Current evidence suggests that refractory cases of COVID-19 have poorer outcomes due to cytokine storm or cytokine releasing syndrome (CRS), characterized by elevation of inflammatory cytokines such as interleukin-6 (IL-6), IL-2, IL-7, TNF-A, IL-1 B, IL-1 Ra, IL-10, IP-10, granulocyte-colony stimulating factor, monocyte chemoattractant protein and is associated with fatal outcome in COVID-19. Here, TNF is linked to COVID-19.