ARDS occurs as a result of SARS-COV2 infection-induced acute inflammation in the lung (Goh et al, 2020).[2,3] This inflammation is mediated by pro-inflammatory cytokines such as interleukin 1 (IL1), interleukin 6 (IL6) and tumor necrosis factor (TNF) and could be very deleterious if left unopposed.[3,4] Therefore, early recognition and management are crucial to reduce associated morbidity and mortality. Here, TNF is linked to acute respiratory distress syndrome.