Acute pancreatitis and COVID-19: a new target for infection?

The pandemic caused by the severe acute respiratory syndrome coronavirus 2 has mainly affected the respiratory system but has expanded to other systems, including the gastrointestinal system. We present an 80-year-old man with sharp epigastric pain and vomiting. Laboratory investigations revealed elevated pancreatic enzymes, and contrast-enhanced computed tomography of the abdomen suggested acute pancreatitis. He was undergoing treatment for acute pancreatitis when he developed respiratory compromise, leading to the use of oxygen. Computed tomography of the chest revealed bilateral pleural effusion. However, a positive nasopharyngeal swab suggested severe acute respiratory syndrome coronavirus 2 infection. He was treated for the viral infection with various medications until clinically stable before being self-isolated at home. His follow-up visits revealed a favorable outcome, with progressive resolve occurring 4 weeks after the onset. There is no specific conclusion regarding pancreatic involvement in severe acute respiratory syndrome coronavirus 2 infection. There are several confounding factors in the etiology of acute pancreatitis during concomitant severe acute respiratory syndrome coronavirus 2 infection. However, further research is warranted to evaluate whether pancreatic involvement is one of the clinical presentations or subsequent complications of severe acute respiratory syndrome coronavirus 2 infection.

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“… 1 However, SARS-CoV-2 outside the lungs may be due to residual viral RNA, as seen in the pancreas. 10 …”

Section: Discussionmentioning

confidence: 99%

Acute pancreatitis in SARS-CoV-2 infection: A case report from Tanzania

Suleiman

Sadiq

Sanga

et al. 2022

SAGE Open Medical Case Reports

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“…A study of 82 patients with COVID-19 who developed AP identified abdominal pain as the major symptom (91.5%); fever (59.8%), vomiting (58.5%), and nausea (47.6%) were also reported[ 17 ]. Another study that investigated 42 patients revealed most patients suffered from typical epigastric pain (31%), followed by pain radiating to the back (29%), or diffuse abdominal pain (19%), though some patients did not report abdominal pain (7%)[ 18 ]. While both respiratory and gastrointestinal symptoms could occur concomitantly, one study found that gastrointestinal symptoms occurred subsequently to the respiratory symptoms (9.0 d vs 7.3 d)[ 19 ].…”

Section: Symptoms Of Covid-19-related Apmentioning

confidence: 99%

“…While both respiratory and gastrointestinal symptoms could occur concomitantly, one study found that gastrointestinal symptoms occurred subsequently to the respiratory symptoms (9.0 d vs 7.3 d)[ 19 ]. Another study revealed that 70% of patients with COVID-19-related AP complained of abdominal pain upon admission to the hospital, with 30% of these patients suffering abdominal pain during their entire period of hospitalization[ 18 ]. Other studies assessing the symptoms of AP in patients with COVID-19 were limited by small sample sizes or the sedation status of the patients[ 20 , 21 ].…”

Section: Symptoms Of Covid-19-related Apmentioning

confidence: 99%

Surgical intervention for acute pancreatitis in the COVID-19 era

Su¹,

Chen²

2022

World J Clin Cases

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Approximately 15%-19% of patients with severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) infections develop gastrointestinal symptoms. Acute pancreatitis (AP) has been reported in 0.1% of patients with coronavirus disease 2019 (COVID-19). Biliary AP was most common (78.4%) before the COVID-19 pandemic; idiopathic AP is most common in patients with COVID-19 (up to 57.1%). The number of emergency department presentations decreased by 23.3% during the pandemic and many governments made national recommendations to delay nonurgent endoscopic procedures, leading to decrements of 22% in combined esophagogastroduodenoscopy (EGD) and colonoscopy and 20% in EGD after the COVID-19 pandemic. The symptoms and signs of COVID-19-related AP are fever (63%), abdominal pain (58%), respiratory symptoms (40%), nausea and vomiting (39%), and headache (4%). Approximately 5-10% of patients develop necrotizing or hemorrhagic AP, and patients who required surgical intervention had a higher mortality risk. Compared to 2019, the rates of elective surgery decreased by 41.8% in 2020; including cholecystectomy (40.1% decrease) and pancreas (111.1% decrease). Surgical volumes also decreased by 18.7% in 2020; device-assisted laparoscopic and robot-assisted procedures reduced by 45.4% and 61.9% during the COVID-19 Lockdown in 2020.

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“…Other viruses with a well‐known ability to infect and inflame the pancreas support the hypothesis that COVID‐19 may contribute to the rise in acute idiopathic pancreatitis diagnoses. 6 …”

Section: Introductionmentioning

confidence: 99%

“…Other viruses with a well-known ability to infect and inflame the pancreas support the hypothesis that COVID-19 may contribute to the rise in acute idiopathic pancreatitis diagnoses. 6 In this report, we discuss an individual who presented with symptoms of AP 2 weeks after being infected with SARS-Cov-2 and who had an elevated troponin level along with non-specific ST-segment and T-wave changes within their ECG, as well as symptoms of AP.…”

mentioning

confidence: 99%