Fig. 2.

Pathogenesis of COVID-19 and potential adjuvant therapy of roflumilast. SARS-CoV-2 infections lead to elevation of inflammatory mediators and suppression of immune response which in turn triggers activation of cytokine storm. Overwhelming immune cell activation thus leads to ARDS, sepsis and multiorgan failure. In this context, Roflumilast might act as a potent adjuvant therapeutic agent by regulating the immune system, inflammation and bronchial smooth muscle relaxation through enhanced cAMP production and provide support for patients with ARDS and related complications. ARDS: Acute respiratory distress syndrome; PDE-4: Phosphodiestrase-4; AC: Adenylate Cyclase.