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COVID-19'da Pankreatik Enzim Yüksekliklerinin Sıklığı ve Hastalık Şiddeti Üzerindeki Etkisi

Year 2023, Volume: 13 Issue: 2, 209 - 215, 10.05.2023

Sevil Alkan Oruç Numan Gökçe Havva Yasemin Çinpolat

https://doi.org/10.33631/sabd.1199161

Abstract

Amaç: Bu çalışmada, COVID-19 ile enfekte hastalarda pankreatik enzim yükselmelerinin sıklığını değerlendirmek ve hastalık şiddetine etkisini incelemek amaçlanmıştır.
Gereç ve Yöntemler: COVID-19 enfeksiyonu ile hastaneye yatırılan toplam 1249 hasta dahil edildi. COVID-19 ile enfekte hastalarda pankreatik enzim yükselmelerinin sıklığı ve hastalık şiddeti üzerindeki etkisi araştırıldı.
Bulgular: 1249 hastanın 32'sinde pankreatik enzim yükselmeleri (amilaz/lipaz veya her ikisi) tespit edilmiştir (insidans %2,96). Bu çalışmaya yaş ortalaması 64,97±5,63 yıl olan 32 olgu dahil edilmiştir. Olguların 30’u (%93,75) erkek cinsiyetteydi. 31’inde (%96,87) amilaz, 26'sında (%81,25) lipaz, 25'inde (%78,12) hem amilaz hem de lipaz yüksekliği saptanmıştır. Bunların sadece 10'u (%31,25) akut pankreatit (AP) için radyolojik test yaptı ve yapılan sınırlı sayıdaki abdominal bilgisayarlı tomografi taramalarının hiçbirinde AP ile uyumlu radyolojik bulguya rastlanmamıştır. Hastaların 18'i (%56,25) klinik kötüleşme ve 13 (%40,62) hastada gelişen mortalite nedeniyle yoğun bakıma alınmıştır. Exitus vakalarının ortalama yaşı 66,4±6,6 yıldı; eksitus ve hayatta kalan COVID-19 hastaları arasında istatistiksel olarak anlamlı bir fark saptanmamıştır (p>0,05).
Sonuç: Exitus grupta medyan lenfosit sayısı daha düşük, medyan AST, ALT ve lipaz seviyeleri daha yüksekti. Bu değerlerde patolojik bulguları olan hastaların yakın klinik takibi ve gerekirse radyolojik görüntüleme hastalığın yönteminde faydalı olabilir.

Keywords

COVID-19 pankreatik enzim artışları hastalık şiddeti

Supporting Institution

yok

Project Number

yok

References

  • 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): 135-9.
  • Mazrouei SSA, Saeed GA, Al Helali AA. COVID-19-associated acute pancreatitis: a rare cause of acute abdomen. Radiol Case Rep. 2020;15(9):1601-3. https://doi.org/ 10.1016/j.radcr.2020.06.019.
  • 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: 51-5. https://doi.org/10.1016/j.jcv.2016.06.017.
  • Agzarian AE. Agzarian AY. Influenza A as a cause of acute pancreatitis: a case report. Proceedings of UCLA Healthcare. 2016; 20: 1-2.
  • Sullivan SJ, Jacobson RM, Dowdle WR, Poland GA. 2009 H1N1 influenza. Mayo Clin Proc. 2010; 85(1): 64-76. https://doi.org/10.4065/mcp.2009.0588.
  • https://covid19.who.int/who –Corona virüs disease (COVID-19) dashboard. Access date: January, 2021.
  • Li LQ, Huang T, Wang YQ, Wang ZP, Liang Y, Huang TB, et al. COVID-19 patients' clinical characteristics, discharge rate, and fatality rate of meta-analysis. J Med Virol. 2020; 92(6): 577-83. https://doi.org/10.1002/jmv.25757
  • Holshue ML, DeBolt C, Lindquist S, Lofy KH, Wiesman J, Bruce H, 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): 929-36. https://doi.org/10.1056/NEJMoa2001191.
  • 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. https://doi.org/10.1007/s00592-009-0109-4.
  • 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): 367-70. https://doi.org/ 10.1053/j.gastro.2020.03.055
  • McNabb-Baltar J, Jin DX, Grover AS, et al. Lipase Elevation in Patients with COVID-19. Am J Gastroenterol. 2020; 115(8): 1286-8. https://doi.org/10.14309/ajg.0000000000000732.
  • 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): 2128-30.e2. https://doi.org/10.1016/j.cgh.2020.04.040
  • Banks PA, Bollen TL, Dervenis C, Gooszen HG, Johnson CD, Sarr MG, 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. https://doi.org/10.1136/gutjnl-2012-302779.
  • Hadi A, Werge M, Kristiansen KT, Pedersen UG, Karstensen JG, Novovic S, et al. Coronavirus Disease-19 (COVID-19) associated with severe acute pancreatitis: Case report on three family members. Pancreatology. 2020; 20(4): 665-7.
  • 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.
  • Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020; 395(10223): 497-506. https://doi.org/ 10.1016/S0140-6736(20)30183-5.
  • de-Madaria E, Capurso G. COVID-19 and acute pancreatitis: examining the causality. Nat Rev Gastroenterol Hepatol. 2021; 18(1): 3-4. https://doi.org/10.1038/s41575-020-00389-y.
  • Banks PA, Bollen TL, Dervenis C, Gooszen HG, Johnson CD, Sarr MG, 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. https://doi.org/10.1136/gutjnl-2012-302779.
  • Lankisch PG, Apte M, Banks PA. Acute pancreatitis. Lancet 2015; 386:85–96. Erratum in: Lancet. 2015; 386: 2058.
  • Furong L, Xin L, Bixiang Z, Wanguang Z, Xiaoping C, Zhanguo Z. ACE2 Expression in pancreas may cause pancreatic damage after SARS-CoV-2 infection. Clin Gastroenterol Hepatol. 2020; 18: 2128-30.
  • Bruno G, Fabrizio C, Santoro CR, Buccoliero GB. Pancreatic injury in the course of coronavirus disease 2019 (COVID-19): a not-so-rare occurrence. J Med Virol. 2021; 93: 74-5.
  • Ebik B, Bacaksiz F, Ekin N. Does COVID-19 cause Pancreatitis? Arq Gastroenterol. 2022; 59(1): 71-4. https://doi.org/10.1590/S0004-2803.202200001-13.
  • Hanley B, Naresh KN, Roufosse C, Nicholson AG, Weir J, Cooke GS, et al. Histopathological findings and viral tropism in UK patients with severe fatal COVID-19: a post-mortem study. Lancet Microbe. 2020; 1: e245-e253.
  • Lax SF, Skok K, Zechner P, Kessler HH, Kaufmann N, Koelblinger C, et al. Pulmonary arterial thrombosis in COVID-19 with fatal outcome: results from a prospective, single-center, clinicopathologic case series. Ann Intern Med. 2020; 173: 350-61.
  • Bacaksız F, Ebik B, Ekin N, Kılıc J. Pancreatic damage in COVID-19: Why? How? Int J Clin Pract. 2021; 75(10): e14692. https://doi.org/10.1111/ijcp.14692.

The Frequency of Pancreatic Enzyme Elevations and Effect on Disease Severity in COVID-19

Year 2023, Volume: 13 Issue: 2, 209 - 215, 10.05.2023

Sevil Alkan Oruç Numan Gökçe Havva Yasemin Çinpolat

https://doi.org/10.33631/sabd.1199161

Abstract

Aim: In this study, we aimed to evaluate the frequency of pancreatic enzyme elevations in COVID-19-infected patients and to examine the effect on disease severity.
Material and Methods: A total of 1249 patients who hospitalized with COVID-19 infection were included. The frequency of pancreatic enzyme elevations and the effect on disease severity in patients infected with COVID-19 were investigated.
Results: The pancreatic enzyme elevations (amylase/lipase or both) were detected in 32 of 1249 patients (incidence 2.96%). 32 cases with a mean age of 64.97±5.63 years were included in this study. 30 (93.75%) of the cases were men’s gender. 31 (96.87%) of them had elevated amylase levels, 26 (81.25%) had elevated lipase levels and 25 (78.12%) of them had elevated both amylase and lipase levels. Only 10 (31.25%) of them tested radiological for acute pancreatitis (AP) and there was no radiological finding compatible with AP in any of the limited numbers of abdominal computerized tomography scans performed. 18 (56.25%) of the patients were transferred to the intensive care unit due to clinical worsening and mortality developed in 13 (40.62%) patients. The mean age of the deceased cases was 66.4±6.6 years and there was no statistically significant difference between deceased and survived COVID-19 patients (>0.05).
Conclusion: The median lymphocyte count was lower, and the median AST, ALT, and lipase levels were higher in the deceased group. Perhaps close clinical follow-up of patients with pathological findings in these values and radiological imaging, if necessary, may be beneficial in the method of the disease.
Keywords: COVID-19; disease severity; pancreatic enzyme elevations.

Keywords

COVID-19 pancreatic enzyme elevations disease severity

Project Number

yok

References

  • 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): 135-9.
  • Mazrouei SSA, Saeed GA, Al Helali AA. COVID-19-associated acute pancreatitis: a rare cause of acute abdomen. Radiol Case Rep. 2020;15(9):1601-3. https://doi.org/ 10.1016/j.radcr.2020.06.019.
  • 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: 51-5. https://doi.org/10.1016/j.jcv.2016.06.017.
  • Agzarian AE. Agzarian AY. Influenza A as a cause of acute pancreatitis: a case report. Proceedings of UCLA Healthcare. 2016; 20: 1-2.
  • Sullivan SJ, Jacobson RM, Dowdle WR, Poland GA. 2009 H1N1 influenza. Mayo Clin Proc. 2010; 85(1): 64-76. https://doi.org/10.4065/mcp.2009.0588.
  • https://covid19.who.int/who –Corona virüs disease (COVID-19) dashboard. Access date: January, 2021.
  • Li LQ, Huang T, Wang YQ, Wang ZP, Liang Y, Huang TB, et al. COVID-19 patients' clinical characteristics, discharge rate, and fatality rate of meta-analysis. J Med Virol. 2020; 92(6): 577-83. https://doi.org/10.1002/jmv.25757
  • Holshue ML, DeBolt C, Lindquist S, Lofy KH, Wiesman J, Bruce H, 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): 929-36. https://doi.org/10.1056/NEJMoa2001191.
  • 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. https://doi.org/10.1007/s00592-009-0109-4.
  • 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): 367-70. https://doi.org/ 10.1053/j.gastro.2020.03.055
  • McNabb-Baltar J, Jin DX, Grover AS, et al. Lipase Elevation in Patients with COVID-19. Am J Gastroenterol. 2020; 115(8): 1286-8. https://doi.org/10.14309/ajg.0000000000000732.
  • 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): 2128-30.e2. https://doi.org/10.1016/j.cgh.2020.04.040
  • Banks PA, Bollen TL, Dervenis C, Gooszen HG, Johnson CD, Sarr MG, 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. https://doi.org/10.1136/gutjnl-2012-302779.
  • Hadi A, Werge M, Kristiansen KT, Pedersen UG, Karstensen JG, Novovic S, et al. Coronavirus Disease-19 (COVID-19) associated with severe acute pancreatitis: Case report on three family members. Pancreatology. 2020; 20(4): 665-7.
  • 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.
  • Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020; 395(10223): 497-506. https://doi.org/ 10.1016/S0140-6736(20)30183-5.
  • de-Madaria E, Capurso G. COVID-19 and acute pancreatitis: examining the causality. Nat Rev Gastroenterol Hepatol. 2021; 18(1): 3-4. https://doi.org/10.1038/s41575-020-00389-y.
  • Banks PA, Bollen TL, Dervenis C, Gooszen HG, Johnson CD, Sarr MG, 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. https://doi.org/10.1136/gutjnl-2012-302779.
  • Lankisch PG, Apte M, Banks PA. Acute pancreatitis. Lancet 2015; 386:85–96. Erratum in: Lancet. 2015; 386: 2058.
  • Furong L, Xin L, Bixiang Z, Wanguang Z, Xiaoping C, Zhanguo Z. ACE2 Expression in pancreas may cause pancreatic damage after SARS-CoV-2 infection. Clin Gastroenterol Hepatol. 2020; 18: 2128-30.
  • Bruno G, Fabrizio C, Santoro CR, Buccoliero GB. Pancreatic injury in the course of coronavirus disease 2019 (COVID-19): a not-so-rare occurrence. J Med Virol. 2021; 93: 74-5.
  • Ebik B, Bacaksiz F, Ekin N. Does COVID-19 cause Pancreatitis? Arq Gastroenterol. 2022; 59(1): 71-4. https://doi.org/10.1590/S0004-2803.202200001-13.
  • Hanley B, Naresh KN, Roufosse C, Nicholson AG, Weir J, Cooke GS, et al. Histopathological findings and viral tropism in UK patients with severe fatal COVID-19: a post-mortem study. Lancet Microbe. 2020; 1: e245-e253.
  • Lax SF, Skok K, Zechner P, Kessler HH, Kaufmann N, Koelblinger C, et al. Pulmonary arterial thrombosis in COVID-19 with fatal outcome: results from a prospective, single-center, clinicopathologic case series. Ann Intern Med. 2020; 173: 350-61.
  • Bacaksız F, Ebik B, Ekin N, Kılıc J. Pancreatic damage in COVID-19: Why? How? Int J Clin Pract. 2021; 75(10): e14692. https://doi.org/10.1111/ijcp.14692.
There are 25 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Research Articles
Authors

Sevil Alkan 0000-0003-1944-2477

Oruç Numan Gökçe 0000-0002-9678-7818

Havva Yasemin Çinpolat 0000-0002-7161-2907

Project Number yok
Publication Date May 10, 2023
Submission Date November 3, 2022
Published in Issue Year 2023 Volume: 13 Issue: 2

Cite

Vancouver Alkan S, Gökçe ON, Çinpolat HY. The Frequency of Pancreatic Enzyme Elevations and Effect on Disease Severity in COVID-19. VHS. 2023;13(2):209-15.
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