Table 2 Exclusion Criteria

1. Age < 21 years;

2. Pregnancy;

3. Inability to obtain consent from patient or legally authorized representative;

4. Contraindications to treatment with Anakinra (Kineret)(i.e. prior allergic reaction to the drug or to E. coli derived products or severe allergy to latex);

5. Severe anemia (Hgb < 8 g/dl—due to the need of more frequent blood sampling with this study)

6. Acute or chronic active infections (not including treated/cured HCV with negative viral load)

7. Acute or chronic inflammatory disease or immunosuppressive therapies (excluding stable [> 1 month] oral corticosteroids at a dose of prednisone less than 0.5 mg/kg/day or methotrexate)

8. Active acute or chronic psychiatric illness that in the opinion of the investigator may prevent from complying with study instructions;

9. Limited English Proficiency that in the opinion of the investigator may prevent from understanding the content of the informed consent form or safely completing the study procedures

10. Live vaccination within the prior month

11. Neutropenia (defined as absolute neutrophil count < 1,500/ml or < 1,000/ml if subject is African American)

12. History of malignancy within the prior 5 years (with exception of basal cell skin cancer, carcinoma in-situ of the cervix or low risk prostate cancer after curative therapy)

13. Participation in another concurrent intervention study within 30 day or treatment with an investigational drug within 5 half-lives prior to randomization

14. Severe kidney disease (GFR < 30 mL/min/1.73m²)

15. Evidence of COVID-19 within the last 60 days or recent (21 days) exposure to close personal contact with COVID-19

16. Chronic, moderate-to-severe kidney disease (GFR < 60 mL/min/1.73m²) or acute kidney injury, or history of severe hypersensitivity reactions to gadolinium-based contrast agents—for VCU Imaging Sub-study, patients may participate but will not undergo CMR