The most accepted description of severe COVID-19 disease is development and over production
of pro-inflammatory cytokines. Autopsy studies have been done on COVID-19 patients proved
that severe disease is resulted due to deviant host-immune response and cytokine storm.
Elevated inflammatory biomarkers like C-Reactive protein (CRP) and pro-inflammatory cytokines
shown to be higher in severe disease of COVID-19. Several studies on severe COVID-19 have
revealed raised levels of plasma cytokines like IL-6, IL-2, IL-10, Gamma interferon (INF),
Tumor necrosis factor Alpha TNF. The Cytokines release syndrome (CRS) is a hyperinflammatory
deadly syndrome characterized by release of uncontrolled immune system activation which is
responsible for multi-organ failure. It has the main role in ARDS due to SARS-CoV-2 virus
which binds to alveolar epithelium and resulting in IL-6 release that is responsible for
increase alveolar-epithelium permeability. In many studies it has been observed that IL-6
have played a main role in CRS induction. Previous experiences from hyperinflammatory and
cytokine storm syndromes recommends that early involvement of inhibiting CRS is essential to
prevent lethal tissue damage and poor clinical outcome. In this scenario the judgement of
clinical specialist who are suggesting that evidence of CRS can be cured with
glucocorticoids, I/V immunoglobulin and anti-cytokine therapy cannot be ignored.