In addition, specific groups of bacterial species that can downregulate the expression of ACE2 in murine gut studies were found in abundance in fecal samples with high SARS-CoV-2 load.19, 20, 21 Additionally, patients with COVID-19 who require hospitalization are submitted to several factors that promote dysbioses such as antibiotic use, proton pump inhibitor use, dysglycemia, and obesity.22 The gene discussed is ACE2; the disease is obesity due to melanocortin 4 receptor deficiency.