(A) Flow cytometry histograms of ACE2 levels on exosomes in BALF from 8 representative COVID-19 patients. Ctrl: isotype control on exosomes from non-covid patient BALF. (B) Correlation analysis of proportion of ACE2+ exosomes in BALF and length of stay in the ICU (N = 78). Red dots indicate deaths. Simple regression analysis. (C) Correlation analysis of % ACE2 exosome levels with comorbidities colored: hypertension (blue), diabetes (green), both (orange). Red line indicates the average % of ACE2+ exosomes of all patients. (D) Length of stay in the ICU (blue), total hospitalization time (orange), and time on a ventilator (black) for each COVID patient (excluding deaths) plotted against the proportion of ACE2+ exosomes isolated from BALF (N = 59). r, Pearson correlation coefficient. P, p-value. Underlying data can be found in S1 Data. BALF, bronchoalveolar lavage fluid; COVID 19, Coronavirus Disease 2019; ICU, intensive care unit.