COVID-19 and acute pancreatitis: More serious and lethal

Introduction: There is increasing evidence about possible pancreatic involvement in SARS-CoV-2(COVID-19) disease in form of acute pancreatitis(AP) or hyperglycemia1. Our objective was to analyze the evolution of patients with AP and COVID-19. Aims & Methods: Retrospective, observational, single-center study including all patients hospitalized with a diagnosis of AP between March 1 and November 1, 2020 at the Miguel Servet University Hospital. They were classified into two groups based on presence or absence of current COVID-19 infection. AP severity was established according to the revised Atlanta Classification. Hospital stay, need for ICU admission, acute respiratory distress syndrome (ARDS), invasive treatment and mortality were evaluated among other variables. Statistical analysis was performed with the package statistic R. Results: 157 patients were admitted with AP in the study period. 13 patients (8.2%) associated COVID-19. There were no significant differences in terms of sex, age, Charlson index and comorbidities between these patients and those without COVID-19. In regard with aetiology, gallstones were the most common cause in both groups. In COVID-19 group, there were 3 idiopathic cases in which no cause of AP was demonstrated. Patients with COVID-19 had increased rate of necrotizing AP, higher AP severity, ARDS, days of admission, ICU admission rate, use of antibiotics (AB), use of intensive fluid therapy, use of invasive treatment and mortality. Conclusion: AP and COVID-19 patients present, regardless of their baseline characteristics and comorbidities, increased risk of severe AP, need for ICU, hospital stay and mortality.