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Favorable Anakinra Responses in Severe Covid-19 Patients with Secondary Hemophagocytic Lymphohistiocytosis

Open access
Dimopoulos, George, de Mast, Quirijn, Markou, Nikolaos, Theodorakopoulou, Maria, Komnos, Apostolos, Mouktaroudi, Maria, Netea, Mihai G., Spyridopoulos, Themistoklis, Verheggen, Rebecca J., Hoogerwerf, Jacobien, Lachana, Alexandra, van de Veerdonk, Frank L., Giamarellos-Bourboulis, Evangelos J.·2020·Cell Host & Microbe

Abstract

Dysregulation of inflammation is hypothesized to play a crucial role in the severe complications of COVID-19, with the IL-1/IL-6 pathway being central. Here, we report on the treatment of eight severe COVID-19 pneumonia patients—seven hospitalized in intensive care units (ICUs) in Greece and one non-ICU patient in the Netherlands—with the interleukin-1 receptor antagonist Anakinra. All patients scored positive for the hemophagocytosis score (HScore) and were diagnosed with secondary hemophagocytic lymphohistocytosis (sHLH) characterized by pancytopenia, hyper-coagulation, acute kidney injury, and hepatobiliary dysfunction. At the end of treatment, ICU patients had less need for vasopressors, significantly improved respiratory function, and lower HScore. Although three patients died, the mortality was lower than historical series of patients with sHLH in sepsis. These data suggest that administration of Anakinra may be beneficial for treating severe COVID-19 patients with sHLH as determined by the HScore, and they support the need for larger clinical studies to validate this concept.

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Metadata

Authors
Dimopoulos, G., de Mast, Q., Markou, N., Theodorakopoulou, M., Komnos, A., Mouktaroudi, M., Netea, M. G., Spyridopoulos, T., Verheggen, R. J., Hoogerwerf, J., Lachana, A., van de Veerdonk, F. L., & Giamarellos-Bourboulis, E. J.
Venue
Cell Host & Microbe
Publisher
Elsevier BV
Published
2020-07
Volume
28
Issue
1
Pages
117-123.e1
ISSN
1931-3128 (ISSN-L)
OpenAlex
W3025045885
Cited by
245
References
4
FWCI
6.91
Type
journal article
Language
en
Open access
bronze

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CoChat. (2026). Citation check: Favorable Anakinra Responses in Severe Covid-19 Patients with Secondary Hemophagocytic Lymphohistiocytosis. https://app.cochat.ai/papers/10.1016/j.chom.2020.05.007
The paper
Dimopoulos, G., de Mast, Q., Markou, N., Theodorakopoulou, M., Komnos, A., Mouktaroudi, M., Netea, M. G., Spyridopoulos, T., Verheggen, R. J., Hoogerwerf, J., Lachana, A., van de Veerdonk, F. L., & Giamarellos-Bourboulis, E. J. (2020). Favorable Anakinra Responses in Severe Covid-19 Patients with Secondary Hemophagocytic Lymphohistiocytosis. Cell Host & Microbe. https://doi.org/10.1016/j.chom.2020.05.007

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.