Abstract
SARS-CoV-2 binds to the angiotensin-converting enzyme 2 (ACE2) receptors found on vascular endothelial cells among others.1 Goshua et al. reported that von Willebrand factor is released by activated vascular endothelial cells and modulates platelet adhesiveness and aggregation; it was most elevated in sickest COVID-19 patients.2 Thus, the endothelial cell infection leads to a hypercoaguable state providing a rationale for the extent of microthrombi seen in those who succumbed to the disease.
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