Although infection does not lead to cytopathic changes, several studies observed endothelial cell dysfunction during hantavirus infection (Yanagihara and Silverman, 1990; Pensiero et al., 1992; Mackow and Gavrilovskaya, 2009), ranging from increased clinical markers of a stressed endothelium in vivo (sICAM-1, VWF and circulating endothelial cells; Han et al., 2010; Krautkramer et al., 2014), to increased permeability and decreased HUVEC integrin ligand migration in vitro (Gavrilovskaya et al., 2002; Geimonen et al., 2002; Taylor et al., 2013). Here, VWF is linked to infection.