SARS-CoV-2 infection in acute pancreatitis increases disease severity and 30-day mortality: COVID PAN collaborative study
Author:
Pandanaboyana SanjayORCID, Moir JohnORCID, Leeds John SORCID, Oppong KofiORCID, Kanwar Aditya, Marzouk Ahmed, Belgaumkar Ajay, Gupta Ajay, Siriwardena Ajith K, Haque Ali Raza, Awan Altaf, Balakrishnan Anita, Rawashdeh Arab, Ivanov Bogdan, Parmar Chetan, M Halloran Christopher, Caruana Clifford, Borg Cynthia-Michelle, Gomez Dhanny, Damaskos Dimitrios, Karavias Dimitrios, Finch Guy, Ebied Husam, K Pine James, R A Skipworth James, Milburn James, Latif Javed, Ratnam Apollos Jeyakumar, El Kafsi Jihène, Windsor John A, Roberts Keith, Wang Kelvin, Ravi Krish, V Coats Maria, Hollyman Marianne, Phillips Mary, Okocha Michael, SJ Wilson Michael, A Ameer Nadeem, Kumar Nagappan, Shah Nehal, Lapolla Pierfrancesco, Magee Connor, Al-Sarireh Bilal, Lunevicius Raimundas, Benhmida Rami, Singhal Rishi, Balachandra Srinivasan, Demirli Atıcı Semra, Jaunoo Shameen, Dwerryhouse Simon, Boyce Tamsin, Charalampakis Vasileios, Kanakala Venkat, Abbas Zaigham, Nayar ManuORCID
Abstract
ObjectiveThere is emerging evidence that the pancreas may be a target organ of SARS-CoV-2 infection. This aim of this study was to investigate the outcome of patients with acute pancreatitis (AP) and coexistent SARS-CoV-2 infection.DesignA prospective international multicentre cohort study including consecutive patients admitted with AP during the current pandemic was undertaken. Primary outcome measure was severity of AP. Secondary outcome measures were aetiology of AP, intensive care unit (ICU) admission, length of hospital stay, local complications, acute respiratory distress syndrome (ARDS), persistent organ failure and 30-day mortality. Multilevel logistic regression was used to compare the two groups.Results1777 patients with AP were included during the study period from 1 March to 23 July 2020. 149 patients (8.3%) had concomitant SARS-CoV-2 infection. Overall, SARS-CoV-2-positive patients were older male patients and more likely to develop severe AP and ARDS (p<0.001). Unadjusted analysis showed that SARS-CoV-2-positive patients with AP were more likely to require ICU admission (OR 5.21, p<0.001), local complications (OR 2.91, p<0.001), persistent organ failure (OR 7.32, p<0.001), prolonged hospital stay (OR 1.89, p<0.001) and a higher 30-day mortality (OR 6.56, p<0.001). Adjusted analysis showed length of stay (OR 1.32, p<0.001), persistent organ failure (OR 2.77, p<0.003) and 30-day mortality (OR 2.41, p<0.04) were significantly higher in SARS-CoV-2 co-infection.ConclusionPatients with AP and coexistent SARS-CoV-2 infection are at increased risk of severe AP, worse clinical outcomes, prolonged length of hospital stay and high 30-day mortality.
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