In addition to laboratory evidence that SARS-CoV-2 infects endothelial cells and that loss of endothelial ACE2 as a consequence of coronavirus infection confers a pro-inflammatory, pro-coagulant, and pro-apoptotic phenotype to endothelial cells, there is now emerging evidence of vascular pathology in most patients with severe COVID-19 (Figure 1). This evidence concerns the gene ACE2 and COVID-19.