In such severe infections like COVID-19, the macrophages are activated and that can trigger a cytokine response cascade by triggering the release of tumor necrosis factor α (TNF-α), interleukin 1 (IL-1), nitric oxide (NO) and reactive oxygen species (ROS) to induce a powerful inflammatory immune response that promotes liver cells to produce serum amyloid A (SAA) [12]. Here, TNF is linked to infection.