It has been suggested that some cytokine patterns associated with COVID-19 severity, such as M-CSF, IP-10 and IL-1RA, are associated with the presence of the macrophage activation syndrome (36) in which infection of macrophages and dendritic cells potentially plays a major role in COVID-19 pathogenesis, even in the absence of productive infection (28). This evidence concerns the gene CSF1 and macrophage activation syndrome.