Anakinra or high-dose corticosteroids in COVID-19 pneumonia patients who deteriorate on low-dose dexamethasone: an observational study of comparative effectiveness

•Dexamethasone 6 mg is the standard of care for patients with COVID-19 requiring oxygen.•Neverthless, some patients with COVID-19 pneumonia worsen or fail to improve on this treatment.•Whether intensifying immunosuppression in such patients is helpful is unknown.•Neither high-dose corticosteroids nor anakinra reduced mortality in these patients.•Continuing dexamethasone 6mg in these patients was safer.