Department of Gastroenterology and Hepatology, Amsterdam Gastroenterology Endocrinology and Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
Department of Neurology, Amsterdam Neuroscience Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
Scand J Gastroenterol. 2021 May;56(5):585-587. doi: 10.1080/00365521.2021.1896776. Epub 2021 Mar 14.
A relation between coronavirus disease 2019 (COVID-19) and acute pancreatitis has been suggested. However, the incidence and clinical relevance of this relation remain unclear.
We aimed to investigate the incidence, severity and clinical impact of acute pancreatitis in patients with COVID-19.
This is a cross-sectional study of a prospective, observational cohort concerning all COVID-19 patients admitted to two Dutch university hospitals between 4 March 2020 and 26 May 2020. Primary outcome was acute pancreatitis potentially related to COVD-19 infection. Acute pancreatitis was defined according to the revised Atlanta Classification. Potential relation with COVID-19 was defined as the absence of a clear aetiology of acute pancreatitis.
Among 433 patients with COVID-19, five (1.2%) had potentially related acute pancreatitis according to the revised Atlanta Classification. These five patients suffered from severe COVID-19 infection; all had (multiple) organ failure and 60% died. None of the patients developed necrotizing pancreatitis. Moreover, development of acute pancreatitis did not lead to major treatment consequences.
In contrast with previous research, our study demonstrated that COVID-19 related acute pancreatitis is rare and of little clinical impact. It is therefore debatable if acute pancreatitis in COVID-19 patients requires specific screening. We hypothesize that acute pancreatitis occurs in patients with severe illness due to COVID-19 infection as a result of transient hypoperfusion and pancreatic ischemia, not as a direct result of the virus.
有人提出 2019 年冠状病毒病（COVID-19）与急性胰腺炎之间存在关联。然而，这种关联的发生率和临床意义尚不清楚。
我们旨在研究 COVID-19 患者中急性胰腺炎的发生率、严重程度和临床影响。
这是一项针对 2020 年 3 月 4 日至 5 月 26 日期间荷兰两所大学医院收治的所有 COVID-19 患者的前瞻性观察性队列的横断面研究。主要结局为与 COVID-19 感染相关的急性胰腺炎。急性胰腺炎根据修订后的亚特兰大分类定义。与 COVID-19 的潜在关系定义为急性胰腺炎无明确病因。
在 433 例 COVID-19 患者中，根据修订后的亚特兰大分类，有 5 例（1.2%）发生潜在相关的急性胰腺炎。这 5 例患者患有严重的 COVID-19 感染；均有（多个）器官衰竭，60%死亡。没有患者发生坏死性胰腺炎。此外，急性胰腺炎的发生并未导致主要治疗后果。
与先前的研究相比，我们的研究表明 COVID-19 相关的急性胰腺炎很少见，对临床影响不大。因此，对于 COVID-19 患者是否需要进行特定的急性胰腺炎筛查，还存在争议。我们假设急性胰腺炎发生在 COVID-19 感染导致严重疾病的患者中，是由于短暂的低灌注和胰腺缺血引起的，而不是病毒直接引起的。
