Prevalence and Outcomes of Pancreatic Enzymes Elevation in Patients With COVID-19: A Meta-Analysis and Systematic Review

Abstract

Background:Although coronavirus disease 2019 (COVID-19) is considered to be a disease that mainly involves the respiratory system, an increasing number of studies have reported that COVID-19 patients had pancreatic enzymes (PE) elevation and even pancreatic injury. The study aims to determine the prevalence of PE elevation, and the relationship between elevated PE and prognosis in COVID-19 patients.MethodsA comprehensive literature search was conducted according to the PRISMA guideline in PubMed, Embase, Scopus, Web of Science, and Google Scholar for studies reporting PE elevation in patients with COVID-19 from 1st January 2020 to 24th November 2021.ResultsA total of 13 studies (24,353 participants) were included in our review. The pooled prevalence of PE elevation in COVID-19 patients was 24% (18%–31%), the pooled odds ratio (OR) of mortality was 2.5 (1.7–3.6), the pooled OR of ICU admission was 4.4 (2.8–6.8), and the pooled OR of kidney injury, respiratory failure and liver injury were 3.5 (1.6–7.4), 2.0 (0.5–8.7), and 2.3 (1.4–3.9) respectively. In addition, the subgroup analysis revealed that although PE elevated to > 3 × upper normal limit (ULN) was significantly related to the mortality (OR = 4.4, 2.1–9.4), it seemed that mild elevation of PE to 1–3 ULN also had a considerable risk of mortality (OR = 2.3, 1.5–3.5).ConclusionsPE elevation was a common phenomenon in patients with COVID-19, and was associated with poor clinical outcomes. However, due to the limited numbers of included studies, the result of our study still needed to be validated.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=295630, identifier: CRD42021295630.

Complicated appendicitis, acute pancreatitis, pleural effusion, and sinus bradycardia in a COVID‐19 patient

“…Amylase level was slightly elevated in this patient at admission, and both amylase and lipase were three times above normal values on the fourth day of hospitalization. Pancreatic enzyme elevation is frequent among patients suffering from COVID‐19 and related to poor prognosis 9 . The criteria did not manifest themselves during the admission of the patient.…”

“…Pancreatic enzyme elevation is frequent among patients suffering from COVID-19 and related to poor prognosis. 9 The criteria did not manifest themselves during the admission of the patient. However, as the abdominal pain worsened and the serum amylase increased threefold higher than what is normal, acute pancreatitis was diagnosed.…”

“…This receptor can be found not only in the lungs but also in other organs, including the gut and pancreas, making them a potential target for SARS-CoV-2. 9 Herein, we report a case of appendicitis and pancreatitis in a patient with COVID-19 infection.…”

“…SARS‐CoV‐2 uses the angiotensin‐converting enzyme (ACE2) to infect cells. This receptor can be found not only in the lungs but also in other organs, including the gut and pancreas, making them a potential target for SARS‐CoV‐2 9 …”

Pathology of exocrine part of pancreas in new coronavirus infection COVID-19

“…Повышение уровня ферментов ПЖ было обычным явлением у пациентов с COVID-19 и было связано с неблагоприятными клиническими исходами. В систематическом обзоре и метаанализе [57] Взаимосвязи между повышенным уровнем ферментов ПЖ и прогнозом у пациентов с COVID-19 рассматривались и в рамках систематического обзора и метаанализа китайских ученых [59], в который было включено 13 исследований (24 353 участника). Совокупная распространенность повышения уровней ферментов ПЖ у пациентов с COVID-19 составила 24 % (18-31 %), ОШ смертности составило 2,5 (95 % ДИ: 1,7-3,6), объединенное ОШ госпитализации в ОРИТ составило 4,4 (95 % ДИ: 2,8-3,6), а объединенное ОШ повреждения почек, дыхательной недостаточности и повреждения печени составило 3,5 (95 % ДИ: 1,6-7,4), 2,0 (95 % ДИ: 0,5-8,7) и 2,3 (95 % ДИ: 1,4-3,9) соответственно.…”