Levels of anti-Annexin A2 antibodies at admission strongly predicted mortality among hospitalised COVID-19 patients. Given its critical protective function in the lung, Annexin A2 antagonism may play an important role in the pathophysiology of COVID-19.

The pathophysiology of severe COVID-19 has largely been attributed to a hyper-inflammatory response without a clear indication of the underlying mechanism [1]. There is a characteristic delay in the onset of respiratory distress, approximately 6 to 12 days after the start of symptoms, which is somewhat atypical for other severe viral respiratory infections [2]. Several theories have been proposed for this delay such as an indolent infection or viral persistence. However, data from viral cultures of SARS-CoV-2 (not PCR) demonstrates a lack of positive cultures beyond day 9 of illness [3].

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