Similarly, dysregulated TNF-α release results in apoptosis-promoting effects on highly activated effector T cells [109], and also increases the adhesion of lymphocytes in ALI by activating the SDF-1(CXCL12)/CXCR4 pathway [110], possibly also explaining decreased T cell counts (lymphopenia) in severe COVID-19. Here, CXCL12 is linked to acute respiratory distress syndrome.