In this study we hypothesized that the extracellular form of cold-inducible RNA-binding protein (CIRP), i.e. eCIRP, a newly identified DAMP, may be a driver of COVID-19 associated respiratory failure as experimental studies have shown that it is an important mediator of sepsis induced acute lung injury (10) and bleomycin induced pulmonary fibrosis (11). This evidence concerns the gene CIRBP and COVID-19.