Two different patterns of immune dysfunction[25] were suggested in SARS-CoV2-related ARDS; the first, driven by interleukine 1β (IL1β), suggestive of macrophage activation syndrome (hyperferritinemia and elevated H score for reactive hemophagocytic syndrome in up to 25% of patients); the second, driven by IL-6, consisting of immune dysregulation associating hypercytokinemia, immuneparalysis (as indicated by decreased Human Leukocyte Antigen – DR molecules on CD14 monocytes), and global lymphopenia. Here, IL6 is linked to secondary hemophagocytic lymphohistiocytosis.