TNF and acute respiratory distress syndrome: The development of ARDS in the context of SARS-CoV-2 is thought to occur through either the virus’s direct invasions on respiratory epithelial cells or through an amplified immune response (3) resulting in the overproduction of cytokines such as interleukin-10 (IL-10) and tumor necrosis factor-alpha (TNF-α), as well as increased levels of neutrophils, C-reactive protein (CRP), and neutrophil to lymphocyte ratio (NLR), while the lymphocyte count decreases (4–7).