Department of Nephrology, Manipal Hospitals, Bangalore, 560017, India.
Clin J Gastroenterol. 2022 Aug;15(4):826-833. doi: 10.1007/s12328-022-01633-5. Epub 2022 Apr 26.
COVID 19 infection is an ongoing pandemic that the world is facing currently. Though SARS-CoV2 infection mainly involves the lungs, it is known to affect other organs like kidneys, brain, heart, endocrine organs and gastrointestinal system. It is hypothesized that the ACE2 and transmembrane serine protease 2 which are expressed in the beta cells of the pancreas are the entry receptors for the SARS-CoV-2 virus, thus causing pancreatitis. A retrospective review of clinical records at our institution during the COVID 19 pandemic from 2019 to 2020 was carried out to find patients with COVID 19 infection presenting with acute pancreatitis. Additionally, a review of literature was conducted about COVID 19 patients presenting with pancreatitis in chronic kidney disease and renal transplantation recipients. Five patients with COVID 19 infection presented with acute pancreatitis during the 2019-2020 pandemic period. All patients were males and mean age of the patients was 48 ± 20 years. Out of 5 patients, 3 were chronic kidney disease patients, 2 were renal transplantation recipients. COVID 19 infection was the cause of acute pancreatitis in all 5 cases. Out of 5, 1 patient had acute necrotizing pancreatitis and the rest had mild to moderate severity pancreatitis. All patients recovered except the patient with acute necrotizing pancreatitis who succumbed to the illness. One patient with chronic kidney disease became dialysis dependent post recovery from pancreatitis. In all 5 patients, there was no correlation between the severity of COVID ARDS and the severity of pancreatitis. There was no correlation between the severity of pancreatitis and the elevation of inflammatory markers. In patients presenting with pancreatitis, we have to keep in mind COVID 19 infection along with other known aetiologies of acute pancreatitis.
新型冠状病毒肺炎（COVID-19）是目前全球面临的持续流行的传染病。虽然严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）感染主要涉及肺部，但已知它会影响肾脏、大脑、心脏、内分泌器官和胃肠道等其他器官。据推测，胰腺β细胞中表达的血管紧张素转换酶 2（ACE2）和跨膜丝氨酸蛋白酶 2 是 SARS-CoV-2 病毒的进入受体，从而导致胰腺炎。对我院在 2019 年至 2020 年 COVID-19 大流行期间的临床记录进行回顾性分析，以寻找患有 COVID-19 感染并伴有急性胰腺炎的患者。此外，还对 COVID-19 患者在慢性肾脏病和肾移植受者中伴有胰腺炎的文献进行了回顾。在 2019-2020 年大流行期间，有 5 例 COVID-19 感染患者出现急性胰腺炎。所有患者均为男性，平均年龄为 48±20 岁。在 5 例患者中，3 例为慢性肾脏病患者，2 例为肾移植受者。在所有 5 例患者中，COVID-19 感染均为急性胰腺炎的病因。在 5 例患者中，1 例为急性坏死性胰腺炎，其余为轻度至中度胰腺炎。除并发急性坏死性胰腺炎的患者外，所有患者均康复。1 例慢性肾脏病患者在胰腺炎康复后转为依赖透析。在所有 5 例患者中，COVID-19 急性呼吸窘迫综合征（ARDS）的严重程度与胰腺炎的严重程度之间无相关性。胰腺炎的严重程度与炎症标志物的升高之间无相关性。在出现胰腺炎的患者中，我们必须牢记 COVID-19 感染以及其他已知的急性胰腺炎病因。
