Basic-Jukic Nikolina, Juric Ivana, Katalinic Lea, Furic-Cunko Vesna, Sesa Vibor, Mrzljak Anna
Department of Nephrology, Arterial Hypertension, Dialysis and Transplantation, University Hospital Centre Zagreb, Zagreb 10000, Croatia.
Department of Medicine, School of Medicine, Zagreb 10000, Croatia.
World J Clin Cases. 2024 Feb 26;12(6):1104-1110. doi: 10.12998/wjcc.v12.i6.1104.
Acute pancreatitis is a rare extrapulmonary manifestation of coronavirus disease 2019 (COVID-19) but its full correlation with COVID-19 infection remains unknown.
To identify acute pancreatitis' occurrence, clinical presentation and outcomes in a cohort of kidney transplant recipients with acute COVID-19.
A retrospective observational single-centre cohort study from a transplant centre in Croatia for all adult renal transplant recipients with a functioning kidney allograft between March 2020 and August 2022 to record cases of acute pancreatitis during acute COVID-19. Data were obtained from hospital electronic medical records. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was proven by a positive SARS-CoV-2 real-time reverse transcriptase-polymerase chain reaction on the nasopharyngeal swab.
Four hundred and eight out of 1432 (28.49%) patients who received a renal allograft developed COVID-19 disease. The analyzed cohort included 321 patients (57% males). One hundred and fifty patients (46.7%) received at least one dose of the anti-SARS-CoV-2 vaccine before the infection. One hundred twenty-five (39.1%) patients required hospitalization, 141 (44.1%) developed pneumonia and four patients (1.3%) required mechanical ventilation. Treatment included immunosuppression modification in 233 patients (77.1%) and remdesivir in 53 patients (16.6%), besides the other supportive measures. In the study cohort, only one transplant recipient (0.3%) developed acute pancreatitis during acute COVID-19, presenting with abdominal pain and significantly elevated pancreatic enzymes. She survived without complications with a stable kidney allograft function.
Although rare, acute pancreatitis may complicate the course of acute COVID-19 in kidney transplant recipients. The mechanism of injury to the pancreas and its correlation with the severity of the COVID-19 infection in kidney transplant recipients warrants further research.
急性胰腺炎是2019冠状病毒病（COVID-19）一种罕见的肺外表现，但其与COVID-19感染的完全相关性仍不清楚。
确定急性COVID-19的肾移植受者队列中急性胰腺炎的发生率、临床表现及结局。
对克罗地亚一家移植中心2020年3月至2022年8月期间所有具有功能正常同种异体肾移植的成年肾移植受者进行一项回顾性观察单中心队列研究，以记录急性COVID-19期间急性胰腺炎的病例。数据来自医院电子病历。通过鼻咽拭子上严重急性呼吸综合征冠状病毒2（SARS-CoV-2）实时逆转录聚合酶链反应阳性证实SARS-CoV-2感染。
1432例接受同种异体肾移植的患者中有408例（28.49%）发生COVID-19疾病。分析的队列包括321例患者（57%为男性）。150例患者（46.7%）在感染前接受了至少一剂抗SARS-CoV-2疫苗。125例（39.1%）患者需要住院治疗，141例（44.1%）发生肺炎，4例（1.3%）患者需要机械通气。除其他支持措施外，233例患者（77.1%）的治疗包括免疫抑制调整，53例患者（16.6%）接受了瑞德西韦治疗。在研究队列中，只有1例移植受者（0.3%）在急性COVID-19期间发生急性胰腺炎，表现为腹痛和胰腺酶显著升高。她存活下来且无并发症，同种异体肾移植功能稳定。
尽管罕见，但急性胰腺炎可能使肾移植受者急性COVID-19的病程复杂化。肾移植受者胰腺损伤的机制及其与COVID-19感染严重程度的相关性值得进一步研究。
