Endothelial cell activation is associated with a hypercoagulable state in COVID-19 (210, 211), with proposed mechanisms including exocytosis of granules containing von Willebrand factor (vWF) and P-selectin (211) in addition to alteration in plasminogen activator inhibitor 1 (PAI-1) and tissue factor pathway inhibitor (TFPI) levels and upregulating cell adhesion molecules like VCAM and ICAM, which facilitates extravasation of circulating white blood cells (212) (Figure 1H). The gene discussed is VWF; the disease is COVID-19.