Mild pancreatic injury patterns were observed in a group of patients who were diagnosed with COVID-19 pneumonia, according to results published in Gastroenterology.
Patients admitted to Zhongnan Hospital in Wuhan, China between January 20th and February 28th, 2020 with COVID-19 pneumonia (n = 52) underwent comprehensive laboratory examination including analysis of blood cytology, biochemistry, and inflammatory indicators of disease.
The investigators observed that of the 52 patients included in the study, 33% presented with heart injuries (abnormal LDH or creatine kinase), 29% with liver injuries (abnormal AST, ALT, GGT, or ALP), 17% with pancreatic injuries (abnormal amylase or lipase), 8% with renal injuries (abnormal creatine), and 2% with diarrhea.
Of the 9 patients with pancreatic injury, the average age was 55 years (aged 25-71) and 5 had an underlying condition (diabetes n=1, hypertension n=1, diabetes and hypertension comorbidities n=2, and heart disease n=1). These patients had higher rates of anorexia (P =.027) and diarrhea (P =.027), lower levels of CD3+ (P =.027) and CD4+ (P =.016) T-cells, and higher levels of AST (P =.001), GGT (P =.003), creatinine (P =.000), LDH (P =.019), and ESR (P =.016) compared with patients without pancreatic injury. No significant difference was observed in rates of corticosteroid treatment (P =.051), mechanical ventilator rates (P =.679), or recovery time (P =.090) based on pancreatic injury.
These data are consistent with observations that were made during the 2003 outbreak of SARS virus where traces of viral particles were detected in lung, liver, intestine, kidney, and pancreas tissues. Studies focusing on the effects of SARS viral particles on pancreatic tissue showed that these particles cause damage to islet cells, which resulted in acute diabetes in some patients. It remains unclear, however, whether the pancreatic injury in the present study was caused by the cytopathic effect mediated by viral replication in pancreatic tissue, or if the injury was an indirect result of the body’s response to infection.
The study authors concluded that the pancreas is a potential viral target of coronavirus and that mild pancreatic injury is possible in patients with COVID-19 pneumonia.
Wang F, Wang H, Fan J, et al. Pancreatic injury patterns in patients with COVID-19 pneumonia [available online April 1, 2020] Gastroenterology doi:10.1053/j.gastro.2020.03.055.