The clinical and laboratory features of COVID-19 are reviewed with attention to 
the immunologic manifestations of the disease. Recent COVID-19 publications 
describe a variety of clinical presentations including an asymptomatic state, 
pneumonia, a hemophagocytic lymphohistiocytosis like syndrome, Multisystem 
Inflammatory Syndrome in Children (MIS-C) but, also called Pediatric 
Inflammatory Multisystem Syndrome-Toxic Shock (PIMS-TS), Kawasaki Disease, and 
myocarditis. A common theme amongst multiple reports suggests an overexuberant 
autoimmune component of the disease but a common pathophysiology to explain the 
variations in clinical presentation has been elusive. Review of the basic 
science of other viral induced autoimmune disorders may give clues as to why 
immunosuppressive and immunomodulating regimens now appear to have some efficacy 
in COVID-19. Review of the immunopathology also reveals other therapies that 
have yet to be explored. There is potential use of T cell depleting therapies 
and possibly anti-CD20 therapy for COVID-19 and clinical research using these 
medications is warranted.