Mild pancreatic injury in patients with COVID-19 pneumonia

Patients with coronavirus disease 2019 (COVID-19) pneumonia appear to exhibit potential mild pancreatic injury patterns, which may be linked to direct viral involvement of the pancreas or to secondary enzyme abnormalities in the setting of severe illness without extensive pancreatic injury, as reported in a study.

Researchers looked at 52 patients with COVID-19 pneumonia. All patients underwent a comprehensive examination, including blood cytology, biochemistry and inflammatory indicators.

In the cohort, the incidence was 33 percent for heart injury (abnormal LDH or creatine kinase), 29 percent for liver injury (any abnormality in AST, ALT, GGT or ALP), 17 percent for pancreatic injury, 8 percent for renal injury (abnormal creatinine), and 2 percent for diarrhoea. Average age of the nine patients with pancreatic injury was 55 years. Pancreatic injury was defined as any abnormality in amylase (normal range, 0–90 U/L) or lipase (0–70 U/L).

Patients with vs without pancreatic injury were more likely to have anorexia and diarrhoea, severer illness on admission, lower level of CD3+ T-cell and CD4+ T-cell, and higher levels of aspartate aminotransferase, γ-glutamyl transferase, creatinine, lactate dehydrogenase and erythrocyte sedimentation rate. There were no significant between-group differences in corticosteroid treatment, mechanical ventilation and virus negative conversion time.

The present data do not demonstrate clinically severe pancreatitis as a common manifestation, the researchers said. More studies are needed to evaluate whether a subset of patients have clinical pancreatitis as a presenting or concomitant disease entity.