TNF and COVID-19: Alpha7 nicotinic acetylcholine receptor (α7-nAChR) activation which is mainly expressed by B cells, T cells, and macrophages, decreases proinflammatory cytokines formation as interleukin-1 (IL-1), interleukin-6 (IL-6), interleukin-8 (IL-8) and tumor necrosis factor-α (TNF-α) by nicotine or nicotinic agonists.13,14 Also, increased inflammatory cytokine may follow disruption of the polarization mechanism of M1 type macrophage through the antagonistic action on α7-nAChRs by SARS-CoV-2.15 This explains the cytokine storm and the hyperinflammatory syndrome seen in several COVID-19 patients.