Saint Michael's Medical Center Newark, NJ, United States
Raed Atiyat, MD1, Hannah Beachwood, 2, Kok Hoe Chan, MD1, Samir Elias, MPH3, Yatinder Bains, MD1, Theodore Dacosta, MD1, Mehul Shah, MD1 1Saint Michael's Medical Center, Newark, NJ; 2University of New England College of Osteopathic Medicine, Newark, NJ; 3St. George's University, Clifton, NJ
Introduction: COVID-19 has been associated with multi-organ failure either due to direct virus invasion and/or cytokine storm. Nonetheless, the exact incidence of pancreatitis and lipase elevation in patients with COVID-19 is poorly understood. Herein, we want to investigate the incidence of elevated lipase and pancreatitis in patients with COVID-19.
Methods: A retrospective study was performed on patients ≥18 years old with confirmed COVID-19 admitted to our hospital between March 2020 and May 2020. Clinical characteristics and outcome were reviewed. Individuals without complete laboratory parameters were excluded from the study.Continuous data was expressed as percentages or mean. The chi-square (χ) test was used to identify the associations between categorical variables. PRISM statistical software was used for all data analysis.
Results: The total number of study participants was 276, after excluding individuals without complete laboratory parameters and clear clinical outcome. The upper normal limit (ULN) of lipase in our institution was 393 U/L. The average of lipase in the study participants were 372.9 ± 1448. The total number of patients with >3 times the ULN of lipase was 6 with an incidence of 2.17%. 5 out of 6 patients expired with lipase levels ≥1200, 3 of those patients (incidence 1.1%) had documented pancreatitis with either abnormal computed tomography and/or typical abdominal pain. With a cut off 590 U/L (1.5 times the ULN), the number of patients was 26, 17 of those expired. Comparing to patients without lipase elevation, elevated lipase ( >1.5X ULN) was significantly associated with increased risk of mortality [odds ratio (PR)6.115, 95% confidence interval (CI) 2.707-14.87, p value < 0.0001)
Discussion: The exact pathophysiology and interplays between COVID-19 and pancreatic injury are poorly understood. The incidence of pancreatitis is rather low (1.1%) in patients with COVID-19. Nonetheless, elevated lipase in our study was significantly associated with poor clinical outcome with an OR of 6.115. Large studies needed to corroborate the relationship between lipase and mortality in COVID-19 patients.
Raed Atiyat indicated no relevant financial relationships.
Hannah Beachwood indicated no relevant financial relationships.
Kok Hoe Chan indicated no relevant financial relationships.
Samir Elias indicated no relevant financial relationships.
Yatinder Bains indicated no relevant financial relationships.
Theodore Dacosta indicated no relevant financial relationships.
Mehul Shah indicated no relevant financial relationships.
Raed Atiyat, MD1, Hannah Beachwood, 2, Kok Hoe Chan, MD1, Samir Elias, MPH3, Yatinder Bains, MD1, Theodore Dacosta, MD1, Mehul Shah, MD1. P2123 - Pancreatic Injury and Elevated Lipase Associated With COVID-19: A Retrospective Cohort Analysis, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.