Chaudhry Hunza, Sohal Aalam, Kohli Isha, Dukovic Dino, Sharma Raghav, Singla Piyush, Hu Bing, Prajapati Devang, Yang Juliana
Department of Internal Medicine, University of California, San Francisco, Fresno, CA, USA (Hunza Chaudhry).
Department of Hepatology, Liver Institute Northwest, Seattle, WA, USA (Aalam Sohal).
Ann Gastroenterol. 2023 Mar-Apr;36(2):208-215. doi: 10.20524/aog.2023.0782. Epub 2023 Feb 3.
Although SARS-CoV-2 primarily affects the respiratory system, gastrointestinal symptoms were also seen. Our study analyzed the prevalence and impact of acute pancreatitis (AP) on COVID-19 hospitalizations in the United States.
The 2020 National Inpatient Sample database was used to identify patients with COVID-19. The patients were stratified into 2 groups based on the presence of AP. AP as well as its impact on COVID-19 outcomes were evaluated. The primary outcome was in-hospital mortality. Secondary outcomes were intensive care unit (ICU) admissions, shock, acute kidney injury (AKI), sepsis, length of stay, and total hospitalization charges. Univariate and multivariate logistic/linear regression analyses were performed.
The study population comprised 1,581,585 patients with COVID-19, from which 0.61% of people had AP. Patients with COVID-19 and AP had a higher incidence of sepsis, shock, ICU admissions, and AKI. On multivariate analysis, patients with AP had higher mortality (adjusted odds ratio [aOR] 1.19, 95% confidence interval [CI] 1.03-1.38; P=0.02). We also noted a higher risk of sepsis (aOR 1.22, 95%CI 1.01-1.48; P=0.04), shock (aOR 2.09, 95%CI 1.83-2.40; P<0.001), AKI (aOR 1.79, 95%CI 1.61-1.99; P<0.001), and ICU admissions (aOR 1.56, 95%CI 1.38-1.77; P<0.001). Patients with AP also had a longer length of stay (+2.03 days, 95%CI 1.45-2.60; P<0.001), and higher hospitalization charges ($44,088.41, 95%CI $33,198.41-54,978.41; P<0.001).
Our study revealed that the prevalence of AP in patients with COVID-19 was 0.61%. Although this was not strikingly high, the presence of AP is associated with worse outcomes and higher resource utilization.
虽然严重急性呼吸综合征冠状病毒2（SARS-CoV-2）主要影响呼吸系统，但也出现了胃肠道症状。我们的研究分析了急性胰腺炎（AP）在美国新冠肺炎住院患者中的患病率及其影响。
使用2020年全国住院患者样本数据库来识别新冠肺炎患者。根据是否存在AP将患者分为两组。评估AP及其对新冠肺炎结局的影响。主要结局是住院死亡率。次要结局包括重症监护病房（ICU）收治、休克、急性肾损伤（AKI）、脓毒症、住院时间和总住院费用。进行单因素和多因素逻辑/线性回归分析。
研究人群包括1581585例新冠肺炎患者，其中0.61%的人患有AP。新冠肺炎合并AP的患者发生脓毒症、休克、ICU收治和AKI的发生率更高。多因素分析显示，AP患者的死亡率更高（调整后的优势比[aOR]为1.19，95%置信区间[CI]为1.03-1.38；P=0.02）。我们还注意到脓毒症（aOR 1.22，95%CI 1.01-1.48；P=0.04）、休克（aOR 2.09，95%CI 1.83-2.40；P<0.001）、AKI（aOR 1.79，95%CI 1.61-1.99；P<0.001）和ICU收治（aOR 1.56，95%CI 1.38-1.77；P<0.001）的风险更高。AP患者的住院时间也更长（延长2.03天，95%CI 1.45-2.60；P<0.001），住院费用更高（44088.41美元，95%CI 33198.41-54978.41美元；P<0.001）。
我们的研究表明，新冠肺炎患者中AP的患病率为0.61%。虽然这一比例不算特别高，但AP的存在与更差预后和更高的资源利用率相关。
