Acute pancreatitis and COVID-19: an integrative review of the literature

Abstract

The first cases of the COVID-19 disease were identified in late 2019 in China, but it didnt take long for it to become pandemic. At first, it was believed that it was restricted to respiratory symptoms only, until extrapulmonary manifestations were reported worldwide. Acute pancreatitis concomitant with the diagnosis of SARS-CoV-2 infection has been observed in some patients, in the absence of the most common etiologies described in the literature. It is postulated that the presence of the ECA-2 viral receptor in the pancreas is responsible for the direct cellular damage and that the hyperinflammatory state of COVID-19 favors the development of pancreatitis through an immune-mediated mechanism. This study aimed to analyze the correlation between acute pancreatitis and COVID-19 disease as a probable causality factor. An integrative literature review was carried out, including studies published between January 2020 and December 2022 that brought data on patients diagnosed with acute pancreatitis according to the revised Atlanta Classification with a confirmed diagnosis of COVID-19 in the same period. A total of thirty studies were reviewed. Demographic, clinical, laboratory and imaging aspects were analyzed and discussed. It is believed that SARS-CoV-2 was responsible for the development of acute pancreatitis in these patients, due to the absence of other precipitating risk factors, as well as the close temporal relationship between both. Attention should be given to gastrointestinal manifestations in patients affected by COVID-19.

Gastric Ischemia after SARS-CoV-2 Infection

“…Most recently, following the COVID-19 pandemic, several reviews of gastrointestinal ischemia have been reported, mostly in the small bowel or colon, with abdominal bleeding or hematoma on the abdominal wall [3,4,[11][12][13][14]. The possible mechanisms of ischemia due to SARS-CoV-2 infection are multifold, involving inflammation, microvascular endotheliaopathy, and hypercoagulable state that leads to tissue hypoxia.…”