An association between gut microbiota dysbiosis and the poor outcomes among elderly COVID-19 patients, particularly among those with pre-existing cardiovascular, cardiometabolic, and cardiorenal diseases, can be hypothesized based on two factors: (1) the link between age-related gut microbiota dysbiosis and cardiometabolic, cardiorenal, and inflammatory disease and (2) the link between gut microbiota dysbiosis and inaccurate local/distal host immunity towards viral infection and RAS deregulation, driven by SARS-CoV-2-induced ACE2 shedding. The gene discussed is ACE2; the disease is COVID-19.