It is now clear that children with chronic diseases are more susceptible to severe COVID-19 manifestations.10-13 Despite progression to severe ARDS, specifically in the presence of comorbidities, recovery is faster, probably due to a better immune response and reduced expression and maturity of angiotensin-converting enzyme 2.13 Angiotensin-converting enzyme 2 is a transmembrane receptor found on the apical membranes of respiratory epithelial cells, mainly in type II pneumocytes.13 The gene discussed is ACE2; the disease is acute respiratory distress syndrome.