Acute pancreatitis in COVID-19 patients: true risk?

A relation between coronavirus disease 2019 (COVID-19) and acute pancreatitis has been suggested. However, the incidence and clinical relevance of this relation remain unclear. We aimed to investigate the incidence, severity and clinical impact of acute pancreatitis in patients with COVID-19. This i...

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Bibliographic Details
Published in:Scandinavian journal of gastroenterology 2021-05, Vol.56 (5), p.585-587
Main Authors: Bulthuis, Margo C., Boxhoorn, Lotte, Beudel, Martijn, Elbers, Paul W. G., Kop, Marnix P. M., van Wanrooij, Roy L. J., Besselink, Marc G., Voermans, Rogier P.
Format: Article
Language:English
Subjects:
Acute pancreatitis
coronavirus disease
COVID-19
COVID-19 - epidemiology
COVID-19 - physiopathology
COVID-19 - therapy
Cross-Sectional Studies
Female
Humans
Incidence
Intensive Care Units - statistics & numerical data
Ischemia - etiology
Ischemia - physiopathology
Length of Stay - statistics & numerical data
Male
Middle Aged
Multiple Organ Failure - diagnosis
Multiple Organ Failure - etiology
Multiple Organ Failure - physiopathology
Netherlands - epidemiology
Outcome and Process Assessment, Health Care
Pancreas - blood supply
Pancreas - physiopathology
Pancreatitis - diagnosis
Pancreatitis - epidemiology
Pancreatitis - etiology
Pancreatitis - physiopathology
Severity of Illness Index
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Summary:A relation between coronavirus disease 2019 (COVID-19) and acute pancreatitis has been suggested. However, the incidence and clinical relevance of this relation remain unclear. We aimed to investigate the incidence, severity and clinical impact of acute pancreatitis in patients with COVID-19. This is a cross-sectional study of a prospective, observational cohort concerning all COVID-19 patients admitted to two Dutch university hospitals between 4 March 2020 and 26 May 2020. Primary outcome was acute pancreatitis potentially related to COVD-19 infection. Acute pancreatitis was defined according to the revised Atlanta Classification. Potential relation with COVID-19 was defined as the absence of a clear aetiology of acute pancreatitis. Among 433 patients with COVID-19, five (1.2%) had potentially related acute pancreatitis according to the revised Atlanta Classification. These five patients suffered from severe COVID-19 infection; all had (multiple) organ failure and 60% died. None of the patients developed necrotizing pancreatitis. Moreover, development of acute pancreatitis did not lead to major treatment consequences. In contrast with previous research, our study demonstrated that COVID-19 related acute pancreatitis is rare and of little clinical impact. It is therefore debatable if acute pancreatitis in COVID-19 patients requires specific screening. We hypothesize that acute pancreatitis occurs in patients with severe illness due to COVID-19 infection as a result of transient hypoperfusion and pancreatic ischemia, not as a direct result of the virus.
ISSN:0036-5521
1502-7708
DOI:10.1080/00365521.2021.1896776