Conclusion
The availability of vaccines will reduce the number of acute cases of COVID-19. However, acute cases will continue to exist, requiring therapeutic interventions to reduce toxicities and improve survival. Reducing the cytokine storm appears to be crucial in preventing end organ damage which is associated with high mortality59. Genetic and immunologic studies of hospitalized COVID-19 subjects showed mutations yielding increased TYK2 or decreased IFNAR2 expression or inactivating mutations in interferon pathway genes—IRF3, IRF7, IFNAR1/2, TBK1 or TLR3 or autoantibodies to interferons had more severe disease60-62. These subjects suffered increased inflammatory cytokines and absent anti-viral interferons. Targeted immune regulation to reverse this state may provide substantial benefit in SARS-CoV-2 infection. Our case suggests that everolimus plus pegylated interferon is a potential regimen for SARS-CoV-2 patients. This treatment combination may benefit select patients if used early in the disease. Future studies are needed to elucidate the potential therapeutic benefits and side effects of this regimen.