Investigation of Relationship with COVID-19 and Acute Pancreatitis

Öz

More than 2 million people worldwide have died due to coronavirus disease-19 (COVID-19). The severity of the disease ranges from subclinical infections to severe illnesses requiring hospitalization. SARS-CoV-2, which is the causative agent of COVID-19 disease, mainly affects the respiratory tract, but gastrointestinal symptoms such as nausea, vomiting and diarrhea may also occur. Abdominal pain is one of the known symptoms associated with COVID-19 disease. There are a few data on the development of acute pancreatitis as a complication of severe COVID-19 infection. Some patients with COVID-19 may develop an elevated pancreatic enzyme and rarely acute pancreatitis. This situation is associated with a particularly serious clinical picture. The mechanism of pancreatic involvement in COVID-19 is not clearly understood. In this review, it was aimed to evaluate COVID-19 associated pancreatitis.

Anahtar Kelimeler

• COVID-19
• acute pancreatitis
• SARS-CoV-2

COVID-19-Akut Pankreatit İlişkisinin İncelenmesi

Öz

Koronavirüs hastalığı-19 (COVID-19) pandemisi şu an için dünya çapında iki milyondan fazla insanın ölümüne neden olmuştur. Hastalığın ciddiyeti subklinik infeksiyonlardan hastaneye yatmayı gerektiren ağır hastalığa kadar değişmektedir. COVID-19 hastalık etkeni olan SARS-CoV-2 esas olarak solunum yolunu etkiler, ancak mide bulantısı, kusma ve ishal gibi gastrointestinal semptomlar da ortaya çıkabilmektedir. Karın ağrısı, COVID-19 hastalığı ile ilişkili bilinen semptomlardan biridir. Şiddetli COVID-19 infeksiyonunun bir komplikasyonu olarak akut pankreatit gelişimi hakkında çok az veri bulunmaktadır. COVID-19 hastalarının bazılarında pankreas enzim yüksekliği ve nadir de olsa akut pankreatit gelişebilmektedir. Bu durum özellikle ciddi klinik tablo ile ilişkilidir. COVID-19’da pankreas tutulum mekanizması net anlaşılamamıştır. Bu derlemede COVID-19 ilişkili pankreatitin değerlendirilmesi amaçlanmıştır.

Anahtar Kelimeler

• COVID-19
• akut pankreatit
• SARS-CoV-2

Kaynakça

1. Kutlu O, Bilgiç Y, Bahri E, Atayan Y, Çağın YF. Alkolik olmayan yağlı karaciğer hastalığı rekürren akut pankreatit için bir risk faktörü müdür? Fırat Tıp Derg. 2020;25(3):135-139.
2. Mazrouei SSA, Saeed GA, Al Helali AA. COVID-19-associated acute pancreatitis: a rare cause of acute abdomen. Radiol Case Rep. 2020;15(9):1601-1603. doi: 10.1016/j.radcr.2020.06.019.
3. Kottanattu L, Lava SAG, Helbling R, Simonetti GD, Bianchetti MG, Milani GP. Pancreatitis and cholecystitis in primary acute symptomatic Epstein-Barr virus infection - systematic review of the literature. J Clin Virol. 2016;82:51-55. doi: 10.1016/j.jcv.2016.06.017.
4. Agzarian AE. Agzarian AY. Influenza A as a cause of acute pancreatitis: a case report. Proceedings of UCLA Healthcare. 2016;20:1-2.
5. Sullivan SJ, Jacobson RM, Dowdle WR, Poland GA. 2009 H1N1 influenza. Mayo Clin Proc. 2010;85(1):64-76. doi: 10.4065/mcp.2009.0588.
6. https://covid19.who.int/who –Corona virüs disease (COVID-19) dashboard. Erişim tarihi 25 Ocak 2021.
7. Li LQ, Huang T, Wang YQ, et al. COVID-19 patients' clinical characteristics, discharge rate, and fatality rate of meta-analysis. J Med Virol. 2020;92(6):577-583. doi: 10.1002/jmv.25757.
8. Holshue ML, DeBolt C, Lindquist S, et al. Washington State 2019-nCoV Case Investigation Team. First Case of 2019 Novel Coronavirus in the United States. N Engl J Med. 2020;382(10):929-936. doi: 10.1056/NEJMoa2001191.

9. Yang JK, Lin SS, Ji XJ, Guo LM. Binding of SARS coronavirus to its receptor damages islets and causes acute diabetes. Acta Diabetol. 2010;47(3):193-9. doi: 10.1007/s00592-009-0109-4.
10. Wang F, Wang H, Fan J, Zhang Y, Wang H, Zhao Q. Pancreatic ınjury patterns in patients with coronavirus disease 19 pneumonia. Gastroenterology. 2020;159(1):367-370. doi: 10.1053/j.gastro.2020.03.055
11. McNabb-Baltar J, Jin DX, Grover AS, et al. Lipase Elevation in Patients with COVID-19. Am J Gastroenterol. 2020;115(8):1286-1288. doi:10.14309/ajg.0000000000000732.
12. Liu F, Long X, Zhang B, Zhang W, Chen X, Zhang Z. ACE2 expression in pancreas may cause pancreatic damage after SARS-CoV-2 infection. Clin Gastroenterol Hepatol. 2020;18(9):2128-2130.e2. doi: 10.1016/j.cgh.2020.04.040
13. Banks PA, Bollen TL, Dervenis C, et al. Acute Pancreatitis Classification Working Group. Classification of acute pancreatitis--2012: revision of the Atlanta classification and definitions by international consensus. Gut. 2013;62(1):102-11. doi: 10.1136/gutjnl-2012-302779.
14. Hadi A, Werge M, Kristiansen KT, et al. Coronavirus Disease-19 (COVID-19) associated with severe acute pancreatitis: case report on three family members. Pancreatology. 2020;20(4):665-667. doi: 10.1016/j.pan.2020.04.021.
15. İnkaya AÇ, Taş Z, Akova M. COVID-19’un güncel tedavisi. Yalçın Ş, Özet A, editörler. Kanser ve COVID-19 Pandemisi. 1. Baskı. Ankara: Türkiye Klinikleri; 2020. p.27-37.
16. Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506. doi: 10.1016/S0140-6736(20)30183-5.
17. Wong EC, Butch AW, Rosenblum JL. The clinical chemistry laboratory and acute pancreatitis. Clinical chemistry. 1993;39:234–43.
18. https://www.uptodate.com/contents/clinical-manifestations-and-diagnosis-of-acute-pancreatitis. Erişim tarihi 11 Ekim 2020.
19. Biberoğlu S, Koyuncu M, Öztürk D, et al. Role of computed tomography severity index in acute diagnosis and follow-up of acute pancreatitis. J Clin Anal Med. 2017;8(2):106-110.
20. Docherty AB, Harrison EM, Green CA, et al. Features of 20 133 UK patients in hospital with COVID-19 using the ISARIC WHO Clinical Characterisation Protocol: prospective observational cohort study. BMJ. 2020;369:m1985.
21. Zhang H, Kang Z, Gong H, et al. Digestive system is a potential route of COVID19: an analysis of single-cell coexpression pattern of key proteins in viral entry process. Gut. 2020;69:1010–8.
22. Ullah AZDM, Sivapalan L, Chelala C, Kocher HM. COVID-19 in patients with hepatobiliary and pancreatic diseases in East London: a single-centre cohort study. medRxiv. 2020.09.07.20189621; doi: https://doi.org/10.1101/2020.09.07.20189621
23. Del Hoyo J, López-Muñoz P, Fernández-de la Varga M, et al. Hepatobiliary and Pancreatic: A fatal case of extensive splanchnic vein thrombosis in a patient with COVID-19. J Gastroenterol Hepatol. 2020;10.1111/jgh.15174. doi: 10.1111/jgh.15174.
24. Singla V, Arora A. Hepatobiliary and pancreatic manifestations of coronavirus disease 2019. Journal of Digestive Endoscopy. 2020;11(1):21–3. doi: 10.1055/s-0040-1712079.
25. Gubatan J, Levitte S, Patel A, et al. Prevalence, risk factors and clinical outcomes of COVID-19 in patients with a history of pancreatitis in Northern California. Gut. 2021;70(2):440-441. doi: 10.1136/gutjnl-2020-321772.
26. 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. doi: 10.14309/ctg.0000000000000215.
27. Ding Y, He L, Zhang Q, et al. Organ distribution of severe acute respiratory syndrome (SARS) associated coronavirus (SARS-CoV) in SARS patients: implications for pathogenesis and virus transmission pathways. J Pathol. 2004;203(2):622-30. doi: 10.1002/path.1560.
28. Hussain A, Bhowmik B, do Vale Moreira NC. COVID-19 and diabetes: Knowledge in progress. Diabetes Res Clin Pract. 2020;162:108142. doi: 10.1016/j.diabres.2020.108142.
29. Qian DH, Zhu GJ, Wu LZ, Hua GX. Isolation and characterization of a coronavirus from pigeons with pancreatitis. Am J Vet Res. 2006;67(9):1575-9. doi: 10.2460/ajvr.67.9.1575.
30. Wills SE, Beaufrère HH, Brisson BA, Fraser RS, Smith DA. Pancreatitis and systemic coronavirus infection in a Ferret (Mustela putorius furo). Comp Med. 2018;68(3):208-211. doi: 10.30802/AALAS-CM-17-000109.
31. Aloysius MM, Thatti A, Gupta A, Sharma N, Bansal P, Goyal H. COVID-19 presenting as acutepancreatitis. Pancreatology. 2020;20(5):1026-1027. doi: 10.1016/j.pan.2020.05.003.
32. Cheung S, Delgado Fuentes A, Fetterman AD. Recurrent acute pancreatitis in a patient with COVID-19 Infection. Am J Case Rep. 2020;21:e927076. doi: 10.12659/AJCR.927076.
33. Lakshmanan S, Malik A. Acute pancreatitis in mild COVID-19 infection. Cureus. 2020;12(8):e9886. doi: 10.7759/cureus.9886.
34. Nikhil Kumar Patnaik R, Gogia A, Kakar A. Acute pancreatic injury induced by COVID-19. IDCases. 2020;10:e00959. doi: 10.1016/j.idcr.2020.e00959.
35. Meireles PA, Bessa F, Gaspar P, et al. Acalculous acute pancreatitis in a COVID-19 patient. Eur J Case Rep Intern Med. 2020;7(6):001710. doi: 10.12890/2020_001710.
36. Miao Y, Lidove O, Mauhin W. First case of acute pancreatitis related to SARS-CoV-2 infection. Br J Surg. 2020;107(8):e270. doi: 10.1002/bjs.11741
37. Mukherjee R, Smith A, Sutton R. Covid‐19‐related pancreatic injury. Br J Surg. 2020;10.1002/bjs.11645 [Epub ahead of print]
38. Szatmary P, Arora A, Thomas Raraty MG, Joseph Dunne DF, Baron RD, Halloran CM. Emerging Phenotype of Severe Acute Respiratory Syndrome-Coronavirus 2-associated Pancreatitis. Gastroenterology. 2020;S0016-5085(20)34741-7. doi:10.1053/j.gastro.2020.05.069.
39. Suchman K, Raphael KL, Liu Y, Wee D, Trindade AJ. Northwell COVID-19 Research Consortium. Acute pancreatitis in children hospitalized with COVID-19. Pancreatology. 2021;21(1):31-33. doi: 10.1016/j.pan.2020.12.005.
40. De-Madaria E, Siau K, Cárdenas-Jaén K. Increased amylase and lipase in patients with COVID-19 pneumonia: don´t blame the pancreas just yet! Gastroenterology. 2020;S0016-5085(20)30561-8. doi:10.1053/j.gastro.2020.04.044.
41. Medpage Today. https://www.medpagetoday.com/infectiousdisease/covid19/88328. Erişim tarihi 10 Ekim 2020.
42. Türk Cerrahi. Akut Pankreatit Tanısı. https://www.turkcerrahi.com/makaleler/pankreas/akut-pankreatit/pankreatit-tanisi/. Erişim tarihi 10 Ekim 2020.
43. Zhang C, Wu Z, Li JW, Zhao H, Wang GQ. Cytokine release syndrome in severe COVID-19: interleukin-6 receptor antagonist tocilizumab may be the key to reduce mortality. Int J Antimicrob Agents. 2020;55(5):105954. doi: 10.1016/j.ijantimicag.2020.105954.
44. Guaraldi G, Meschiari M, Cozzi-Lepri A, et al. Tocilizumab in patients with severe COVID-19: a retrospective cohort study. Lancet Rheumatol. 2020;2(8):e474-e484. doi: 10.1016/S2665-9913(20)30173-9.
45. Zielecki P, Kaniewska M, Furmanek M, Bulski T, Rydzewska G. Effective treatment of severe acute pancreatitis and COVID-19 pneumonia with tocilizumab. Prz Gastroenterol. 2020;15(3):267-272. doi: 10.5114/pg.2020.99042.
46. Chen KL, Lv ZY, Yang HW, et al. Effects of tocilizumab on experimental severe acute pancreatitis and associated acute lung ınjury. Crit Care Med. 2016;44(8):e664-77. doi: 10.1097/CCM.0000000000001639.
47. Hançerli Y, Kaplan M, Tanoğlu A, Yeşilbaş S, Küçükodacı Z, Yıldırım M. Efficacy of tocilizumab treatment in cerulein-induced experimental acute pancreatitis model in rats. Turk J Gastroenterol. 2017;28(6):485-491. doi: 10.5152/tjg.2017.16738.
48. Clinical Trials. A Study to Evaluate the Safety and Efficacy of Tocilizumab in Patients With Severe COVID-19 Pneumoni (COVACTA). https://clinicaltrials.gov/ct2/show/NCT04320615. Erişim tarihi 5 Ekim 2020.