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探讨影响 COVID-19 胰腺损伤的因素:一项单中心、回顾性研究。

Investigation of factors affecting COVID-19 pancreatic injury: a single-center, retrospective study.

机构信息

Department of Anesthesiology and Critical Care Medicine, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan.

Emergency Center, Nishichita General Hospital, Tokai, Aichi, Japan.

出版信息

J Anesth. 2023 Jun;37(3):487-491. doi: 10.1007/s00540-023-03175-7. Epub 2023 Mar 17.

Abstract

Pancreatic injury is considered an organ-related complication in patients with coronavirus disease 2019 (COVID-19). However, it is unclear whether COVID-19 status affects pancreatic injury. This retrospective study aimed to determine whether COVID-19 affects the occurrence of pancreatic injuries. Consecutive patients diagnosed with sepsis admitted to the ICU between March 2020 and September 2021 were included. The primary endpoint was a pancreatic injury, which was defined as amylase or lipase levels > 3 times the upper limit of the normal range. Among the 177 patients included in the analysis, 40 (23%) were COVID-19 patients, and 54 (31%) had pancreatic injuries. Of these three patients, acute pancreatitis was diagnosed based on computed tomography. The pancreatic injury was significantly more common among COVID-19 patients (75 vs. 18%, p < 0.001). Multivariate analysis showed that COVID-19 and steroid use were independent risk factors for pancreatic injury (Odds Ratio (OR) 4.79 [95% confidence interval (CI) 1.48-15.5], p = 0.009; OR 4.02 [95% CI 1.42-11.4], p = 0.009). This study revealed that the proportion of pancreatic injury in septic patients with COVID-19 was significantly higher than in those without COVID-19. It may be difficult to diagnose pancreatitis based on amylase and lipase levels in COVID-19 patients.

摘要

胰腺损伤被认为是 2019 冠状病毒病(COVID-19)患者的器官相关并发症。然而,COVID-19 状态是否影响胰腺损伤尚不清楚。本回顾性研究旨在确定 COVID-19 是否影响胰腺损伤的发生。纳入 2020 年 3 月至 2021 年 9 月期间入住 ICU 的败血症连续患者。主要终点是胰腺损伤,定义为淀粉酶或脂肪酶水平高于正常范围的 3 倍以上。在分析的 177 名患者中,40 名(23%)为 COVID-19 患者,54 名(31%)有胰腺损伤。其中 3 名患者根据计算机断层扫描诊断为急性胰腺炎。COVID-19 患者的胰腺损伤明显更为常见(75%比 18%,p<0.001)。多变量分析显示,COVID-19 和类固醇使用是胰腺损伤的独立危险因素(优势比(OR)4.79 [95%置信区间(CI)1.48-15.5],p=0.009;OR 4.02 [95% CI 1.42-11.4],p=0.009)。本研究表明,COVID-19 败血症患者胰腺损伤的比例明显高于无 COVID-19 患者。COVID-19 患者可能难以根据淀粉酶和脂肪酶水平诊断胰腺炎。

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