“…D allele of ACE I/D polymorphism mediates higher ACE expression) [10] and have been associated with acute respiratory distress syndrome (ARDS), hypertension, obesity/metabolic syndrome, cardiovascular risk, and abnormal blood clotting tendency; all of which represent clinical hallmarks of severe COVID-19 disease [reviewed in [4,11]]. In contrast, no clinical advantage was observed in COVID-19 patients treated with ACE inhibitors or angiotension receptor blockers (mediating high ACE2 and low angiotension II) [12], suggesting that further efforts are needed to fully comprehend the role of RAAS in COVID-19. Therefore, the present study employed an ecological meta-regression design to evaluate the ACE1 I/D genotypic data in relation to the observed differences in COVID- 19 inhabitants), GDP/capita (PPP), current health expenditure/capita (PPP), healthy life expectancy at birth, DALY diabetes mellitus, DALY hypertensive heart disease and DALY respiratory infections as retrieved from the World Health Organization website www.who.int/countries/en/.…”