A Case Report on Acute Pancreatitis in a Patient With Coronavirus Disease 2019 (COVID-19) Pneumonia

Gupta, Aviral; Bansal, Dharam P; Rijhwani, Puneet; Singh, Vipasha

doi:10.7759/cureus.14628

Cited by 10 publications

(5 citation statements)

References 17 publications

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“…This case report was diagnosed as interstitial edematous pancreatitis with acute peri-pancreatic fluid collection according to the revised Atlanta classification. This was similar to the previous case reports provided by Kandasamy et al [ 5 ], Al Mazrouei et al [ 7 ], Wang et al [ 12 ], Gupta et al [ 17 ], and Lakshmanan et al [ 18 ]. On the other hand, it was different from the previous rare case report provided by Mohammadi Arbati et al [ 15 ] which described an acute necrotizing form of pancreatitis with COVID-19 infection.…”

Section: Discussionsupporting

confidence: 92%

“…This matched the previous case reports provided by Kandasamy et al [ 5 ], Karimzadeh et al [ 13 ] and Wang et al [ 14 ]. On the other hand, this was different from the previous case reports provided by Al Mazrouei et al [ 7 ], Mohammadi Arbati et al [ 15 ], Anand et al [ 16 ], Gupta et al [ 17 ], and Lakshmanan et al [ 18 ], where the COVID-19 infection preceded the diagnosis of acute pancreatitis.…”

Section: Discussioncontrasting

confidence: 74%

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COVID-19 infection initially presented by interstitial edematous pancreatitis and acute peri-pancreatic collection; the first CT case report in Egypt

Samir

Elnekeidy

El-Kady

2021

Egypt J Radiol Nucl Med

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Background The extra-pulmonary computed tomography (CT) findings of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or coronavirus disease 2019 (COVID-19) have been described in the literature, including the neurologic, cardiac, and abdominal manifestations. Ischemic and inflammatory bowel changes were the most frequent abdominal CT findings. Acute pancreatitis was seldom found all over the world outside of China and described in case reports, but not in Egypt. Case presentation A 44-years-old female patient presented with severe abdominal pain, vomiting, and mild fever for six days. No respiratory symptoms were encountered till the time of the radiological investigation. Abdominal CT examination revealed interstitial edematous pancreatitis with acute peri-pancreatic fluid collection according to the revised Atlanta classification. No pancreatic necrosis or vascular complications were depicted. Secondary pyloro-duodenitis was noticed. The modified Balthazar CT-severity index was moderate (6/10). Basal chest scans showed bilateral variable-sized bronchocentric and sub-pleural consolidative pneumonic patches with mild bilateral pleural effusion. The patient was admitted to the intensive-care unit (ICU) for two weeks. The serum amylase and lipase titers were elevated and the polymerase chain reaction (PCR) test for COVID-19 was positive. She received pancreatic, circulatory, and pulmonary medical support, then she was discharged after stabilization of her condition. Conclusion The authors provided this case report for the association between COVID-19 infection and acute pancreatitis, which is mostly the first in Egypt. It documented their Egyptian experience to be added to the international literature. It radiologically described their chest and abdominal CT findings in detail using the COVID-19 Reporting and Data System (CO-RADS) and the revised Atlanta classification with modified Balthazar CT-severity index (CTSI). This could eventually enrich the radiological point of view in addition to the previously published clinical case reports.

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Section: Discussionsupporting

confidence: 92%

Section: Discussioncontrasting

confidence: 74%

COVID-19 infection initially presented by interstitial edematous pancreatitis and acute peri-pancreatic collection; the first CT case report in Egypt

Samir

Elnekeidy

El-Kady

2021

Egypt J Radiol Nucl Med

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“…The most common features of AP are the absence of similar attacks in the past medical history, most often the absence of any other etiological factors that could cause the development of the disease (excessive alcohol and fatty food consumption, trauma, gallstone migration and etc.) as well as mild course of the disease (results of CT) with moderate abdominal pain [2,10,12,16]. In addition, AP can develop as the complication of the underlying COVID-19.…”

Section: Discussionmentioning

confidence: 99%

A case report of severe acute pancreatitis with infected necrosis and concomitant Coronavirus Disease‑19 (COVID‑19): a nosocomial infection or delayed respiratory manifestation of viral disease?

et al. 2021

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The association between COVID‑19 and acute pancreatitis (AP) has been extensively analyzed in recent research and review papers worldwide. It should be noted that most studies have focused on AP as a COVID‑19 complication and/or an extra‑pulmonary manifestation of the disease, although the investigation reports on the cases of prior pancreatitis and subsequent COVID‑19 infection are limited. The aim of this case report is to describe the treatment protocol and clinical outcome of a patient with acute necrotizing pancreatitis who developed nosocomial COVID‑19.. Case presentation. The data were collected from patient S., a 42‑year‑old male admitted with AP to the intensive care unit of Kyiv City Clinical Emergency Hospital, in October 2020. This study was reviewed and approved by the local Ethics Committee (Protocol No 25‑15‑60). The patient signed written informed consent to participate in the study, after having been informed of all relevant aspects that could influence his decision. The patient, primarily diagnosed with AP, was admitted to the hospital without a PCR test for detecting SARS‑CoV‑2. 21 days after his admission to the hospital, the patient developed COVID‑19. AP progression to severe AP with infected necrosis, the development of systemic inflammatory response syndrome and multiple organ failure necessitated operative pancreatic debridement, which was postponed due to severe acute respiratory failure. Operative pancreatic debridement was performed on the 45th day of hospital stay after the resolution of COVID‑19‑associated pneumonia. The postoperative period was typical for the disease severity and the extent of the surgery, and was complicated by external pancreatic and colonic fistulas. The length of hospital stay for this patient was 115 days which included 20 days of treatment and monitoring in the intensive care unit due to pneumonia. He was discharged after clinical symptom improvement. Conclusions. It is imperative to screen patients presenting with AP for SARS‑CoV‑2 in order to avoid misdiagnosis and inappropriate treatment strategy. Further detailed investigation of mechanisms of pancreatic injury in patients with SARS‑CoV‑2 is necessary.

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“…Many studies evaluated the epidemiological and clinical fi ndings of COVID-19, however, the data on pancreatic tissue damage caused by COVID-19 are rare (17). Some publications reported pancreatitis cases caused by SARS-CoV-2 (18,19,20).…”

Section: A B C Dmentioning

confidence: 99%

Evaluation of patients with acute pancreatitis associated with SARS-CoV-2 (COVID-19); The importance of lipase/lymphocyte ratio in predicting mortality

Haydar¹,

Otal²,

Avcıoğlu³

2022

BLL

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BACKGROUND: SARS-CoV-2 is the cause of a pandemic with high mortality. In the present study, the effects of the lipase/lymphocyte ratio on mortality were investigated in cases diagnosed with Covid-19 and acute pancreatitis. METHODS: A total of 21 patients who were diagnosed with Covid-19 and acute pancreatitis, 34 patients who were not diagnosed with COVID-19 but diagnosed with acute pancreatitis, and 55 healthy control groups were divided into 3 groups and included in the study retrospectively. The patients who had positive RT-PCR (real-time polymerized chain reaction) test results were included in the study. Complete blood count and biochemical values of the patients were compared with those of the control group. RESULTS: When the data of the cases diagnosed with COVID-19 and acute pancreatitis were examined retrospectively, the amylase, lipase, lipase/lymphocyte ratio, and D-dimer levels were found to be signifi cantly higher than in the control group (p < 0.01). In the ROC analysis, the amylase, lipase, and lipase/lymphocyte ratio had a high AUC (area under the curve) value (0.993 / 0.949 / 0.978, respectively). CONCLUSION: The lipase/lymphocyte ratio can be used in cases diagnosed with Covid-19 and acute pancreatitis to predict mortality (Tab.

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A Case Report on Acute Pancreatitis in a Patient With Coronavirus Disease 2019 (COVID-19) Pneumonia

Cited by 10 publications

References 17 publications

COVID-19 infection initially presented by interstitial edematous pancreatitis and acute peri-pancreatic collection; the first CT case report in Egypt

COVID-19 infection initially presented by interstitial edematous pancreatitis and acute peri-pancreatic collection; the first CT case report in Egypt

A case report of severe acute pancreatitis with infected necrosis and concomitant Coronavirus Disease‑19 (COVID‑19): a nosocomial infection or delayed respiratory manifestation of viral disease?

Evaluation of patients with acute pancreatitis associated with SARS-CoV-2 (COVID-19); The importance of lipase/lymphocyte ratio in predicting mortality

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