TNFα inhibitor may be effective for severe COVID-19: learning from toxic epidermal necrolysis

Increased inflammatory cytokines [such as tumor necrosis factor alpha (TNF alpha) and interleukin-6 (IL-6)] are observed in COVID-19 patients, especially in the severe group. The phenomenon of a cytokine storm may be the central inducer of apoptosis of alveolar epithelial cells, which leads to rapid progression in severe group patients. Given the similarities of clinical features and pathogenesis between toxic epidermal necrolysis (TEN) and COVID-19, we hypothesize that the application of etanercept, an inhibitor of TNF alpha, could attenuate disease progression in severe group COVID-19 patients by suppressing systemic auto-inflammatory responses.