The discordant IL-18/IL-18R pattern points to NF-κB pathway activation,42 a key driver of inflammation in adult COVID-1943 and pediatric lung disease.44 TNFSF14 (LIGHT) has also been implicated in acute respiratory distress (ARDS) in hospitalized adult COVID-19 cases45 and virus-induced asthma exacerbation in children.46 In adults, growth factors, typically induced following lung injury, are associated with COVID-19 severity and tissue repair processes.47–50 Elevation of growth factors in neonates may indicate similar roles. This evidence concerns the gene IL18R1 and acute respiratory distress syndrome.