TNF and COVID-19: Endothelial damage, one of the critical components of the Virchow triad, seems to be the primary driver of thrombosis.1The direct viral endothelial infection causes endothelial activation, aided by the “cytokine storm” caused by COVID-19 (mainly due to interleukin [IL]-1, IL-6, and tumor necrosis factor [TNF]-α).