Rapid Response to Cytokine Storm Inhibition using Anakinra in a Patient with COVID-19 Myocarditis

Cvetan Trpkov, Paul MacMullan, Patricia Feuchter, Rahim Kachra, Bobak Heydari, Naeem Merchant, Michael S Bristow, James A White
CJC open 2020 October 12
A 62-year-old female with COVID-19 developed acute respiratory failure and cardiogenic shock in the setting of a systemic hyper-inflammatory state and apparent ST-elevation myocardial infarction. Cardiac magnetic resonance (CMR) imaging showed fulminant acute myocarditis with severe left ventricular dysfunction. Treatment with the recombinant interleukin-1 (IL-1) receptor antagonist anakinra and dexamethasone resulted in rapid clinical improvement, reduction in serum inflammatory markers and a marked recovery in CMR-based markers of inflammation and contractile dysfunction. The patient was subsequently discharged from hospital. Emerging evidence supports use of anti-inflammatory therapies, including anakinra and dexamethasone, in severe COVID-19.

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