The “cytokine storm” results from a sudden rise in circulating levels of some pro-inflammatory cytokines such as interleukin-6 (IL-6), interleukin-1 (IL-1), tumor necrosis factor-α (TNF- α), and interferon-γ (IFN- γ). These high levels of cytokines lead to the influx of mast cells that contribute to inflammation into the site of infection. Cytokine storms can occur in different pathological contexts: malignancy, infections, sepsis, acute respiratory distress syndrome (ARDS), and even in auto-inflammatory diseases. Lung injury is one consequence of the cytokine storm that can progress into acute lung injury or its more severe form ARDS.
The results of numerous studies illustrated that cytokine storm is associated with COVID‐19 severity and is also a crucial cause of death from COVID‐19. Nevertheless, Existing evidence indicates relatively low incidence and mild severity of COVID-19 in pediatrics compared with adults. Many hypotheses have been proposed as reasons for the mild to moderate severity of COVID-19 in children and the absence of cytokine storm is one of these hypotheses.

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