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There is accumulating evidence that ARDS and respiratory failure by COVID-19 may be caused by a defective immune response, characterized by a rapid proliferation and hyperactivation of T cells, macrophages, natural killer cells, and an overproduction of more than 150 chemical mediators (the so called cytokines storm), including pro-inflammatory cytokines (TNF-, INF-, IL-6, IL-1, IL-8), and chemokines (CCL-2, CCL-3, CCL-5, CXCL-8, CXCL-10), leading to an increased vascular permeability and multiple-organ failure [2, 3]

The knees are a common problem area

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Patients were assumed to receive initial therapies until HbA1c exceeded 7.5% and then treatment-intensified to basal insulin