Inclusion criteria:  Severe COVID-19 , as defined by clinical signs indicative of severe systemic illness with COVID-19, being given oxygenation and meeting  ONE of the following:  Respiratory rate ≥ 30 per minute Heart rate ≥ 125 per minute SpO2 ≤ 93% on room air at sea level PaO2/FiO2 < 300 mmHg or SpO2/FiO2 < 315 mmHg  Positive test by standard RT-PCR assay or equivalent within last 7 days Physician determination that patient is on SOC therapy, and will receive standard of care if patient progresses to Critical COVID-19, patient must be full CODE  Exclusion criteria:  Evidence of Critical COVID-19 Inability to utilize nebulized drugs, or history of bronchospasm with inhaled medications Age <12 years; Mean arterial pressure < 65 mm Hg after initial hospital stabilization, Non-COVID-19 irreversible underlying condition with projected fatal course within 6 months or with high risk of mortality; Immunosuppressive treatment for transplant or other diseases associated with high mortality; Stage IV cancer or cancer on active treatment with chemotherapy immunotherapy or checkpoint inhibitors; acute renal failure or chronic renal insufficiency with GFR less than 30; CHF New York Heart Association class III or IV, new neurologic disorder in the last 3 months or chronic neurologic disorder or other that would impact on assessing the resolution of severe COVID-19 respiratory failure Myocardial Infarction in previous six months or troponin >0.5 Recent history of venous thrombotic events (PE / DVT) within the last 3 months. New diagnosis of atrial fibrillation within the last 3 months. Acceptable if greater than 3 months and well controlled in the opinion of the investigator Watery diarrhea requiring replacement of 1 liter or more of iv fluids and electrolytes Pregnancy