inclusion criteria: - 1) patient over 18 years old - 2) ability to grant consent - 3) bilateral pneumonia produced by sars-cov-2 without response in 48-72 hours after starting the treatment used according to the local protocol. this is defined as persistence of fever (above 37.5ºc without another focus) and respiratory worsening (more dyspnea and / or more cough and / or oxygen therapy at increasing doses and / or worsening of the degree of respiratory distress according to the pao2 / fio2 ratio in categories "mild, moderate or severe") or absence of improvement compared to the previous state - 4) persistently elevated inflammatory markers, among which the following must be met: ferritin greater than 1000 ng / ml and / or d-dimer greater than 1500 ng / ml and / or il-6 greater than 40 pg / ml [35-37], and / or crp above 150 (mg / l) or having doubled the crp provided it was above 50. since this is what is included within the definition of "inflammatory phenotype"

inclusion criteria: - 1) patient over 18 years old - 2) ability to grant consent - 3) bilateral pneumonia produced by sars-cov-2 without response in 48-72 hours after starting the treatment used according to the local protocol. this is defined as persistence of fever (above 37.5ºc without another focus) and respiratory worsening (more dyspnea and / or more cough and / or oxygen therapy at increasing doses and / or worsening of the degree of respiratory distress according to the pao2 / fio2 ratio in categories "mild, moderate or severe") or absence of improvement compared to the previous state - 4) persistently elevated inflammatory markers, among which the following must be met: ferritin greater than 1000 ng / ml and / or d-dimer greater than 1500 ng / ml and / or il-6 greater than 40 pg / ml [35-37], and / or crp above 150 (mg / l) or having doubled the crp provided it was above 50. since this is what is included within the definition of "inflammatory phenotype"