Irrespective of ACE2, people with diabetes are more susceptible to worse infection as the low-grade chronic inflammation and hyperglycaemia associated with the condition results in impaired immune responses with lower interleukin 1 (IL-1), IL-6, tumor necrosis factor (TNF)-α and delayed mobilisation of immune cells in response to pathogens.20 This comorbidity, like many other confounders, is highly relevant when examining the risk of death with COVID-19 disease. This evidence concerns the gene TNF and diabetes mellitus.