In the lungs, after entering in type II alveolar cells, SARS-CoV-2 infected cells become defective for surfactant production (Ghati et al., 2021) and release cytokines, like IL-8 among others, which in turn activate alveolar macrophages to release IL-1, IL-6, and TNF-, that induce natural killer and dendritic cell differentiation and macrophage M1 polarization, enhancing the proinflammatory response with increased vasodilation causing neutrophil and activated T cell influx from the capillaries into the alveolus, all leading to the cytokine storm (Carcaterra and Caruso, 2021
Ducastel M, Chenevier-Gobeaux C, Ballaa Y, Meritet JF, Brack M, Chapuis N, et al
G., Patel, S
With the 0.5% solutions, the endothelium was necrotic with multiple brown spherules approximately 1 m in diameter seen within the endothelial wall ( Fig