TNF and COVID-19: Macrophage-produced TNF-α can directly inhibit viral replication and indirectly activate tissue-resident macrophages, dendric cells, innate NKs and neutrophils;19 they are upregulated in COVID-19 infections as a response to viral entry but also this induces cell apoptosis and potentially cytokine storms.20 Our observation confirms that the TNF-α and associated genes are the major distinct responses in COVID-19 patients compared to HAP/CAP patients, which potentially contribute to the severity of the disease and has the potential to be targeted in COVID-19 specific therapies.