Acute pancreatitis and its impact in COVID-19 pandemic: A prospective study
Sathik, Balraj, Deepan Karthick, Rajmohan, JA Jayalal
Coronavirus disease 2019 (COVID-19) caused by the novel SARS-COV-2 typically presents with pulmonary symptoms and complications. However various extrapulmonary manifestations and resultant complications are studied and reported. Extra-pulmonary symptomatology of COVID-19 has drawn significant attention. One among this in the Gastroenterology is Pancreatitis but it is rare. However, the general incidence of Pancreatitis have shown a upward trend in the pandemic with increased amount of use of alcohol adulterated and spurious it is mandatory to check for all cases presenting with signs and symptoms of acute pancreatitis with COVID testing and aggressive conservative management. Material and Methods: It is a prospectivestudy enrolling all the first 50 patients presented with symptoms of acute pancreatitis from April 2020 to July 2020 in the department of surgery Tirunelveli medical college hospital. Cases were studied with reference to clinical/biochemical/radiological signs of pancreatitis. Treatment was planned according to the severity of pancreatitis and presence or absence of complications with either conservative or surgical methods. All patients were taken RT-PCR swab testing to confirm the presence or absence of the SARS-COV -2 infections. Patients were followed up for 1 month to look for recurrence or complications developing after discharge. Results: 82% patients were male and 18 % female. The highest incidence was noted in 30-50 years age group (mean – 43.5 years, Median 44 yrs., Standard deviation 11.342). More common among unskilled workers. Alcohol was the most common cause (58% patients). Abdominal pain is the most common mode of presentation (90%), and epigastric tenderness is most common sign (90%). All the patients except one were managed conservatively. Three patients (6%) tested positive for COVID -19 and they had conservative management. 30% cases had moderate,12% had severe and 58% cases had mild pancreatitis. Comorbidity was present with Hypertension in 32%, Diabetes 22% and 36% presented without any comorbidity. Morality was 2% in our study. Conclusions: The accurate diagnosis and aggressive management of acute pancreatitis in COVID-19 patients are mandatory to prevent the double-blind impact on the target organs. All cases of acute pancreatitis shall be evaluated for COVID-19 infection also to plan for treatment protocol and surgeons should adhere to safety protocols. The possible association between COVID-19 and pancreas at some point of time during its course, should be kept in mind and diagnosis shall not depend upon isolated raise of pancreatic enzyme.