ATP11A and COVID-19: Additionally, TLR4 signaling contributes to proper AT2 renewal and lung repair.92 In the case of COVID-19, the ectodomain of the SARS-CoV-2 spike protein has been consistently reported to stimulate TLR4.93,94 Without adequate internalization of TLR4 by ATP11A, downstream immune signaling may be overactivated, leading to hypersecretion of proinflammatory cytokines.