Increased mortality in patients with alcohol-induced pancreatitis during the COVID-19 pandemic

Background

COVID-19 pandemic affected millions of people worldwide. Alcohol consumption increased during the pandemic, leading to rising numbers of cases of alcohol-related pancreatitis. We aimed to assess the mortality of alcohol-induced pancreatitis during the COVID-19 pandemic in the United States.

Methods

We analyzed the National Vital Statistical System's (NVSS) provisional multiple causes of death data, provided by the Centers for Disease Control and Prevention, to assess the mortality of alcohol-induced pancreatitis during the pandemic. Patients with alcohol-induced pancreatitis as a cause of death were analyzed between 2018 and 2021. Patient demographics such as age, sex, ethnicity, and location were studied.

Results

During 2018-2021, there were 2547 deaths from alcohol-induced pancreatitis. The total cases and age-adjusted rates of alcohol-induced pancreatitis per 100,000 were similar in 2018 (n=515) and 2019 (n=501) (crude rate=0.1). The number increased to 747 in 2020 and 784 in 2021 (crude rate=0.2). A statistically significant increase in mortality rates was noted in all age groups except 75-84. An increase in mortality in both males and females was noted (48% increase and 64% increase, respectively, P<0.001). The number of deaths increased in both Hispanics (59%, P<0.001) and non-Hispanics (48%, P<0.001).

Conclusions

Our analysis demonstrated a substantial increase in the mortality of patients with alcohol-induced pancreatitis during the first 2 years of the COVID-19 pandemic. The increase in alcohol consumption and the burden on mental health caused massive collateral damage to society. Urgent public health interventions are needed at state and national levels to prevent further rise in cases.

Screening of Sera from Patients with Pancreatitis by an Apoptosis Assay of Skin-derived Cells

Background/Aims

An excessive inflammatory response is typical in acute pancreatitis and a significant cause of early mortality in severe acute pancreatitis. This is believed to be caused by inflammatory molecules or upregulated cytokine levels in the serum of patients. The aim of this study was to identify the serum-mediated apoptosis-inducing effects in acute pancreatitis patients.

Methods

A skin tissue-derived cell line, BJ, was treated for 24 hours with the sera of 22 healthy volunteers (control) and 71 acute pancreatitis patients (22 with gallstone pancreatitis, 16 with alcoholic pancreatitis, and 11 with pancreatitis with other causes) collected at the time of hospital admission (active) and discharge (resolved). Apoptosis was analyzed by flow cytometry.

Results

The average percentage of living cells, early apoptotic cells, and late apoptotic cells ranged from 78.8% to 85.0%, 5.5% to 7.3%, and 7.7% to 13.1%, respectively. The number of live cells increased significantly using the serum from the resolved state of gallstone-induced pancreatitis. In addition, the number of early apoptotic cells increased significantly using the serum from the resolved state of pancreatitis with other causes. The number of late apoptotic cells decreased significantly with the serum from the resolved state compared to the active state of gallstone- and alcohol-induced pancreatitis.

Conclusions

Serum samples from patients with pancreatitis induced a change in the apoptosis profiles of skin-derived cells. These results indicate changes in the serum components in patients with acute pancreatitis.