We previously reported that elevation in endothelial biomarkers ANGPT2/ANGPT1 ratio, VCAM1, and vWF distinguished children with ARDS due to indirect (e.g., extrapulmonary sepsis or trauma, shock, transfusion, pancreatitis) compared to direct (e.g., pneumonia, aspiration, drowning) lung injury (Whitney et al., 2020a). This evidence concerns the gene VCAM1 and pneumonia.