From the Division of Gastroenterology, Lenox Hill Hospital, Zucker School of Medicine at Hofstra/Northwell, Northwell Health System, New York, NY.
Division of Gastroenterology, Department of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR.
Pancreas. 2021 Oct 1;50(9):1310-1313. doi: 10.1097/MPA.0000000000001922.
Coronavirus disease 2019 (COVID-19) patients may have varying degrees of hyperlipasemia. The aim was to compare outcomes among different levels of hyperlipasemia in patients with COVID-19.
This is a retrospective study examining outcomes among hospitalized COVID-19 patients with a lipase <3× upper limit of normal (ULN), asymptomatic hyperlipasemia (>3× ULN), secondary pancreatitis (typical respiratory COVID-19 symptoms and found to have pancreatitis), and primary pancreatitis (presenting with pancreatitis).
Of 11,883 patients admitted with COVID-19, 1560 patients were included: 1155 patients had normal serum lipase (control group), 270 had elevated lipase <3× ULN, 46 patients had asymptomatic hyperlipasemia with lipase >3× ULN, 57 patients had secondary pancreatitis, and 32 patients had primary pancreatitis. On adjusted multivariate analysis, the elevated lipase <3× ULN and asymptomatic hyperlipasemia groups had worse outcomes with higher mortality (odds ratio [OR], 1.6 [95% confidence interval [CI], 1.2-2.2) and 1.1 [95% CI, 0.5-2.3], respectively), higher need for mechanical ventilation (OR, 2.8 [95% CI, 1.2-2.1] and 2.8 [95% CI, 1.5-5.2], respectively), and longer length of stay (OR, 1.5 [95% CI, 1.1-2.0] and 3.16 [95% CI, 1.5-6.5], respectively).
Patients with COVID-19 with elevated lipase <3× ULN and asymptomatic hyperlipasemia have generally worse outcomes than those with pancreatitis.
2019 年冠状病毒病(COVID-19)患者可能有不同程度的高脂蛋白血症。本研究旨在比较 COVID-19 患者不同程度高脂蛋白血症的结局。
这是一项回顾性研究,分析了住院 COVID-19 患者的结局,这些患者的脂肪酶<3×正常值上限(ULN)、无症状性高脂蛋白血症(>3×ULN)、继发胰腺炎(典型的呼吸道 COVID-19 症状并发现胰腺炎)和原发性胰腺炎(表现为胰腺炎)。
在 11883 例因 COVID-19 住院的患者中,有 1560 例患者被纳入研究:1155 例患者血清脂肪酶正常(对照组),270 例患者脂肪酶升高<3×ULN,46 例患者无症状性高脂蛋白血症脂肪酶>3×ULN,57 例患者继发胰腺炎,32 例患者原发性胰腺炎。经调整的多变量分析显示,脂肪酶升高<3×ULN 和无症状性高脂蛋白血症组的死亡率更高(比值比[OR],1.6[95%置信区间[CI],1.2-2.2]和 1.1[95%CI,0.5-2.3]),需要机械通气的可能性更高(OR,2.8[95%CI,1.2-2.1]和 2.8[95%CI,1.5-5.2]),住院时间更长(OR,1.5[95%CI,1.1-2.0]和 3.16[95%CI,1.5-6.5])。
与胰腺炎患者相比,COVID-19 患者脂肪酶升高<3×ULN 和无症状性高脂蛋白血症的总体结局更差。