Patient Inclusion Criteria

- Recent ( ≥ 6 days of flu-like symptoms or malaise yet ≤16 days of flu-like symptoms or malaise prior to randomization) infection with COVID-19. - Confident COVID-19 diagnosis confirmed by antigen detection test and/or PCR and/or positive serology, or any emerging and validated diagnostic laboratory test for COVID-19 within this period. - In some patients, it may be impossible to get a confident laboratory confirmation of COVID-19 diagnosis after 24h of hospital admission because viral load is low and/or problems with diagnostic sensitivity. In those cases, in absence of an alternative diagnosis, and with highly suspect bilateral ground glass opacities on recent (<24h) chest-CT scan (confirmed by a radiologist and pulmonary physician as probable COVID-19), and a typical clinical and chemical diagnosis with signs of cytokine release syndrome, a patient can be enrolled as probable COVID-19 infected. In all cases, this needs confirmation by later seroconversion. - Presence of hypoxia defined as PaO2/FiO2 below 350 while breathing room air in upright position or PaO2/FiO2 below 280 on supplemental oxygen and immediately requiring high flow oxygen device or mechanical ventilation - signs of cytokine release syndrome defined as ANY of the following: 1. serum ferritin concentration >1000 mcg/L and rising since last 24h 2. single ferritin above 2000 mcg/L in patients requiring immediate high flow oxygen device or mechanical ventilation 3. lymphopenia defined as <800 lymphocytes/microliter) and two of the following extra criteria - Ferritin > 700 mcg/L and rising since last 24h - increased LDH (above 300 IU/L) and rising last 24h - D-Dimers > 1000 ng/mL and rising since last 24h - CRP above 70mg/L and rising since last 24h and absence of bacterial infection - if three of the above are present at admission, no need to document 24h rise - Chest X-ray or CT scan showing bilateral infiltrates within last 2 days - Admitted to specialized COVID-19 ward or an ICU ward taking care of COVID-19 patients - Age ≥ 18yrs - Male or Female - Willing and able to provide informed consent or legal representative willing to provide informed consent

Patient Exclusion Criteria

- Patients with known history of serious allergic reactions, including anaphylaxis, to any of the study medications, or any component of the product. - mechanical ventilation > 24 h at Randomization - Patient on ECMO at time of screening - clinical frailty scale above 3 (This frailty score is the patient status before first symptoms of COVID-19 episode.) - active bacterial or fungal infection - unlikely to survive beyond 48h - neutrophil count below 1500 cells/microliter - platelets below 50.000/microliter - Patients enrolled in another investigational drug study - patients on high dose systemic steroids (> 20 mg methylprednisolone or equivalent) for COVID-19 unrelated disorder - patients on immunosuppressant or immunomodulatory drugs - patients on current anti-IL1 or anti-IL6 treatment - signs of active tuberculosis - serum transaminase levels >5 times upper limit of normal - bowel perforation or diverticulitis - pregnant or breastfeeding females (all female subjects deemed of childbearing potential by the investigator must have negative pregnancy test at screening) - Women of childbearing potential must have a negative serum pregnancy test pre-dose on day 1. Woùmen of childbearing potential must consistently and correctly use (during the entire treatment period and 3 months after last reatment) 1 highly effective method for contraception.