Low Frequency of Acute Pancreatitis in Hospitalized COVID-19 Patients
Low Frequency of Acute Pancreatitis in Hospitalized COVID-19 Patients
复制标题
DOI：
10.1097/mpa.0000000000001770
复制
发表时间：
2021-03-01
期刊：
影响因子：
2.9
通讯作者：
Blanco, Giovanna Del Vecchio
中科院分区：
文献类型：
--
作者：
Troncone, Edoardo;Salvatori, Silvia;Blanco, Giovanna Del Vecchio
目的2019冠状病毒病（COVID-19）患者血清胰腺酶（PE）升高的临床意义尚未完全了解。我们的目的是研究此类患者PE升高和急性胰腺炎的频率及其对临床结局的影响。方法分析罗马Tor Vergata医院收治的COVID-19患者的临床数据、实验室检查和横断面图像。通过单变量和多变量分析和考克斯比例风险模型研究与PE异常、重症监护室（ICU）入院或死亡相关的变量。结果282例COVID-19患者中有254例可获得胰酶。PE轻度升高66例（26%），重度升高11例（4.3%）。总体而言，2例患者符合急性胰腺炎的诊断标准。肝和肾受累与PE升高相关。多变量分析显示，轻度和重度PE升高与ICU入院显著相关（比值比，5.51 [95%置信区间，2.36-12.89; P < 0.0001]和26.2 [95%置信区间，4.82-142.39; P < 0.0001]）。结论在COVID-19住院患者中，血清PE升高（而非急性胰腺炎）较为常见，且与ICU入院相关。
Objective The clinical significance of increased serum pancreatic enzymes (PEs) in coronavirus disease 2019 (COVID-19) patients has not yet been fully understood. We aimed to investigate the frequency and the impact on clinical outcome of PE elevation and acute pancreatitis in such patients. Methods Clinical data, laboratory tests, and cross-sectional images were analyzed from COVID-19 patients admitted to the Tor Vergata Hospital in Rome. Variables associated with PE abnormalities, intensive care unit (ICU) admission, or death were investigated through univariate and multivariate analyses and Cox proportional hazard model. Results Pancreatic enzymes were available in 254 of 282 COVID-19 patients. Among these, 66 patients (26%) showed mild elevation of PE, and 11 patients (4.3%) had severe elevation (>3 times of the upper limit of normal). Overall, 2 patients met the diagnostic criteria for acute pancreatitis. Hepatic and renal involvements were associated with PE elevation. Multivariate analysis showed that mild and severe PE elevations were significantly associated with ICU admission (odds ratios, 5.51 [95% confidence interval, 2.36-12.89; P < 0.0001] and 26.2 [95% confidence interval, 4.82-142.39; P < 0.0001]). Conclusions Increase in serum PE, but not acute pancreatitis, is frequent in hospitalized COVID-19 patients and associates with ICU admission.