VWF and COVID-19: In lung tissue, however, although slight upregulation of VWF in response to tissue damage might be conceivable, eg, due to increased shear stress [61] or hypoxia [62,63], at least in early disease when the endothelium is still functional, in our cohort with lethal COVID-19, we did not find evidence of VWF overexpression (ie, no significant difference between groups).