Figure 2.
Hypothetical application of TKIs during the SARS-COV-2–induced immunopathology. Phase 0 consists of infection with the virus; phase 1 entails the polarization of macrophages to an M1 phenotype (and their subsequent activation) and their production of cytokines to attract other immune cells. Phase 2 is the recruitment and activation of cytokine-producing innate immune cells and T cells and B cells, which (together with the cytokine storm that results from phase 1) results in phase 3: depletion and exhaustion of lymphocytes and, subsequently, secondary bacterial infections. In phase 4, acute respiratory distress syndrome, secondary infections and multiorgan failure arise, leading to respiratory insufficiency and life-threatening situations. The applicable TKIs are indicated below the phases during which their immunomodulatory effects would be the most beneficial. Image created with Biorender.com.