Thus far, ESCPE-1 has been associated with the sorting of over 60 cargos with broad functions, including the cation-independent mannose-6-phosphate receptor (CI-MPR), the roundabout homolog 1 receptor (ROBO1), the insulin-like growth factor 1 receptor (IGF1R), the tumor necrosis factor-related apoptosis-inducing ligand receptor (TRAILR1)5–8, and the multifunctional coreceptor neuropilin-1 involved in cardiovascular and neuronal development, as well as in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection9, and in Chlamydia trachomatis pathogenesis10–12. The gene discussed is IGF1R; the disease is COVID-19.