27 Aug COVID-19 Can Present with Pancreatitis
MedicalResearch.com Interview with:
Dr. Arvind J. Trindade, MD
Director of Endoscopy
Long Island Jewish Medical Center
Associate professor at Feinstein Institutes for Medical Research
Division of Gastroenterology, Zucker School of Medicine
Hofstra/Northwell, Northwell Health System
New Hyde Park, NY
MedicalResearch.com: What is the background for this study?
Response: Although most patients with COVID-19 present with respiratory symptoms, gastrointestinal (GI) symptoms have also been reported in up to 25% of patients. Some case reports have shown acute pancreatitis as the initial presentation in patients with COVID-19, however the literature supporting this is limited. Our study aimed to report the point prevalence, risk factors, and outcomes of hospitalized patients with COVID-19 presenting with acute pancreatitis in a large health system and to compare outcomes of pancreatitis in patients without COVID-19.
MedicalResearch.com: What are the main findings? Were there particular groups or risk factors ie pre-existing alcohol use identified?
Response: During the study period, 48,012 patients were hospitalized and 11,883/48,012 (24.75%) were COVID-19 positive on admission. A total of 189/48,012 met criteria for a diagnosis of pancreatitis (point prevalence 0.39%), and 32/189 (17%) were COVID-19 positive, yielding a point prevalence of 0.27% of pancreatitis among patients hospitalized with COVID-19.
Among the group of patients who were COVID-19 negative, gallstone and alcohol etiologies were most common at 34% and 37% respectively, similar to that of the general population7. However among patients with COVID-19, these etiologies only accounted for 16% and 6% of cases respectively. Rather, idiopathic pancreatitis was the most common etiology in this group at 69% compared to 21% in patients who were COVID-19 negative (p<0.0001).
There were a higher proportion of Black and Hispanics with pancreatitis in the COVID positive group compared to the COVID negative group (p=0.03). After controlling for clinical relevant factors in an adjusted multivariate analysis among patients with pancreatitis, the association of Black and Hispanic race with COVID-19 remained statistically significant (OR 4.48; p=0.01 and OR 5.07; p=0.006).
With regards to outcomes, patients with pancreatitis who were also COVID-19 positive were more likely to require mechanical ventilation and had longer length of hospital stays compared to patients with pancreatitis without COVID-19 ((OR 5.65; p=0.01 and OR 3.22; p=0.009 respectively).
MedicalResearch.com: What should readers take away from your report?
Response: This study shows that patients with COVID-19 can present with pancreatitis. Pancreatitis should be added to the list of gastrointestinal manifestations of COVID-19. Physicians should be screening for upper abdominal pain, and if present, order serum lipase levels. We also show that Black and Hispanic races with pancreatitis were more likely to be diagnosed with COVID-19 after multivariate analysis during the pandemic in New York at our health system.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: We are hopeful that our findings would be further validated through additional, large studies. While the prevalence of pancreatitis was low in this study, future larger studies from other health systems would be valuable to understand the true connection.
Sumant Inamdar, Petros C. Benias, Yan Liu, Divyesh V. Sejpal, Sanjaya K. Satapathy, Arvind J. Trindade,
Prevalence, risk factors, and outcomes of hospitalized patients with COVID-19 presenting as acute pancreatitis,
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Last Updated on August 27, 2020 by Marie Benz MD FAAD