Background and objective: Anakinra is an adjuvant option in patients with severe COVID-19 by blocking IL-1. Aim of this Study: to summarize the studies that evaluated the safety and efficacy of Anakinra in COVID-19. Methods: We performed a search in PubMed, Cochrane Library, Scopus, and Web of Science (WOS) databases. We searched randomized and non-randomized clinical trials, cohort, case series, case control, case report > 3 patients which contain confirmed cases of COVID-19 who received Anakinra. A meta-analysis was conducted using review manager 5.4. Results: We included 44 articles in the systematic review and 23 studies were incorporated in the meta-analysis with a total number of 3179 patients. Our analysis showed significant difference in the following outcomes: duration of ICU stays [MD= -0.65, 95% CI (-1.09, -0.03), p = 0.04], 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]. There was no significant difference in: length of hospital stays [MD= -0.16, 95% CI (-.42, 0.11), p = 0.26], oxygen-free days [MD= -0.81, 95% CI (-3.81, 2.20), p = 0.60], and need for non-invasive mechanical ventilation [RR= 1.09, 95% CI (0.47, 2.52), p = 0.84]. Conclusion: Anakinra use is safe in cases of COVID-19 at dose < 100 mg.  It showed promising results, as it significantly reduced the rate of mortality and the need of invasive mechanical ventilation. It should be used in severe cases (not mild- moderate) to avoid possible immunosuppression complications.