Endothelial cell activation, the major player in COVID-19 associated coagulopathy and venous thrombosis, is mediated either directly via SARS-CoV-2 infection of the vascular endothelium or indirectly by cytokine storm, complement activation, or hypoxia-induced by SARS-CoV-2, with subsequent release of factor VIII and von Willebrand factor (VWF) (12). Here, VWF is linked to blood coagulation disease.