The role of angiotensin-converting enzyme 2 (ACE2) in the association between DM and COVID-19 is plausible. ACE2 is a type 1 integral membrane glycoprotein that is constitutively expressed by the epithelial cells of the lungs, kidney, intestine and blood vessels. In normal physiology, ACE2 breaks down angiotensin-II and to a lesser extent, angiotensin-I to smaller peptides, angiotensin (1–7) and angiotensin (1–9), respectively [11]. ACE2/Ang (1–7) system plays an important anti-inflammatory and anti-oxidant role protecting the lung against ARDS; indeed ACE2 has been shown to be protective against lethal avian influenza A H5N1 infection [12]. ACE2 expression is reduced in patients with DM possibly due to glycosylation; this might explain the increased predisposition to severe lung injury and ARDS with COVID-19 [4], [11].