The overall association between plasma sACE2, the ADAM-17 substrate score, renin, and inflammatory markers was stronger than the correlation between plasma sACE2 and lung injury markers, suggesting that plasma sACE2 levels are, to a greater extent, related to increased ADAM-17 activity, inflammation-induced membrane bound shedding of mACE2 and dysregulation of the RAS rather than direct lung cell injury, secondary to viral infection. Here, ADAM17 is linked to viral infectious disease.