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Ge P, Luo Y, Liu J, Liu J, Wen H, Zhang G, Chen H. Eliminating COVID-19 as the immediate culprit for igniting pancreatitis. J Med Virol 2023; 95:e29272. [PMID: 38054501 DOI: 10.1002/jmv.29272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 10/24/2023] [Accepted: 11/16/2023] [Indexed: 12/07/2023]
Abstract
The impact of severe acute respiratory syndrome coronavirus 2 infection on the potential development of pancreatitis is a subject of ongoing debate within academic discourse. Establishing a causal link between COVID-19 and pancreatitis may not be fully supported by relying only on retrospective studies or case reports. This study examined the relationship between COVID-19 phenotypes and pancreatitis by Mendelian randomization (MR) method. The identification of instrumental variables (single nucleotide polymorphisms) that exhibit a robust association with the COVID-19 phenotypes was accomplished through a meticulous process of rigorous screening procedures. We included acute pancreatitis and chronic pancreatitis (CP) as the outcomes in the MR analysis, even though no definitive studies exist between COVID-19 and CP. A direct causal relationship between genetically predicted COVID-19 phenotypes and pancreatitis risk cannot be established. There is an ongoing debate over the designation of COVID-19 as a definitive cause of pancreatitis.
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Affiliation(s)
- Peng Ge
- Department of General Surgery, The First Affiliated Hospital of Dalian Medical University, Dalian, China
- Institute (College) of Integrative Medicine, Dalian Medical University, Dalian, China
- Laboratory of Integrative Medicine, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Yalan Luo
- Department of General Surgery, The First Affiliated Hospital of Dalian Medical University, Dalian, China
- Institute (College) of Integrative Medicine, Dalian Medical University, Dalian, China
- Laboratory of Integrative Medicine, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Jie Liu
- Department of General Surgery, The First Affiliated Hospital of Dalian Medical University, Dalian, China
- Institute (College) of Integrative Medicine, Dalian Medical University, Dalian, China
- Laboratory of Integrative Medicine, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Jin Liu
- Department of General Surgery, The First Affiliated Hospital of Dalian Medical University, Dalian, China
- Laboratory of Integrative Medicine, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Haiyun Wen
- Department of General Surgery, The First Affiliated Hospital of Dalian Medical University, Dalian, China
- Institute (College) of Integrative Medicine, Dalian Medical University, Dalian, China
- Laboratory of Integrative Medicine, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Guixin Zhang
- Department of General Surgery, The First Affiliated Hospital of Dalian Medical University, Dalian, China
- Institute (College) of Integrative Medicine, Dalian Medical University, Dalian, China
- Laboratory of Integrative Medicine, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Hailong Chen
- Department of General Surgery, The First Affiliated Hospital of Dalian Medical University, Dalian, China
- Institute (College) of Integrative Medicine, Dalian Medical University, Dalian, China
- Laboratory of Integrative Medicine, The First Affiliated Hospital of Dalian Medical University, Dalian, China
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2
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Stöllberger C, Kastrati K, Dejaco C, Scharitzer M, Finsterer J, Bugingo P, Melichart-Kotik M, Wilfing A. Necrotizing pancreatitis, microangiopathic hemolytic anemia and thrombocytopenia following the second dose of Pfizer/BioNTech COVID-19 mRNA vaccine. Wien Klin Wochenschr 2023; 135:436-440. [PMID: 37280395 PMCID: PMC10243681 DOI: 10.1007/s00508-023-02225-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 05/07/2023] [Indexed: 06/08/2023]
Abstract
Implementing vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a major asset in slowing down the coronavirus disease 2019 (COVID-19) pandemic. For mRNA vaccines, the main severe adverse events reported in pharmacovigilance systems and post-authorization studies were anaphylaxis and myocarditis. Pancreatitis after Pfizer/BioNTech COVID-19 vaccination has been reported only in 10 patients.We report a 31-year-old female with a history of borderline personality disorder, intravenous drug abuse, allergic asthma, eating disorder, psoriatic arthritis treated with tofacitinib, neurogenic bladder disturbance, cholecystectomy, recurrent thoracic herpes zoster, vaginal candida infections and urinary tract infections, who developed pancreatitis associated with thrombotic microangiopathy and hemolytic-uremic syndrome 10 days after the second vaccination, whereas the first has been well tolerated. She was treated by plasma exchange, and eventually by transgastric drainage with implantation of a plastic stent to remove fluid abdominal retentions. She was discharged after 19 days. Since then her condition has improved continuously. Computed tomography after 12 months did not reveal retentions anymore.As other causes of pancreatitis have been excluded, this case of acute pancreatitis, microangiopathic hemolytic anemia and thrombocytopenia, temporally associated with the Pfizer-BioNTech COVID-19 vaccine, suggests a causal link.
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Affiliation(s)
- Claudia Stöllberger
- Office Wehlistrasse, Wehlistr. 131–143/20A/3, 1020 Wien, Austria
- Anton Sattler Gasse 4/22, 1220 Wien, Austria
| | - Kastriot Kastrati
- Medizinische Universität Wien, Währinger Gürtel 18–20, 1090 Wien, Austria
| | - Clemens Dejaco
- Medizinische Universität Wien, Währinger Gürtel 18–20, 1090 Wien, Austria
| | - Martina Scharitzer
- Medizinische Universität Wien, Währinger Gürtel 18–20, 1090 Wien, Austria
| | - Josef Finsterer
- Office Wehlistrasse, Wehlistr. 131–143/20A/3, 1020 Wien, Austria
| | - Patrick Bugingo
- Office Wehlistrasse, Wehlistr. 131–143/20A/3, 1020 Wien, Austria
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3
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Boraschi P, Donati F, Ambrosini I, Bruni L, Mazzeo ML, Tintori R, Tonerini M, Neri E. Diagnostic and Therapeutic Radiology of the GI Tract, Liver, and Pancreas in Patients with COVID. Gastroenterol Clin North Am 2023; 52:185-200. [PMID: 36813425 PMCID: PMC9626443 DOI: 10.1016/j.gtc.2022.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Coronavirus disease 2019 (COVID-19) pulmonary involvement has been extensively reported in the literature. Current data highlight how COVID-19 is a systemic disease, affecting many other organs, including the gastrointestinal, hepatobiliary, and pancreatic organs. Recently, these organs have been investigated using imaging modalities of ultrasound and particularly computed tomography. Radiological findings of the gastrointestinal, hepatic, and pancreatic involvement in patients with COVID-19 are generally nonspecific but are nonetheless helpful to evaluate and manage COVID-19 patients with involvement of these organs.
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Affiliation(s)
- Piero Boraschi
- 2nd Unit of Radiology, Department of Diagnostic and Interventional Radiology, and Nuclear Medicine, Pisa University Hospital, Via Paradisa 2, Pisa 56124, Italy.
| | - Francescamaria Donati
- 2nd Unit of Radiology, Department of Diagnostic and Interventional Radiology, and Nuclear Medicine, Pisa University Hospital, Via Paradisa 2, Pisa 56124, Italy
| | - Ilaria Ambrosini
- Academic Radiology, Department of Translational Research, University of Pisa, Via Roma 67, Pisa 56126, Italy
| | - Luciana Bruni
- Academic Radiology, Department of Translational Research, University of Pisa, Via Roma 67, Pisa 56126, Italy
| | - Maria Letizia Mazzeo
- Academic Radiology, Department of Translational Research, University of Pisa, Via Roma 67, Pisa 56126, Italy
| | - Rachele Tintori
- 2nd Unit of Radiology, Department of Diagnostic and Interventional Radiology, and Nuclear Medicine, Pisa University Hospital, Via Paradisa 2, Pisa 56124, Italy
| | - Michele Tonerini
- Unit of Emergency Radiology, Department of Surgical, Medical, Molecular and Critical Area Pathology, Pisa University Hospital, Via Paradisa 2, Pisa 56124, Italy
| | - Emanuele Neri
- Academic Radiology, Department of Translational Research, University of Pisa, Via Roma 67, Pisa 56126, Italy
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4
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Jalal Eldin A, Lyonga A, Ohiokpehai B, Rizwan M, Musa A. COVID-19, Hypertriglyceridemia, and Acute Pancreatitis: A Case Report and Clinical Considerations. Cureus 2023; 15:e35431. [PMID: 36994303 PMCID: PMC10040487 DOI: 10.7759/cureus.35431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/24/2023] [Indexed: 02/27/2023] Open
Abstract
Acute pancreatitis (AP) is a serious condition that can result in numerous negative outcomes including death. The underlying causes of AP are varied, with both COVID-19 and hypertriglyceridemia being documented in the medical literature. Here, we present the case of a young man with a pre-existing diagnosis of prediabetes and class 1 obesity who developed severe hypertriglyceridemia, AP, and mild diabetic ketoacidosis while concurrently infected with COVID-19. It is crucial for healthcare providers to be vigilant in recognizing the potential complications associated with COVID-19, regardless of whether the patient has received a vaccination.
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5
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Su YJ, Chen TH. Surgical intervention for acute pancreatitis in the COVID-19 era. World J Clin Cases 2022; 10:11292-11298. [PMID: 36387796 PMCID: PMC9649528 DOI: 10.12998/wjcc.v10.i31.11292] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 08/20/2022] [Accepted: 09/20/2022] [Indexed: 02/05/2023] Open
Abstract
Approximately 15%-19% of patients with severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) infections develop gastrointestinal symptoms. Acute pancreatitis (AP) has been reported in 0.1% of patients with coronavirus disease 2019 (COVID-19). Biliary AP was most common (78.4%) before the COVID-19 pandemic; idiopathic AP is most common in patients with COVID-19 (up to 57.1%). The number of emergency department presentations decreased by 23.3% during the pandemic and many governments made national recommendations to delay nonurgent endoscopic procedures, leading to decrements of 22% in combined esophagogastroduodenoscopy (EGD) and colonoscopy and 20% in EGD after the COVID-19 pandemic. The symptoms and signs of COVID-19-related AP are fever (63%), abdominal pain (58%), respiratory symptoms (40%), nausea and vomiting (39%), and headache (4%). Approximately 5-10% of patients develop necrotizing or hemorrhagic AP, and patients who required surgical intervention had a higher mortality risk. Compared to 2019, the rates of elective surgery decreased by 41.8% in 2020; including cholecystectomy (40.1% decrease) and pancreas (111.1% decrease). Surgical volumes also decreased by 18.7% in 2020; device-assisted laparoscopic and robot-assisted procedures reduced by 45.4% and 61.9% during the COVID-19 Lockdown in 2020.
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Affiliation(s)
- Yu-Jang Su
- Toxicology Division, Emergency Department, MacKay Memorial Hospital, Taipei 10449, Taiwan
- Department of Medicine, MacKay Medical College, New Taipei 252, Taiwan
- Department of Nursing, Yuanpei University of Medical Technology, HsinChu 300, Taiwan
- Department of Nursing, MacKay Junior College of Medicine, Nursing, and Management, New Taipei 25245, Taiwan
| | - Tse-Hao Chen
- Emergency Medicine, MacKay Memorial Hospital, Taipei 10449, Taiwan
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Suleiman J, Sadiq A, Sanga E, Sadiq A, Urasa S, Msuya D, Chugulu S, Lodhia J. Acute pancreatitis in SARS-CoV-2 infection: A case report from Tanzania. SAGE Open Med Case Rep 2022; 10:2050313X221135253. [PMID: 36324597 PMCID: PMC9619277 DOI: 10.1177/2050313x221135253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 10/06/2022] [Indexed: 11/07/2022] Open
Abstract
The pandemic caused by the severe acute respiratory syndrome coronavirus 2 has mainly affected the respiratory system but has expanded to other systems, including the gastrointestinal system. We present an 80-year-old man with sharp epigastric pain and vomiting. Laboratory investigations revealed elevated pancreatic enzymes, and contrast-enhanced computed tomography of the abdomen suggested acute pancreatitis. He was undergoing treatment for acute pancreatitis when he developed respiratory compromise, leading to the use of oxygen. Computed tomography of the chest revealed bilateral pleural effusion. However, a positive nasopharyngeal swab suggested severe acute respiratory syndrome coronavirus 2 infection. He was treated for the viral infection with various medications until clinically stable before being self-isolated at home. His follow-up visits revealed a favorable outcome, with progressive resolve occurring 4 weeks after the onset. There is no specific conclusion regarding pancreatic involvement in severe acute respiratory syndrome coronavirus 2 infection. There are several confounding factors in the etiology of acute pancreatitis during concomitant severe acute respiratory syndrome coronavirus 2 infection. However, further research is warranted to evaluate whether pancreatic involvement is one of the clinical presentations or subsequent complications of severe acute respiratory syndrome coronavirus 2 infection.
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Affiliation(s)
- Jamil Suleiman
- Department of General Surgery, Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | - Abid Sadiq
- Department of Internal Medicine, Kilimanjaro Christian Medical Centre, Moshi, Tanzania,Faculty of Medicine, Kilimanjaro Christian Medical University College, Moshi, Tanzania,Abid Sadiq, Department of Internal Medicine, Kilimanjaro Christian Medical Centre, P.O. Box 3010, Moshi, Tanzania.
| | - Evans Sanga
- Department of Anesthesia and Intensive Care, Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | - Adnan Sadiq
- Faculty of Medicine, Kilimanjaro Christian Medical University College, Moshi, Tanzania,Department of Radiology, Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | - Sarah Urasa
- Department of Internal Medicine, Kilimanjaro Christian Medical Centre, Moshi, Tanzania,Faculty of Medicine, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - David Msuya
- Department of General Surgery, Kilimanjaro Christian Medical Centre, Moshi, Tanzania,Faculty of Medicine, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Samwel Chugulu
- Department of General Surgery, Kilimanjaro Christian Medical Centre, Moshi, Tanzania,Faculty of Medicine, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Jay Lodhia
- Department of General Surgery, Kilimanjaro Christian Medical Centre, Moshi, Tanzania,Faculty of Medicine, Kilimanjaro Christian Medical University College, Moshi, Tanzania
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