Coronavirus disease 2019 (COVID-19) presents with a broad clinical spectrum, varying from asymptomatic infection to severe pneumonitis, leading to acute respiratory distress syndrome (ARDS) and death(Guan, et al 2020). Accumulating evidence suggests that in severe COVID-19, an acute hyperinflammatory syndrome characterised by fever, hypoxia and increased serum inflammatory markers, occurring 5–10 days from the first symptoms, is the major driver of morbidity and death(Zhou, et al 2020b). Hyperinflammation is not specific to COVID-19. Similar syndromes were previously described in respiratory disease associated with other coronaviruses, including the severe acute respiratory syndrome-coronavirus (SARS-CoV) in 2003 and Middle East respiratory syndrome-coronavirus (MERS-CoV) in 2012(Castilletti, et al 2005, Tseng, et al 2005).
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