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. 2022 Apr 27;9(1):e000871. doi: 10.1136/bmjgast-2022-000871

Figure 7.

Figure 7

Potential mechanism for cytokine storm and immune hyper-response in SARS-CoV-2 positive patients. In individuals infected with SARS-CoV-2, the macrophages become activated; these in turn activate T-cells, additional macrophages, and neutrophils―all of which release cytokines, including TNF-α. Bifidobacterium, when present in sufficient numbers, can bind to TNF-α and prevent the subsequent cytokine storm. Therefore, patients with a bifidobacterial dysbiosis characterised by low levels of Bifidobacterium lack this line of defense, which may lead to a cytokine storm.