查看文章

Fernandes et al. reported a case of acute pancreatitis (AP) in a patient with SARS-CoV-2 (1). Although the authors make a detailed analysis of the possible causes of the AP (direct cytopathic effect of SARS-CoV-2 replication, severe systemic inflammatory response), they make no mention of the possible thrombotic etiopathogenesis of the AP.

Since the beginning of the SARS-CoV-2 pandemic, one notable feature of patients admitted with the disease has been the frequency of thrombotic and ischemic phenomena (myocardial infarction, stroke, ischemia of the lower extremities, intestinal ischemia), and even the development of disseminated intravascular coagulation (2). SARS-Cov-2 infection is associated with a severe immune response and the release of proinflammatory cytokines (systemic cytokine storm) and procoagulant (3). The gastrointestinal tract is the largest immune organ and the enterocytes, together with the pancreatic islets and the endothelial cells found there, express abundant angiotensin-converting enzyme 2-related carboxypeptidase (ACE-2). Thus facilitating the entry of SARS-CoV-2.