TNF and acute respiratory distress syndrome: TNF-α presents in the blood and lungs of patients with COVID-19 (244), and in severe COVID-19 cases, high systemic TNF-α levels were associated with respiratory distress syndrome (98, 245, 253, 254), and lower survival along with pulmonary dysfunction [edema, proteinaceous exudates, pneumocyte desquamation, and ARDS (66)] as well as impaired hematopoietic function, disseminated intravascular coagulation, debilitating hyperlipidemia, liver damage, chronic kidney disease, diabetes, and hypertension (8, 33, 77, 135, 255).