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急性胰腺炎与 COVID-19:文献综合述评。

Acute pancreatitis and COVID-19: an integrative review of the literature.

机构信息

- Centro Universitário Maurício de Nassau - Recife - PE - Brasil.

- Hospital Universitário Oswaldo Cruz - Recife - PE - Brasil.

出版信息

Rev Col Bras Cir. 2023 Jul 10;50:e20233559. doi: 10.1590/0100-6991e-20233559-en. eCollection 2023.

Abstract

The first cases of the COVID-19 disease were identified in late 2019 in China, but it didnt take long for it to become pandemic. At first, it was believed that it was restricted to respiratory symptoms only, until extrapulmonary manifestations were reported worldwide. Acute pancreatitis concomitant with the diagnosis of SARS-CoV-2 infection has been observed in some patients, in the absence of the most common etiologies described in the literature. It is postulated that the presence of the ECA-2 viral receptor in the pancreas is responsible for the direct cellular damage and that the hyperinflammatory state of COVID-19 favors the development of pancreatitis through an immune-mediated mechanism. This study aimed to analyze the correlation between acute pancreatitis and COVID-19 disease as a probable causality factor. An integrative literature review was carried out, including studies published between January 2020 and December 2022 that brought data on patients diagnosed with acute pancreatitis according to the revised Atlanta Classification with a confirmed diagnosis of COVID-19 in the same period. A total of thirty studies were reviewed. Demographic, clinical, laboratory and imaging aspects were analyzed and discussed. It is believed that SARS-CoV-2 was responsible for the development of acute pancreatitis in these patients, due to the absence of other precipitating risk factors, as well as the close temporal relationship between both. Attention should be given to gastrointestinal manifestations in patients affected by COVID-19.

摘要

新型冠状病毒疾病的首批病例于 2019 年底在中国被发现,但没过多久它就迅速蔓延成为全球性大流行病。起初,人们认为它仅局限于呼吸系统症状,直到世界各地报告了肺外表现。在一些患者中观察到了急性胰腺炎与 SARS-CoV-2 感染同时存在的情况,而这些患者没有出现文献中描述的最常见病因。有人推测,胰腺中存在 ECA-2 病毒受体是导致细胞直接损伤的原因,而 COVID-19 的高炎症状态通过免疫介导机制有利于胰腺炎的发展。本研究旨在分析急性胰腺炎与 COVID-19 疾病之间的相关性,作为一个可能的因果关系因素。进行了综合文献回顾,纳入了 2020 年 1 月至 2022 年 12 月期间发表的研究,这些研究均根据修订后的亚特兰大分类标准,对同期确诊 COVID-19 的患者的急性胰腺炎诊断数据进行了报道。共回顾了三十项研究。分析并讨论了这些研究的人口统计学、临床、实验室和影像学方面的内容。人们认为,由于这些患者没有其他诱发风险因素,且两者之间存在密切的时间关系,因此 SARS-CoV-2 可能是导致这些患者发生急性胰腺炎的原因。应注意 COVID-19 患者的胃肠道表现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/108e/10508656/9776debe0405/rcbc-50-e20233559-g001.jpg

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