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Putative mechanisms of endothelial dysfunction in patients with COVID-19. A combination of direct SARS-CoV-2 infection of endothelial cells and a cytokine storm originating in the lungs may synergistically cause endothelial cell injury and/or activation, leading to endothelial dysfunction. ARDS, acute respiratory distress syndrome; ACE2, angiotensin-converting enzyme 2.
