Recently, a cross-sectional study found that patients in the ICU had significant elevation of markers of endothelial cell and platelet activation compared to non-ICU patients.12 The patients were noted to have von Willebrand factor antigen concentrations markedly elevated with mortality correlation.12 In addition, the endotheliopathy process is unique in comparison to other viral infections, namely influenza A virus subtype H1N1 (H1N1). This evidence concerns the gene VWF and viral infectious disease.