In the context of CoVs, the significant morbidity and mortality associated with severe disease is due to acute lung injury (ALI) and the development of ARDS (19, 141). Pathological analysis of tissues obtained from SARS and MERS patients showed edematous lungs with areas of consolidation, bronchial epithelial denudation, loss of cilia, squamous metaplasia, pneumocyte hyperplasia, and bronchial submucosal gland necrosis (19, 29). Histological features include diffuse alveolar damage and acute fibrinous and organizing pneumonia (29). A heightened inflammatory response in the lungs resulting in tissue damage has been hypothesized to explain the development of ALI.