TNF and Multiple Organ Failure: Cytokine release syndrome and hemodynamic instability: Acute systemic inflammation and cytokine release syndrome caused by elevated levels of ferritin, Interleukin-6 (IL-6), IL-2, tumor necrosis factor (TNF)-α, C-reactive protein (CRP), D-dimer and high-sensitivity cardiac troponin I leading to multiple organ failure (including the heart) can occur mostly in severe cases of COVID-19 (60, 62–64).