisco author Pablos, José Luis author Lora-Tamayo, Jaime author Maestro-de la Calle, Guillermo author Sanchez-Fernandez, Marcos author Fernandez-Ruiz, Mario author Perez-Jacoiste Asin, Maria Asunción author Caro-Teller, Jose Manuel author Garcia-Garcia, Rocio author Catalan, Mercedes author Martinez-López, Joaquín author Sevillano, Angel author Origüen, Julia author Ripoll, Mar author San Juan, Rafael author Lalueza, Antonio author de Miguel, Borja author Carretero, Octavio author Aguilar, Fernando author Gómez, Carlos author Paz-Artal, Estela author Bueno, Hector author Lumbreras, Carlos author Aguado, José María author 2021-04 A subgroup of patients with SARS-CoV-2 infection was thought to have developed cytokine release syndrome and were treated with tocilizumab; however, a significant percentage of patients evolved. This study aimed to determine the usefulness of anakinra as a rescue treatment for patients with tocilizumab-refractory COVID-19 disease. A prospective cohort of patients with COVID-19 pneumonia who received anakinra as salvage therapy after failure of tocilizumab were compared (1:1) with selected controls in a historical cohort of patients treated with tocilizumab. Cases and controls were matched by age, comorbidities, pulse oximetry oxygen saturation to fraction of inspired oxygen (SpO2/FiO2) ratio at baseline, and time elapsed since the initiation of treatment with tocilizumab. The primary outcome was the improvement in clinical status measured by a 6-point ordinal scale, from baseline to day 21. The study included 20 cases and 20 controls (mean age 65.3 ± 12.8 years, 65% males). No differences were found in the clinical improvement rates at 7, 14 and 21 days of follow-up. The in-hospital mortality rate for patients receiving anakinra was 55% vs. 45% in the control group (P = 0.527). Treatment with anakinra was not useful in improving the prognosis of patients with tocilizumab-refractory severe COVID-19. Int J Infect Dis. 2021; 105:319-325 10.1016/j.ijid.2021.02.041 1878-3511 1201-9712 International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases 33592340 http://hdl.handle.net/20.500.12105/13431 Effectiveness of anakinra for tocilizumab-refractory severe COVID-19: A single-centre retrospective comparative study.