SARS-CoV-2 pandemic has impacted on patterns of aetiology for acute pancreatitis and management of gallstone pancreatitis in the UK

Varghese, Chris; Nayar, Manu; Pandanaboyana, Sanjay

doi:10.1136/gutjnl-2021-326845

Cited by 3 publications

(2 citation statements)

References 5 publications

(5 reference statements)

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“…Although the rehospitalization rate was numerically higher in the COVID-19 era group, no statistically significant difference was identified, which may be related to the relatively short study period. These findings were consistent with results of a recently study from United Kingdom, 23 which reported the COVID-19 pandemic reducing access to cholecystectomy in eligible AGP patients and potentially driven the increased risk of AP recurrence and readmission. 24 In this context, the risk and benefits of index cholecystectomy should be reassessed according to clinical condition of AGP patients and stratification of SARS-CoV-2 transmission risk in endemic areas.…”

Section: Discussionsupporting

confidence: 92%

Impact of COVID-19 pandemic on acute pancreatitis presentations, management, and in-hospital outcomes: a single-center, retrospective observational study from the northeast of China

Zhang

et al. 2022

Therap Adv Gastroenterol

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Background: Since initially detected in late December 2019, the novel coronavirus disease 2019 (COVID-19) outbreak rapidly swept the world, which has profoundly affected healthcare system and clinical practice in the management of gastrointestinal diseases. Objectives: We aimed to evaluate the impact of COVID-19 pandemic on the pattern of hospital admissions and healthcare services for acute pancreatitis (AP). Design: We conducted a retrospective observational cohort study using the anonymized electronic medical records. Methods: This single-center, retrospective observational study from a regional medical center in the northeast of China included all consecutively admitted patients with AP from 23 January to 10 June 2020 (during the COVID-19 outbreak in Harbin), compared with the equivalent period of the previous year, in terms of demographics, clinical characteristics, and in-hospital outcomes. Results: In this article, we observed a reduction in AP admissions after the beginning of COVID-19 outbreak. With the prolonged time from symptom onset to hospitalization [32.0 (22.0–72.0) versus 18.0 (12.0–24.0) h; p < 0.001], a higher proportion of AP patients developed acute renal failure (14.0% versus 7.4%, p = 0.004) and acute necrotic collection (16.5% versus 11.2%; p = 0.038) in the COVID-19 era. The percentage of alcohol etiology significantly decreased after the implementation of social restriction measures (11.5% versus 20.4%; p = 0.002), whereas biliary etiology was numerically more common amidst the COVID-19 era (41.6% versus 32.6%; p = 0.014). No significant differences were found in the rates of intensive care unit admission and mortality between the two groups. Conclusion: This study preliminarily demonstrated the descending trend and delay in hospital presentations for AP during the outbreak of COVID-19. Given that the pandemic may persist for several years, adjustments of medical services according to the varying degrees of local breakouts are imperative to provide appropriate care for AP patients and diminish the risk of viral transmission. Registration: ClincialTrials.gov number ChiCTR2100043350.

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Section: Discussionsupporting

confidence: 92%

Impact of COVID-19 pandemic on acute pancreatitis presentations, management, and in-hospital outcomes: a single-center, retrospective observational study from the northeast of China

Zhang

et al. 2022

Therap Adv Gastroenterol

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“…In addition, malnutrition remained at 54% and 32% among patients with distinct GI manifestations at 3- and 6-month of follow-up, respectively [ 39 ]. The readmission rate of AP after 1 year of recovery from COVID-19 was about 14%, most of whom were due to alcohol-related or gallstone pancreatitis [ 40 ]. Our study observed persistent excess deaths related to the GI system and an increasing trend for C. difficile colitis during the pandemic.…”

Section: Discussionmentioning

confidence: 99%

Excess Deaths of Gastrointestinal, Liver, and Pancreatic Diseases During the COVID-19 Pandemic in the United States

Han¹,

Shi

Li³

et al. 2023

Int J Public Health

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Objectives: To evaluate excess deaths of gastrointestinal, liver, and pancreatic diseases in the United States during the COVID-19 pandemic.Methods: We retrieved weekly death counts from National Vital Statistics System and fitted them with a quasi-Poisson regression model. Cause-specific excess deaths were calculated by the difference between observed and expected deaths with adjustment for temporal trend and seasonality. Demographic disparities and temporal-spatial patterns were evaluated for different diseases.Results: From March 2020 to September 2022, the increased mortality (measured by excess risks) for Clostridium difficile colitis, gastrointestinal hemorrhage, and acute pancreatitis were 35.9%; 24.8%; and 20.6% higher than the expected. For alcoholic liver disease, fibrosis/cirrhosis, and hepatic failure, the excess risks were 1.4–2.8 times higher among younger inhabitants than older inhabitants. The excess deaths of selected diseases were persistently observed across multiple epidemic waves with fluctuating trends for gastrointestinal hemorrhage and fibrosis/cirrhosis and an increasing trend for C. difficile colitis.Conclusion: The persistently observed excess deaths of digestive diseases highlights the importance for healthcare authorities to develop sustainable strategies in response to the long-term circulating of SARS-CoV-2 in the community.

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

Трухан

Degovtsov

2022

Medicinskij alfavit

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The initial stage of infection is the penetration of SARS-CoV-2 into target cells that have receptors for angiotensin-converting enzyme type II (ACE2). Levels of ACE2 receptors in exocrine and islet cells of the pancreas are higher than in the lungs, suggesting the potential for SARS-CoV-2 infection to cause pancreatic injury, and most notably the development of acute pancreatitis. It has been established that SARS-CoV-2 can infect exocrine and endocrine cells of the pancreas ex vivo and in vivo. In the electronic search engines PubMed and Scopus, we searched for literature on the association of a new coronavirus infection COVID-19 with pancreatic pathology, with an emphasis on ‘SARS-CoV-2’ or ‘COVID-19’ and ‘pancreas’ and ‘pancreatitis’. The sources found indicate that direct, indirect and systemic mechanisms of damage to the pancreas in COVID-19 are possible. The review considers the prevalence of acute pancreatitis in COVID-19, features of diagnosis, clinic and prognosis. Special attention is paid to hyperenzymemia observed in COVID-19. The conclusion notes that there is fairly strong evidence for an association between acute pancreatitis and COVID-19, but the diagnosis of acute pancreatitis associated with COVID-19 is challenging as other potential etiological factors must be ruled out

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SARS-CoV-2 pandemic has impacted on patterns of aetiology for acute pancreatitis and management of gallstone pancreatitis in the UK

Cited by 3 publications

References 5 publications

Impact of COVID-19 pandemic on acute pancreatitis presentations, management, and in-hospital outcomes: a single-center, retrospective observational study from the northeast of China

Impact of COVID-19 pandemic on acute pancreatitis presentations, management, and in-hospital outcomes: a single-center, retrospective observational study from the northeast of China

Excess Deaths of Gastrointestinal, Liver, and Pancreatic Diseases During the COVID-19 Pandemic in the United States

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

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