Here is the design of a clinical trial:

Official Title: A Prospective, Randomized, Factorial Design, Interventional Study to Compare the Safety and Efficacy of Combinations of Blockade of Interleukin-6 Pathway and Interleukin-1 Pathway to Best Standard of Care in Improving Oxygenation and Short- and Long-term Outcome of COVID-19 Patients With Acute Hypoxic Respiratory Failure and Systemic Cytokine Release Syndrome

Included conditions:
- COVID-19

Study Armgroups:
- {'label': 'Usual Care', 'type': 'PLACEBO_COMPARATOR', 'interventionNames': ['Other: Usual Care']}
- {'label': 'Anakinra', 'type': 'ACTIVE_COMPARATOR', 'interventionNames': ['Drug: Anakinra']}
- {'label': 'Siltuximab', 'type': 'ACTIVE_COMPARATOR', 'interventionNames': ['Drug: Siltuximab']}
- {'label': 'Anakinra + Siltuximab', 'type': 'ACTIVE_COMPARATOR', 'interventionNames': ['Drug: Anakinra', 'Drug: Siltuximab']}
- {'label': 'Tocilizumab', 'type': 'ACTIVE_COMPARATOR', 'interventionNames': ['Drug: Tocilizumab']}
- {'label': 'Anakinra + Tocilizumab', 'type': 'ACTIVE_COMPARATOR', 'interventionNames': ['Drug: Anakinra', 'Drug: Tocilizumab']}

Interventions:
- {'type': 'OTHER', 'name': 'Usual Care', 'description': 'Usual Care', 'armGroupLabels': ['Usual Care']}
- {'type': 'DRUG', 'name': 'Anakinra', 'description': 'Anakinra will be given as a daily subcutaneous injection of 100 mg for 28 days or until hospital discharge, whichever is first', 'armGroupLabels': ['Anakinra', 'Anakinra + Siltuximab', 'Anakinra + Tocilizumab'], 'otherNames': ['KINERET®']}
- {'type': 'DRUG', 'name': 'Siltuximab', 'description': 'Siltuximab will be given via single IV infusion at a dose of 11 mg/kg', 'armGroupLabels': ['Anakinra + Siltuximab', 'Siltuximab'], 'otherNames': ['SYLVANT®']}
- {'type': 'DRUG', 'name': 'Tocilizumab', 'description': 'Tocilizumab will be given via single IV infusion at a dose of 8 mg/kg with a maximum infusion of 800 mg/injection', 'armGroupLabels': ['Anakinra + Tocilizumab', 'Tocilizumab'], 'otherNames': ['ROACTEMRA®']}

Primary Outcomes:
- {'measure': 'Time to Clinical Improvement', 'description': 'Time to Clinical Improvement is defined as the time from randomization to either an increase of at least two points on a six category ordinal scale from the status at randomization or live discharge from the hospital.The 6-point ordinal scale for clinical improvement is defined as 1 = Death; 2 = Hospitalized, on invasive mechanical ventilation or ECMO; 3 = Hospitalized, on non-invasive ventilation or high flow oxygen devices; 4 = Hospitalized, requiring supplemental oxygen; 5 = Hospitalized, not requiring supplemental oxygen; 6 = Not hospitalized. A higher score represent a better outcome', 'timeFrame': 'at day 15'}

Please estimate the sample size based on the assumption: 
Not explicitly stated in the paragraph.
Numbers to be randomised (sample size)
          A total of 342 participants will be enrolled: 76 patients will receive usual care, 76 patients will receive Siltuximab alone, 76 patients will receive Tocilizumab alone, 38 will receive Anakinra alone, 38 patients will receive Anakinra and Siltuximab and 38 patients will receive Anakinra and Tocilizumab.