Background: Based on the investigations, cytokine-release syndrome (CRS) play a key role in the development of acute respiratory distress syndrome (ARDS) following SARS-CoV-2 infection. Anakinra can be effective in the management of CRS by inhibiting IL-1 from binding to the interleukin-1 receptors. We aimed to review the current clinical evidence regarding the therapeutic effects of anakinra in the management of ARDS in the context of the coronavirus disease 2019 (COVID-19). Methods: PubMed and google scholar databases were searched and all of the case reports, case series and RCTs were reviewed. Also, we searched www.clinicaltrial.gov database for ongoing clinical trials of anakinra. Results: Overall, 31 articles were found, and included 9 case report, 6 case-series and 11 RCTs. One of the reports of RCTs was not peer reviewed. Also, ten ongoing studies were found in the clinicaltrial.gov database searching. Conclusion: Four items have been shown to be important to achieve the optimal therapeutic effect of anakinra in patients withCOVID-19. These items include duration of treatment ≥ 10 days, doses of more than 100 mg, intravenous administration and early initiation of therapy. Also, the use of corticosteroids in combination with anakinra appears to improve clinical outcome compared to monotherapy with anakinra.