Angiotensin-converting Enzyme 2–containing Small Extracellular Vesicles and Exomeres Bind the Severe Acute Respiratory Syndrome Coronavirus 2 Spike Protein

There is an increasing appreciation for the role of secreted extracellular vesicles (EVs) and nonvesicular nanoparticles in both physiologic and pathophysiologic conditions. Small EVs (sEVs) are 40- to 200-nm lipid-bilayer enclosed membrane vesicles, whereas exomeres are small (<50 nm), nonmembranous, extracellular nanoparticles.1,2 The coronavirus disease 2019 (COVID-19) pandemic is caused by the recent emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).3 For infection, SARS-CoV-2 must bind to the host cell receptor angiotensin-converting enzyme 2 (ACE2) to gain entry.