While both VWF-mediated platelet adhesion and aggregation mainly in the microcirculation of brain, kidney and heart as seen in TTP [51] and fibrin microthrombi located predominantly in the kidney as seen in HUS [21,22], will result in erythrocyte fragmentation in the partially occluded microcirculation with the high blood pressure gradient in the arterial circulation, it may be hypothesized that the “COVID-19-associated thrombotic microangiopathy that is often restricted to the pulmonary microcirculation will not produce schistocytes owing to the much lower blood pressure gradient”. Here, VWF is linked to thrombotic microangiopathy.