Abstract
Aims: Elevated pancreatic enzyme can be observed in the course of coronavirus disease-2019 (COVID-19) due to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Here, we aimed to determine the frequency of lipase elevation in the course of COVID-19 and examine its effect on disease outcomes.
Methods: Of 42742 patients with the positivity of SARS-CoV-2 reverse transcriptase-polymerase chain reaction test (RT-PCR), 3167 undergoing lipase tests were included. The relationship between patients’ clinical features, development of acute pancreatitis (AP), and mortality rates was investigated.
Results: Higher lipase levels than normal limits were found in 399 (12.6%) patients. Lipase levels were three times higher than the normal limit in 119 (3.8%) patients; compared to the rest of the patients, patients’ age (62.8±17.9 vs 52.1±17.9 years, p<0.001), and rates of male patients (58% vs 45%, p=0.006) and mortality (17.6% vs 8%, p=0.001 respectively) were higher. Thirty-two (1.01%) patients were diagnosed with acute pancreatitis (AP). As lipase levels elevated, hospitalization (p<0.001) and requirement for intensive care unit (p=0.002) also increased. A total of 264 (8.3%) patients died, and mortality rates were higher in males (11% vs 6%, p<0.001). The dead were older (72.0±12.3 years vs 50.7±17.4 years, p<0.001). There was a linear positive correlation between patients’ age (p<0.001), lipase levels (p<0.001), and mortality. Mortality was increased among men and in the presence of AP (p<0.001).
Conclusion: Pancreatic enzyme levels should be measured in the course of COVID-19 due to increased mortality in patients of advanced age, males with AP, and high lipase levels.
Ethical Statement
BU ÇALIŞMAMIZ, UŞAK ÜNİVERSİTESİ TIP FAKÜLTESİ KLİNİK ARAŞTIRMALAR ETİK KURULU'NUN, 25.05.2023 TARİHLİ VE 89-89-12 NUMARALI ETİK KURUL İZNİ İLE GERÇEKLEŞTİRİLMİŞTİR.
References
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- 15. Rasch S, Herner A, Schmid RM, Huber W, Lahmer T. High lipasemia is frequent in COVID-19-associated acute respiratory distress syndrome. Pancreatol. 2021;21(1):306-311.
- 16. Bacaksiz F, Ebik B, Ekin N, Kilic J. Pancreatic damage in COVID-19: why? how?. Int J Clin Pract. 2021;75(10):e14692.
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- 18. Toouli J, Brooke-Smith M, Bassi C, et al. Guidelines for the management of acute pancreatitis. J Gastroenterol Hepatol. 2002;17(Suppl):S15-S39.
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Abstract
References
- 1. Muller JA, Gross R, Conzelmann C, et al. SARS-CoV-2 infects and replicates in cells of the human endocrine and exocrine pancreas. Nat Metab. 2021;3(2):149-165.
- 2. Sinonquel P, Aerts M, Badaoui A, et al. BSGIE survey on COVID-19 and gastrointestinal endoscopy in Belgium: results and recommendations. Acta Gastroenterol Belg. 2020;83(2):344-354.
- 3. Moreels TG. COVID-19 and gastrointestinal endoscopy in Belgium: uncertainty and ambiguity. Acta Gastroenterol Belg. 2020;83:337-338.
- 4. Bulthuis MC, Boxhoorn L, Beudel M, et al. Acute pancreatitis in COVID-19 patients: true risk? Scand J Gastroenterol. 2021;56(5):585-587.
- 5. Suchman K, Raphael KL, Liu Y, Wee D, Trindade AJ, Northwell COVID-19 Research Consortium. Acute pancreatitis in children hospitalized with COVID-19. Pancreatol. 2021;21(1):31-33.
- 6. Akkus C, Yilmaz H, Mizrak S, Adibelli Z, Akdas O, Duran C. Development of pancreatic injuries in the course of COVID-19. Acta Gastroenterol Belg. 2020;83(4):585-592.
- 7. de-Madaria E, Siau K, Cardenas-Jaen K. Increased amylase and lipase in patients with COVID-19 pneumonia: don't blame the pancreas just yet! Gastroenterol. 2021;160(5):1871.
- 8. Wang F, Wang H, Fan J, Zhang Y, Wang H, Zhao Q. Pancreatic injury patterns in patients with Coronavirus Disease 19 pneumonia. Gastroenterol. 2020;159(1):367-370.
- 9. McNabb-Baltar J, Jin DX, Grover AS, et al. Lipase elevation in patients with COVID-19. Am J Gastroenterol. 2020;115(8):1286-1288.
- 10. Barlass U, Wiliams B, Dhana K, et al. Marked elevation of lipase in COVID-19 disease: a cohort study. Clin Transl Gastroenterol. 2020;11(7):e00215.
- 11. Liu F, Long X, Zhang B, Zhang W, Chen X, Zhang Z. ACE2 expression in the pancreas may cause pancreatic damage after SARS-CoV-2 infection. Clin Gastroenterol Hepatol. 2020;18(9):2128-2130.
- 12. Goyal H, Sachdeva S, Perisetti A, Mann R, Inamdar S, Tharian B. Hyperlipasemia and potential pancreatic injury patterns in COVID-19: a marker of severity or innocent bystander?. Gastroenterol. 2021;160(3):946-948.
- 13. Akarsu C, Karabulut M, Aydin H, et al. Association between acute pancreatitis and COVID-19: could pancreatitis be the missing piece of the puzzle about increased mortality rates? J Invest Surg. 2022;35(1):119- 125.
- 14. Ding P, Song B, Liu X, et al. Elevated pancreatic enzymes in ICU patients with COVID-19 in Wuhan, China: a retrospective study. Front Med. 2021;8:663646.
- 15. Rasch S, Herner A, Schmid RM, Huber W, Lahmer T. High lipasemia is frequent in COVID-19-associated acute respiratory distress syndrome. Pancreatol. 2021;21(1):306-311.
- 16. Bacaksiz F, Ebik B, Ekin N, Kilic J. Pancreatic damage in COVID-19: why? how?. Int J Clin Pract. 2021;75(10):e14692.
- 17. Yadav D, Hawes RH, Brand RE, et al. Alcohol consumption, cigarette smoking, and the risk of recurrent acute and chronic pancreatitis. Arch Intern Med. 2009;169(11):1035-1045.
- 18. Toouli J, Brooke-Smith M, Bassi C, et al. Guidelines for the management of acute pancreatitis. J Gastroenterol Hepatol. 2002;17(Suppl):S15-S39.
- 19. Rawla P, Bandaru SS, Vellipuram AR. Review of infectious etiology of acute pancreatitis. Gastroenterol Res. 2017;10(3):153-158.
- 20. Yawar B, Marzouk A, Ali H, et al. Acute pancreatitis during COVID-19 pandemic: an overview of patient demographics, disease severity, management, and outcomes in an acute district hospital in Northern Ireland. Cureus. 2021;13(10):e18520.
- 21. Banks PA, Bollen TL, Dervenis C, et al. Acute Pancreatitis Classification Working G. Classification of acute pancreatitis--2012: revision of the Atlanta classification and definitions by international consensus. Gut. 2013;62:102-111.
- 22. Smatti MK, Cyprian FS, Nasrallah GK, Al Thani AA, Almishal RO, Yassine HM. Viruses and autoimmunity: a review on the potential interaction and molecular mechanisms. Viruses. 2019;11(8):762.
- 23. Hegyi P, Szakacs Z, Sahin-Toth M. Lipotoxicity and cytokine storm in severe acute pancreatitis and COVID-19. Gastroenterol. 2020;159(3):824-827.
- 24. Cheung KS, Hung IFN, Chan PPY, et al. Gastrointestinal manifestations of SARS-CoV-2 infection and virus load in fecal samples from a Hong Kong cohort: systematic review and meta-analysis. Gastroenterol. 2020;159(1):81-95.
- 25. Nango D, Nakashima H, Hirose Y, Shiina M, Echizen H. Causal relationship between acute pancreatitis and methylprednisolone pulse therapy for fulminant autoimmune hepatitis: a case report and review of the literature. J Pharm Health Care Sci. 2018;4(1):14.
Details
| Primary Language | English |
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| Subjects | Internal Diseases |
| Journal Section | Original Article |
| Authors | |
| Publication Date | March 25, 2024 |
| Submission Date | January 1, 2024 |
| Acceptance Date | March 10, 2024 |
| Published in Issue | Year 2024 Volume: 7 Issue: 2 |
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