SARS-CoV-2 infection in acute pancreatitis increases disease severity and 30 day mortality: Results of the COVID PAN collaborative study

ABSTRACT NUMBER: NESS PRIZE FOR JUNIOR TRAINEES (BELOW ST3)_1

 

AUTHOR
Ghazaleh Mohammadi-Zaniani

MAIN ABSTRACT TEXT

Introduction
There is emerging evidence that the pancreas may be a target organ of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection. This aim of this study was to investigate the outcome of patients with acute pancreatitis (AP) and co existent SARS-CoV-2 infection.

Methods
A prospective international multicenter cohort study including consecutive patients admitted with AP during the current pandemic was undertaken. Primary outcome measure was severity of AP. Secondary outcome measures were aetiology of AP, intensive care unit (ICU) admission, length of hospital stay, local complications, acute respiratory distress syndrome (ARDS), persistent organ failure and 30-day mortality. Multilevel logistic regression was used to compare the two groups.

Results
1777 patients with AP were included during the study period from 1st March to 23rd July 2020. 149 patients (8.3%) had concomitant SARS-CoV-2 infection. Overall, SARS-CoV-2 positive patients were older male patients and more likely to develop severe AP and ARDS (p<0.001). Unadjusted analysis showed that SARS-CoV-2 positive patients with AP were more likely to require ICU admission [Odds ratio (OR) 5.21, p<0.001], local complications [OR 2.91, p<0.001], persistent organ failure [OR 7.32, p<0.001], prolonged hospital stay [OR 1.89, p<0.001] and a higher 30-day mortality [OR 6.56, p<0.001]. Adjusted analysis showed length of stay [OR 1.32, p<0.001], persistent organ failure [OR 2.77, p<0.003] and 30-day mortality [OR 2.41, p<0.04] were significantly higher in SARS-CoV-2 co-infection.

Conclusion
Patients with AP and coexistent SARS-CoV-2 infection are at increased risk of severe AP, persistent organ failure, prolonged length of hospital stay and high 30-day mortality.