The angiotensin metabolite profiles of the ICU patients with COVID-19 ARDS in this study showed a larger increase in Ang I than in Ang II levels leading to reduced ACE-S (Ang II/Ang I ratio) that were also observed in non-COVID-19 ARDS [22, 23] and in patients with severe COVID-19 [28] in earlier studies. The gene discussed is AGT; the disease is acute respiratory distress syndrome.