ACE and acute respiratory distress syndrome: Any imbalance between ACE1 and ACE2 tilts the balance between the healthy state and disease severity, and it has been shown that this imbalance between ACE1 and ACE2, mediated by SARS-CoV-2-mediated suppression of ACE2, results in RAS over-activation and pulmonary shut-down which is a consequence of induced- pulmonary edema, inflammation, hyper-proliferation, and cytokine storm together causing ARDS (Figure 4).