Abstract
Background: Pancreatic enzyme elevation has been reported in patients with COVID-19 during the pandemic. However, with the shortage of medical resources and information, several challenges are faced in the examination and treatment of this condition in COVID-19 patients. There is little information on whether such condition is caused by pancreatic injury, and if this is a warning sign of life threatening complications like multiple organ failure in patients. The objective of this study is to explore the relationship between elevated pancreatic enzymes and the underlying risk factors during the management of COVID-19 patients.Method: A total of 55 COVID-19 patients admitted to the intensive care unit (ICU) of Wuhan Jinyintan hospital from January 1 to March 30, 2020 were enrolled in this study. All participants underwent transabdominal ultrasound imaging to assess their pancreas.Results: Out of the 55 patients, three patients had pancreatitis, 29 (52.7%) with elevated pancreatic enzymes, and 23 (41.8%) without. The most common symptoms of patients with COVID-19 were fever and cough. There was no statistical difference in most baseline characteristics except myalgia on admission. Compared with those having normal enzyme levels, patients with elevated pancreatic enzymes had higher rates of mortality (79.3 vs. 52.2%; P = 0.038), and lower rates of discharge (20.7 vs. 47.8%; P = 0.038). Patients with elevated enzymes had higher incidence of mechanical ventilation (P = 0.004) and kidney injury (P = 0.042) than patients without elevated pancreatic enzymes. The results of multivariable logistic analysis showed that the odds ratio were 10.202 (P = 0.002) for mechanical ventilation and 7.673 (P = 0.014) for kidney injury with the elevated enzymes vs. the normal conditions.Conclusions: The findings show that the incidences of pancreatic enzymes elevation are not low in critical COVID-19 patients and only a few of them progressed to acute pancreatitis (AP). Increased pancreatic enzymes levels is associated with poor prognosis in COVID-19 patients. In addition, the kidney injury and oxygenation degradation are associated with the pancreatic enzymes elevation in COVID-19 patients.
Highlights
There was reported outbreak of a typical pneumonia-like respiratory disease in Wuhan, Hubei, China, that quickly spread all over the country and the world
It binds with ACE2 receptors more strongly and this facilitates its quick entry to human cells [7]
There were no significant differences in the inflammatory indicators, such as C-reactive protein (CRP), PCT, erythrocyte sedimentation rate (ESR), and interleukin 6 (IL-6), blood coagulation functions, as well as blood biochemistry among the 55 patients with COVID-19
Summary
There was reported outbreak of a typical pneumonia-like respiratory disease in Wuhan, Hubei, China, that quickly spread all over the country and the world. Similar to SARS-COV and MERS-COV, SARS-CoV-2 enters the human body cells through spike protein to combine with the angiotensinconverting enzyme-2 (ACE-2) receptor [2,3,4]. Both SARS-CoV-2 and SRAS-COV have spike proteins sharing a high degree of homology in sequences and a number of amino acids [5, 6]. It is suspected that SARS-CoV-2 has higher and more efficient ability to identify human ACE2 receptor than SARSCOV. The objective of this study is to explore the relationship between elevated pancreatic enzymes and the underlying risk factors during the management of COVID-19 patients
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