COVID-19的主要表现是由于炎症介质过度增加，特别是促炎白细胞介素如IL-1β、IL-6和肿瘤坏死因子-α引起的高度炎症状况和细胞因子风暴。目前还没有COVID-19疾病的确定性治疗方法，但根据该疾病的病理生理学，阿那基妥（白细胞介素-1抑制剂）是严重COVID-19患者的辅助治疗选择，通过阻断IL-1的作用。因此，我们旨在总结评估COVID-19诊断患者中阿那基妥的安全性和有效性的研究。我们在PubMed、Cochrane图书馆、Scopus和Web of Science (WOS)数据库中进行了检索，时间从创建至2022年1月7日。另外，我们搜索了随机和非随机临床试验，队列研究，病例系列，病例对照，包含至少3例确诊COVID-19并接受阿那基妥（白细胞介素-1抑制剂）治疗的病例报告。我们使用Review Manager 5.4进行了荟萃分析。我们在系统综述中纳入了44篇文章。最终，我们将23项研究纳入荟萃分析中，共计3179例患者。我们的分析显示以下指标存在统计学显著差异：ICU逗留时间[MD = -0.65, 95% CI (-1.09, -0.03), p = 0.04]，需要侵入性机械通气的患者数量[RR = 0.57, 95% CI (0.39, 0.84), p = 0.004]，和死亡人数[RR = 0.80, 95% CI (0.66, 0.99), p = 0.04]。我们的分析显示以下指标不存在统计学显著差异：住院时间[MD = -0.16, 95% CI (-0.42, 0.11), p = 0.26]，无需氧气支持的天数[MD = -0.81, 95% CI (-3.81, 2.20), p = 0.60]，和需要非侵入性机械通气的患者数量[RR = 1.09, 95% CI (0.47, 2.52), p = 0.84]。阿那基妥在COVID-19相关的重要结果方面显示出一些有希望的结果，因为它显著降低了死亡率和对侵入性机械通气的需求。它应该在严重病例中使用，而不是轻度和中度病例，以避免可能的免疫抑制并发症。在COVID-19病例中，使用低于100mg的剂量是安全的。另一个重要的结果是D-二聚体水平的显著降低。阿那基妥可能对特定的免疫缺陷病例治疗有效，但应谨慎使用。版权所有©2023 Elsevier Ltd. 保留所有权利。

The most important presentation of COVID-19 is hyper inflammatory condition and cytokine storm that occurs due to excessive increase of the inflammatory mediators specially, pro-inflammatory interleukins such as IL-1β, IL-6 and tumor necrosis factor-α which have an important role in the cytokine storm pathway. Up till now there is not a definitive treatment for COVID-19 disease, but according to the pathophysiology of the disease, Anakinra (Interleukin- 1 inhibitor) is an adjuvant treatment option in patients with severe COVID-19 by blocking the effect of IL-1. So, we aimed to summarize the studies that evaluated the safety and efficacy of Anakinra in patients diagnosed with COVID-19.We performed a search in PubMed, Cochrane Library, Scopus, and Web of Science (WOS) databases from inception till 7 Jan 2022. Additionally, we searched randomized and non-randomized clinical trials, cohort, case series, case control, case report more than 3 patients which contain confirmed cases of COVID-19 who received Anakinra (Interleukin- 1 inhibitor) for the management of hyper-inflammatory condition associated with COVID-19 disease. A meta-analysis was conducted using review manager 5.4.We included 44 articles in the systematic review. Ultimately, 23 studies were incorporated in the meta-analysis with a total number of 3179 patients. Our analysis showed statistically significant difference in the following outcomes: duration of ICU stays [MD = -0.65, 95% CI (-1.09, -0.03), p = 0.04], the number of patients who needed invasive mechanical ventilation [RR = 0.57, 95% CI (0.39, 0.84), p = 0.004], and number of deaths [RR = 0.80, 95% CI (0.66, 0.99), p = 0.04]. Our analysis showed no statistically significant difference in the following outcomes: length of hospital stays [MD = -0.16, 95% CI (-0.42, 0.11), p = 0.26], oxygen-free days [MD = -0.81, 95% CI (-3.81, 2.20), p = 0.60], and the number of patients who needed non-invasive mechanical ventilation [RR = 1.09, 95% CI (0.47, 2.52), p = 0.84].Anakinra showed some promising results in important outcomes related to COVID-19 as it significantly reduced the rate of mortality and the need of invasive mechanical ventilation. It should be used in severe cases more than mild and moderate cases to avoid possible immunosuppression complications. Anakinra use is safe in cases of COVID-19 at dose less than 100 mg. Another important outcome was significant reduction is the D-dimer level. Anakinra may be effective in the treatment of specific immunocompromised cases, but it should be used cautiously.Copyright © 2023 Elsevier Ltd. All rights reserved.