Admission serum lipase and ICU mortality in critically ill COVID-19 patients: non-pancreatic hyperlipasemia as a marker of renal and multiorgan dysfunction rather than acute pancreatitis

Mustafa Ay; Serap Avcı Ay; Ezgi Kaya; Dilara Tüfek Öztan; Şule Asri

Admission serum lipase and ICU mortality in critically ill COVID-19 patients: non-pancreatic hyperlipasemia as a marker of renal and multiorgan dysfunction rather than acute pancreatitis

Abstract

Aims: Serum lipase is frequently elevated in critically ill patients, and non-pancreatic hyperlipasemia may be misread as acute pancreatitis. Using a COVID-19 ICU cohort as a model of severe critical illness, we examined whether admission lipase independently predicts ICU mortality and whether lipase elevation corresponds to acute pancreatitis or instead primarily reflects renal and multiorgan dysfunction. Methods: We retrospectively studied 219 adults with RT-PCR-confirmed COVID-19 admitted to a tertiary ICU in 2020. Admission lipase was entered into a predefined multivariable logistic regression for all-cause ICU mortality, adjusted for age, gender, comorbidities, creatinine, PaO₂/FiO₂, LDH, NLR, and troponin. Peak lipase defined the hyperlipasemia phenotype, and acute pancreatitis was diagnosed by the revised Atlanta criteria. Renal function was assessed by CKD-EPI 2021 eGFR. Results: ICU mortality was 54.3%. Hyperlipasemia occurred in 58 patients (26.5%) and marked hyperlipasemia (>201 U/L) in 11, whereas clinically diagnosed acute pancreatitis was identified in only 1 (0.5%). Admission lipase did not discriminate mortality (AUC 0.46; 95% CI 0.39–0.54) and was not an independent predictor (OR 0.88 per 10 U/L; 95% CI 0.73–1.06); older age and lower PaO₂/FiO₂ were the dominant predictors. Hyperlipasemia was more frequent with eGFR <60 ml/min/1.73 m² (35.6% vs 21.9%; p=0.045) but did not stratify mortality within renal-function categories. Conclusion: In critically ill patients, hyperlipasemia was common but rarely represented acute pancreatitis and did not independently predict mortality, behaving instead as a marker of renal and multiorgan dysfunction. Isolated lipase elevation should be interpreted within clinical and imaging context rather than triggering a pancreatitis-directed work-up on its own.

Keywords

Supporting Institution

None

Ethical Statement

This study was approved by the Scientific Research Ethics Committee of Batman Training and Research Hospital (approval no: 265, date: 24 February 2021). All procedures were performed in accordance with the 1964 Declaration of Helsinki and its later amendments. Owing to the retrospective design, the requirement for informed consent was waived.

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Details

Primary Language

English

Subjects

Intensive Care

Journal Section

Research Article

Authors

Mustafa Ay ^*
0000-0001-6210-1083
Türkiye

Serap Avcı Ay
0000-0002-3871-9884
Türkiye

Ezgi Kaya
0000-0003-1254-4382
United Kingdom

Dilara Tüfek Öztan
0000-0003-0242-6307
Türkiye

Şule Asri
0000-0001-9972-7020
Türkiye

Publication Date

August 15, 2026

Submission Date

June 13, 2026

Acceptance Date

August 3, 2026

Published in Issue

Year 2026 Volume: 7 Number: 4

IZ

https://izlik.org/JA88EX67BW

Cite

RIS / Bibtex

APA

Ay, M., Avcı Ay, S., Kaya, E., Tüfek Öztan, D., & Asri, Ş. (2026). Admission serum lipase and ICU mortality in critically ill COVID-19 patients: non-pancreatic hyperlipasemia as a marker of renal and multiorgan dysfunction rather than acute pancreatitis. Journal of Medicine and Palliative Care, 7(4), 855-863. https://izlik.org/JA88EX67BW

AMA

1.Ay M, Avcı Ay S, Kaya E, Tüfek Öztan D, Asri Ş. Admission serum lipase and ICU mortality in critically ill COVID-19 patients: non-pancreatic hyperlipasemia as a marker of renal and multiorgan dysfunction rather than acute pancreatitis. J Med Palliat Care / JOMPAC / jompac. 2026;7(4):855-863. https://izlik.org/JA88EX67BW

Chicago

Ay, Mustafa, Serap Avcı Ay, Ezgi Kaya, Dilara Tüfek Öztan, and Şule Asri. 2026. “Admission Serum Lipase and ICU Mortality in Critically Ill COVID-19 Patients: Non-Pancreatic Hyperlipasemia As a Marker of Renal and Multiorgan Dysfunction Rather Than Acute Pancreatitis”. Journal of Medicine and Palliative Care 7 (4): 855-63. https://izlik.org/JA88EX67BW.

EndNote

Ay M, Avcı Ay S, Kaya E, Tüfek Öztan D, Asri Ş (August 1, 2026) Admission serum lipase and ICU mortality in critically ill COVID-19 patients: non-pancreatic hyperlipasemia as a marker of renal and multiorgan dysfunction rather than acute pancreatitis. Journal of Medicine and Palliative Care 7 4 855–863.

IEEE

[1]M. Ay, S. Avcı Ay, E. Kaya, D. Tüfek Öztan, and Ş. Asri, “Admission serum lipase and ICU mortality in critically ill COVID-19 patients: non-pancreatic hyperlipasemia as a marker of renal and multiorgan dysfunction rather than acute pancreatitis”, J Med Palliat Care / JOMPAC / jompac, vol. 7, no. 4, pp. 855–863, Aug. 2026, [Online]. Available: https://izlik.org/JA88EX67BW

ISNAD

Ay, Mustafa - Avcı Ay, Serap - Kaya, Ezgi - Tüfek Öztan, Dilara - Asri, Şule. “Admission Serum Lipase and ICU Mortality in Critically Ill COVID-19 Patients: Non-Pancreatic Hyperlipasemia As a Marker of Renal and Multiorgan Dysfunction Rather Than Acute Pancreatitis”. Journal of Medicine and Palliative Care 7/4 (August 1, 2026): 855-863. https://izlik.org/JA88EX67BW.

JAMA

1.Ay M, Avcı Ay S, Kaya E, Tüfek Öztan D, Asri Ş. Admission serum lipase and ICU mortality in critically ill COVID-19 patients: non-pancreatic hyperlipasemia as a marker of renal and multiorgan dysfunction rather than acute pancreatitis. J Med Palliat Care / JOMPAC / jompac. 2026;7:855–863.

MLA

Ay, Mustafa, et al. “Admission Serum Lipase and ICU Mortality in Critically Ill COVID-19 Patients: Non-Pancreatic Hyperlipasemia As a Marker of Renal and Multiorgan Dysfunction Rather Than Acute Pancreatitis”. Journal of Medicine and Palliative Care, vol. 7, no. 4, Aug. 2026, pp. 855-63, https://izlik.org/JA88EX67BW.

Vancouver

1.Mustafa Ay, Serap Avcı Ay, Ezgi Kaya, Dilara Tüfek Öztan, Şule Asri. Admission serum lipase and ICU mortality in critically ill COVID-19 patients: non-pancreatic hyperlipasemia as a marker of renal and multiorgan dysfunction rather than acute pancreatitis. J Med Palliat Care / JOMPAC / jompac [Internet]. 2026 Aug. 1;7(4):855-63. Available from: https://izlik.org/JA88EX67BW