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The COVID-19 pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused more than 320 000 deaths as of May 19, 2020. COVID-19 deaths are primarily caused by acute respiratory distress syndrome (ARDS) and by a cytokine storm syndrome—ie, a state of hyperinflammation leading to multiorgan failure. 1 A recent Lancet letter2 suggested that screening patients with COVID-19 for hyperinflammation and treating them with immunosuppressive drugs could improve mortality. Cytokine storm complicating macrophage activation syndrome associated with rheu matic disease shares considerable biochemical overlap with the hyperinflammation observed in patients with COVID-19. 1, 3 At the time of writing, there are ten ongoing clinical trials in COVID-19 with the drug anakinra (table). Anakinra inhibits the proinflammatory cytokines interleukin (IL)-1α and IL-1β and has been …