Activation of NF-kB leading to ARDS in COVID-19 could be linked to the higher affinity of the S protein of SARS-CoV-2 with ACE2, leading to the release of angiotensin II via angiotensin receptor type 1, activating NF-kB [77, 78] and releasing proinflammatory cytokines such as IL-6 [78]. The gene discussed is ACE2; the disease is acute respiratory distress syndrome.