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. 2021 Mar 31;7(1):e001638. doi: 10.1136/rmdopen-2021-001638

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© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Structural causal model of how an intervention (do(X)=1) in patients fulfilling certain selection criteria (X) may have impact on a certain outcome (Y) in the context of a non-equivalent group design (A). (B) The situation worked out for the CHIC study in particular, where treatment refers to immunosuppressive treatment for patients with COVID-19 who are in a state of life-threatening hyperinflammation (X), outcome to WHO improvement or survival (30 days and 90 days, respectively) (Y), and ΔCRP to a mediator 80% CRP response (M). CHIC, COVID-19 High-intensity Immunosuppression in Cytokine storm syndrome; CRP, C reactive protein.