The Effect of COVID-19 Infection on Severity of Acute Pancreatitis: A Prospective Cohort Study

Abstract

Background: Coronavirus Disease 2019 (COVID-19) is multisystemic disorder. It uses angiotensin converting enzyme 2 (ACE2) to gain access to human cells. The ACE2 receptor is present on cell types, one of them is pancreatic cell. This study aimed to assess the impact of COVID 19 infection on severity of acute pancreatitis (AP). Subjects and Methods: A prospective cohort study that was conducted at a major teaching hospital. The study group included all cases of AP with COVID 19. Medical records of randomly selected fifty cases of AP presented one year before COVID 19 pandemic with matching months of the year were considered as control. A comparison of the effect of COVID 19 on the severity of AP was done by measuring Glasgow and revised Atlanta scores. Results: 37 cases of COVID 19 patients developed AP in this study. The serum calcium, and albumin were lower, while blood urea, sugar, and Glasgow score all were higher in cases of COVID 19 than control. Follow up, showed that 17 (19.5%) of the cases developed severe pancreatitis, 76.5% of severe cases of AP had COVID 19 on comparison to control. COVID 19 is an independent predictor for severity of AP. Conclusions: COVID 19 is an independent predictor for severity of AP. More directed care to the cases of COVID 19 with superimposed AP, as they prone to develop severe form. Future studies to examine the effect of COVID 19 antiviral therapy on the severity of AP is recommended.

Keywords

• Acute pancreatitis
• Coronaviruses
• Atlanta score
• Glasgow score
• amylase