TNF and COVID-19–associated multisystem inflammatory syndrome in children: In MIS-C-related renal injury pathophysiology, initial renal ischemia triggers an inflammatory cascade through chemokine and cytokine production (IL-1, IL-6, IL-8, MCP-1, RANTES, TNF-α), leading to continued inflammation even after the ischemic event resolves, resulting in tubular cell death and reduced glomerular filtration [10,38].