Differently from FVIII, vWF is mainly synthetize by the endothelium, which in COVID-19 is activated not only by the inflammatory reaction to the infection but also by the direct viral attack.31, 32, 33It has been suggested that a pre-existing endothelial dysfunction combined with the direct assault of SARS-CoV-2 on vascular system may account for a high mortality of COVID-19 patients. This evidence concerns the gene VWF and endothelial dysfunction.