SARS-CoV-2 directly impacts several of established instigators that contribute to pathogenesis of ALI/ARDS including mitochondrial function (Srinivasan et al., 2021), NOX (Damiano et al., 2020; Violi et al., 2020; de Oliveira and Nunes, 2021), xanthine oxidase (Pratomo et al., 2021; Al-Kuraishy et al., 2022), eNOS (Guimaraes et al., 2021), glutathione peroxidase (Labarrere and Kassab, 2022) and Nrf2 (Olagnier et al., 2020; Zhang et al., 2022). The gene discussed is XDH; the disease is acute respiratory distress syndrome.