Patients with concomitant severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and acute pancreatitis are at increased risk of developing severe acute pancreatitis with associated increased morbidity and mortality, according to a multicenter, international cohort study published in Gut.
Although respiratory complications due to SARS-CoV-2 infection are the predominant cause of significant morbidity and mortality, extrapulmonary symptoms and presentations have also been described. Emerging data suggest that the pancreas could be a target organ for SARS-CoV-2 infection with an increase in severity of pancreatitis; however, there are limited data on the clinical outcomes of patients with coexistent SARS-CoV-2 and acute pancreatitis. Thus, researchers prospectively investigated the etiology, clinical trajectory, and outcomes of consecutive patients admitted with acute pancreatitis from March 1, 2020, to July 23, 2020 by inviting all hospitals in the United Kingdom and other global pancreatic units to input their data on REDCap.
Of the 1777 admitted patients with acute pancreatitis, 149 (8.3%) had concomitant SARS-CoV-2 infection. The researchers found that overall, SARS-CoV-2-positive patients were older male patients and were more likely to develop severe acute pancreatitis and acute respiratory distress syndrome (P <.001). An unadjusted analysis demonstrated that SARS-CoV-2-positive patients with acute pancreatitis were more likely to require admission to the intensive care unit (P <.001) and have local complications (P <.001), persistent organ failure (P <.001), a prolonged hospital stay (P <.001), and a higher 30-day mortality (P <.001). An adjusted analysis showed that length of stay (P <.001), persistent organ failure (P <.003), and 30-day mortality (P <.04) were significantly higher in patients with SARS-CoV-2 co-infection.
The authors concluded that, “Patients with [acute pancreatitis] and coexistent SARS-CoV-2 have a significantly high 30-day inpatient mortality.” They added, “These patients also have significantly worse clinical outcomes including increased severity of pancreatitis, length of stay and organ failure.”
Pandanaboyana S, Moir J, Leeds JS, et al; COVID PAN Collaborative Group. SARS-CoV-2 infection in acute pancreatitis increases disease severity and 30-day mortality: COVID PAN collaborative study. Gut. Published online February 5, 2021. doi:https://doi.org/10.1136/gutjnl-2020-323364