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Editorial
. 2021 Jun 4;12(6):e00367.
doi: 10.14309/ctg.0000000000000367.

Is the Intestine a Portal of Entry for the Serious COVID-19 Complications of Endotoxemia and Thrombosis?

David H Alpers  1
Affiliations
Editorial

Is the Intestine a Portal of Entry for the Serious COVID-19 Complications of Endotoxemia and Thrombosis?

David H Alpers. Clin Transl Gastroenterol. .

Abstract

Severe acute respiratory syndrome coronavirus 2 infection has been associated with both endotoxemia and thrombosis of small and large vessels, but the relationship between these 2 phenomena has not been pursued. Oliva et al. in this issue of Clinical and Translational Gastroenterology demonstrate an association between the 2 findings and suggest that increased intestinal permeability is a possible mechanism to explain the endotoxemia. Although the evidence to support this hypothesis is only suggestive, the role of the small intestine in the illness produced by the virus needs to be further explored.

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Conflict of interest statement

Guarantor of the article: David H. Alpers, MD.

Specific author contributions: Conception and writing.

Financial support: NIH NORC grant. Supported by NIH grant P30 DK056341 (Nutrition Obesity Research Center).

Potential competing interests: None to report.

References

    1. Sirivongrangson P, Kulvichit W, Payungporn S, et al. . Endotoxemia and circulating bacteriome in severe COVID-19 patients. Intensive Care Med 2020;8(1):72. - PMC - PubMed
    1. Kruglikov IL, Scherer PE. Preexisting and inducible endotoxemia as crucial contributors to the severity of COVID-19 outcomes. PLOS Pathogens 2021;17(2):e1009306. - PMC - PubMed
    1. Gasecka A, Borovac JA, Guerrero RA, et al. . Thrombotic complications in patients with COVID-19: Pathophysiological mechanisms, diagnosis, and treatment. Cardiovasc Drugs Ther 2021;35(2):215–29. - PMC - PubMed
    1. Sriram K, Incel PA. Inflammation and thrombosis in COVID-19 pathophysiology: Proteinase-activated and purinergic receptors as drivers and therapeutic candidate targets. Physiol Rev 2021;101:545–67. - PMC - PubMed
    1. Piazza G, Monroe DA. Diagnosis, management, and pathophysiology of arterial and venous thrombosis in COVID-19. JAMA 2020;324:3548–9. - PubMed

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