Annunziata Anna, Coppola Antonietta, Andreozzi Paolo, Lanza Maurizia, Simioli Francesca, Carannante Novella, Di Somma Camilla, Di Micco Pierpaolo, Fiorentino Giuseppe
Department of Critic Area, I Unit COVID, Monaldi-Cotugno Hospital, Naples, Italy.
Endoscopy and Gastroenterology Unit, Marcianise Hospital, Asl Caserta, Caserta, Italy.
J Multidiscip Healthc. 2021 Oct 9;14:2857-2861. doi: 10.2147/JMDH.S334835. eCollection 2021.
Gastrointestinal involvement in SARS-CoV-2 disease (COVID-19) can occur and evolve fatally. Reports are emerging that SARS-CoV-2 virus attacks the pancreatic cells, causing the boost of amylase and lipase serum activity and rarely frank pancreatitis. We retrospectively assessed all the patients admitted to the respiratory sub-intensive care and evaluated pancreatitis cases and their course. In our study, we included all patients admitted to our respiratory sub-intensive care unit from 1st to 30th November. All patients had a confirmed diagnosis of COVID-19 and a CT finding of interstitial pneumonia associated with signs of respiratory failure. We observed the course and evaluated who developed acute pancreatitis according to standard definitions. In this study, etiology of acute pancreatitis was defined on the basis of risk factors (ie, biliary pancreatitis was defined in presence of common bile duct stone or sludge at CT or MR). According to the Revised Atlanta Classification, we diagnosed and classified the patients and evaluated the radiological severity according to the Balthazar index and a computed tomography severity index. We found that 19% (15 of 78 patients) met the criteria for acute pancreatitis. The mortality rate among patients with pancreatitis was 20%. Interestingly, in our population, cholelithiasis' imaging findings were found in only 7% of the patients, whereas no patient-reported alcohol consumption. Considering that alcohol and biliary stones represent the two major causes of AP in the general population, it is reasonable to hypothesize that SARS-CoV-2 could play a role in the etiology of acute pancreatitis in a subgroup of these patients.
严重急性呼吸综合征冠状病毒2型（SARS-CoV-2）疾病（新冠肺炎）可累及胃肠道，并可能发展为致命性病变。有报告称，SARS-CoV-2病毒会攻击胰腺细胞，导致淀粉酶和脂肪酶血清活性升高，引发明显胰腺炎的情况较为罕见。我们回顾性评估了所有入住呼吸亚重症监护病房的患者，对胰腺炎病例及其病程进行了评估。在我们的研究中，纳入了11月1日至30日期间入住我们呼吸亚重症监护病房的所有患者。所有患者均确诊为新冠肺炎，胸部CT显示为间质性肺炎并伴有呼吸衰竭体征。我们观察了病程，并根据标准定义评估了哪些患者发生了急性胰腺炎。在本研究中，急性胰腺炎的病因是根据危险因素来定义的（即，在CT或磁共振成像检查发现胆总管结石或胆泥时，定义为胆源性胰腺炎）。根据修订后的亚特兰大分类标准，我们对患者进行了诊断和分类，并根据巴尔萨泽指数和计算机断层扫描严重程度指数评估了放射学严重程度。我们发现，19%（78例患者中的15例）符合急性胰腺炎的标准。胰腺炎患者的死亡率为20%。有趣的是，在我们的研究人群中，仅7%的患者有胆结石的影像学表现，而没有患者报告有饮酒史。鉴于酒精和胆结石是普通人群中急性胰腺炎的两大主要病因，因此有理由推测，SARS-CoV-2可能在这些患者的一个亚组中急性胰腺炎的病因中起作用。
