IL6 and Cowden syndrome 1: In addition, increased VEGF and decreased E-cadherin can lead to vascular permeability and leakage and accelerate the presence of hypotension and pulmonary dysfunction in COVID-CS.87 Moreover, IL-6 can promote the secretion of various acute-phase proteins such as CRP, hepcidin, fibrinogen, thrombopoietin, complement C3, and ferritin in hepatocytes.118,119 Collectively, IL-6 contributes to both immune cell hyperactivation and target organ dysfunction in CS.