From the Department of Systems Medicine, University of Rome "Tor Vergata".
Emergency Department.
Pancreas. 2021 Mar 1;50(3):393-398. doi: 10.1097/MPA.0000000000001770.
The clinical significance of increased serum pancreatic enzymes (PEs) in coronavirus disease 2019 (COVID-19) patients has not yet been fully understood. We aimed to investigate the frequency and the impact on clinical outcome of PE elevation and acute pancreatitis in such patients.
Clinical data, laboratory tests, and cross-sectional images were analyzed from COVID-19 patients admitted to the Tor Vergata Hospital in Rome. Variables associated with PE abnormalities, intensive care unit (ICU) admission, or death were investigated through univariate and multivariate analyses and Cox proportional hazard model.
Pancreatic enzymes were available in 254 of 282 COVID-19 patients. Among these, 66 patients (26%) showed mild elevation of PE, and 11 patients (4.3%) had severe elevation (>3 times of the upper limit of normal). Overall, 2 patients met the diagnostic criteria for acute pancreatitis. Hepatic and renal involvements were associated with PE elevation. Multivariate analysis showed that mild and severe PE elevations were significantly associated with ICU admission (odds ratios, 5.51 [95% confidence interval, 2.36-12.89; P < 0.0001] and 26.2 [95% confidence interval, 4.82-142.39; P < 0.0001]).
Increase in serum PE, but not acute pancreatitis, is frequent in hospitalized COVID-19 patients and associates with ICU admission.
新冠肺炎（COVID-19）患者血清胰腺酶（PEs）升高的临床意义尚未完全明确。本研究旨在探讨此类患者中 PE 升高和急性胰腺炎的频率及其对临床结局的影响。
对罗马 Tor Vergata 医院收治的 COVID-19 患者的临床数据、实验室检查和横断面影像进行分析。通过单变量和多变量分析以及 Cox 比例风险模型，探讨与 PE 异常、入住重症监护病房（ICU）或死亡相关的变量。
282 例 COVID-19 患者中有 254 例可获得胰腺酶数据。其中，66 例（26%）患者的 PE 轻度升高，11 例（4.3%）患者的 PE 严重升高（>正常值上限的 3 倍）。总体而言，2 例患者符合急性胰腺炎的诊断标准。肝肾功能异常与 PE 升高有关。多变量分析显示，轻度和重度 PE 升高与入住 ICU 显著相关（比值比，5.51 [95%置信区间，2.36-12.89；P<0.0001] 和 26.2 [95%置信区间，4.82-142.39；P<0.0001]）。
住院 COVID-19 患者血清 PE 升高（而非急性胰腺炎）较为常见，且与入住 ICU 相关。
