TNF and gangrene: As described in the literature, most patients with severe COVID-19 had persistently high levels of erythrocyte sedimentation rate, C-reactive protein, IL-6, TNFα (tumor necrosis factor alpha), IL-1β, IL-8, and IL2R and had associated occurrence of ARDS, hypercoagulation and disseminated intravascular coagulation with clinical manifestations of thrombosis, thrombocytopenia and gangrene of the extremities [24].