A case-control emergency department-based analysis of acute pancreatitis in Covid-19: Results of the UMC-19-S6
A case-control emergency department-based analysis of acute pancreatitis in Covid-19: Results of the UMC-19-S6
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DOI：
10.1002/jhbp.873
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发表时间：
2021-01-07
影响因子：
3
通讯作者：
Gonzalez del Castillo, Juan
中科院分区：
文献类型：
--
作者：
Miro, Oscar;Llorens, Pere;Gonzalez del Castillo, Juan
背景/目的：我们调查了急性胰腺炎（AP）的发病率，危险因素，临床特征和结果的COVID-19患者参加急诊科（艾德），住院前。方法：我们回顾性分析了所有COVID患者诊断为AP在62西班牙ED（20%的西班牙ED，COVID-AP）在COVID爆发期间。我们形成了两个对照组：没有AP的COVID患者（COVID-非AP）和患有AP的非COVID患者（non-COVID-AP）。对病例和对照组之间的59个基线和临床特征以及4个outcome.Results进行了未经调整的比较：我们在参加艾德的74814名COVID-19患者中确定了54例AP（频率= 0.72千分之0.72，95%CI = 0.54-0.94千分之0.94）。该频率低于非COVID患者（2231/1388879，1.61份/千，95%CI = 1.54-1.67; OR = 0.44，95%CI = 0.34-0.58）。两组AP的病因相似，约50%为胆源性。新冠肺炎患者的26种临床特征与AP发生风险较高相关：腹痛（OR = 59.4，95%CI = 23.7-149），血淀粉酶升高（OR = 31.8，95% CI = 1.60 ~ 632）和呕吐（OR = 15.8，95% CI = 6.69-37.2）的发生率最高，部分炎性标志物（C反应蛋白、降钙素原、血小板、D二聚体）升高较多。与非COVID-AP患者相比，COVID-AP患者在23个变量上存在差异;最强的变量与COVID症状相关，但报告的腹痛较少，胰腺酶升高较低，严重程度（根据艾德到达时的BISAP和SOFA评分估计）较高。COVID-AP的住院死亡率（经年龄和性别调整）与COVID-非AP没有差异（OR = 1.12，95% CI = 0.45-245），但高于非COVID-AP（OR = 2.46，95% CI = 1.35-4.48）。结论：急性胰腺炎作为COVID-19在艾德的表现形式是不寻常的（
Background/Purpose: We investigated the incidence, risk factors, clinical characteristics and outcomes of acute pancreatitis (AP) in patients with COVID-19 attending the emergency department (ED), before hospitalization.Methods: We retrospectively reviewed all COVID patients diagnosed with AP in 62 Spanish EDs (20% of Spanish EDs, COVID-AP) during the COVID outbreak. We formed two control groups: COVID patients without AP (COVID-non-AP) and non-COVID patients with AP (non-COVID-AP). Unadjusted comparisons between cases and controls were performed regarding 59 baseline and clinical characteristics and four outcomes.Results: We identified 54 AP in 74 814 patients with COVID-19 attending the ED (frequency = 0.72 parts per thousand, 95% CI = 0.54-0.94 parts per thousand). This frequency was lower than in non-COVID patients (2231/1 388 879, 1.61 parts per thousand, 95% CI = 1.54-1.67; OR = 0.44, 95% CI = 0.34-0.58). Etiology of AP was similar in both groups, being biliary origin in about 50%. Twenty-six clinical characteristics of COVID patients were associated with a higher risk of developing AP: abdominal pain (OR = 59.4, 95% CI = 23.7-149), raised blood amylase (OR = 31.8; 95% CI = 1.60-632) and vomiting (OR = 15.8, 95% CI = 6.69-37.2) being the strongest, and some inflammatory markers (C-reactive protein, procalcitonin, platelets, D-dimer) were more increased. Compared to non-COVID-AP, COVID-AP patients differed in 23 variables; the strongest ones related to COVID symptoms, but less abdominal pain was reported, pancreatic enzymes raise was lower, and severity (estimated by BISAP and SOFA score at ED arrival) was higher. The in-hospital mortality (adjusted for age and sex) of COVID-AP did not differ from COVID-non-AP (OR = 1.12, 95% CI = 0.45-245) but was higher than non-COVID-AP (OR = 2.46, 95% CI = 1.35-4.48).Conclusions: Acute pancreatitis as presenting form of COVID-19 in the ED is unusual (