tetano
Editor, Senior Moderator
World J Gastroenterol
. 2022 May 21;28(19):2034-2056.
doi: 10.3748/wjg.v28.i19.2034.
Review on acute pancreatitis attributed to COVID-19 infection
Takumi Onoyama[SUP] 1 [/SUP], Hiroki Koda[SUP] 2 [/SUP], Wataru Hamamoto[SUP] 2 [/SUP], Shiho Kawahara[SUP] 2 [/SUP], Yuri Sakamoto[SUP] 2 [/SUP], Taro Yamashita[SUP] 2 [/SUP], Hiroki Kurumi[SUP] 2 [/SUP], Soichiro Kawata[SUP] 2 [/SUP], Yohei Takeda[SUP] 2 [/SUP], Kazuya Matsumoto[SUP] 2 [/SUP], Hajime Isomoto[SUP] 2 [/SUP]
Affiliations
Abstract
The coronavirus disease 2019 (COVID-19) is known to cause gastrointestinal symptoms. Recent studies have revealed COVID-19-attributed acute pancreatitis (AP). However, clinical characteristics of COVID-19-attributed AP remain unclear. We performed a narrative review to elucidate relation between COVID-19 and AP using the PubMed database. Some basic and pathological reports revealed expression of angiotensin-converting enzyme 2 and transmembrane protease serine 2, key proteins that aid in the entry of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) into the pancreas. The experimental and pathological evaluation suggested that SARS-CoV-2 infects human endocrine and exocrine pancreas cells, and thus, SARS-CoV-2 may have a direct involvement in pancreatic disorders. Additionally, systemic inflammation, especially in children, may cause AP. Levels of immune mediators associated with AP, including interleukin (IL)-1β, IL-10, interferon-γ, monocyte chemotactic protein 1, and tumor necrosis factor-α are higher in the plasma of patients with COVID-19, that suggests an indirect involvement of the pancreas. In real-world settings, some clinical features of AP complicate COVID-19, such as a high complication rate of pancreatic necrosis, severe AP, and high mortality. However, clinical features of COVID-19-attributed AP remain uncertain due to insufficient research on etiologies of AP. Therefore, high-quality clinical studies and case reports that specify methods for differential diagnoses of other etiologies of AP are needed.
Keywords: COVID-19; Etiology; Pancreatitis; Prognosis; Revised atlanta classification; SARS-CoV-2.
. 2022 May 21;28(19):2034-2056.
doi: 10.3748/wjg.v28.i19.2034.
Review on acute pancreatitis attributed to COVID-19 infection
Takumi Onoyama[SUP] 1 [/SUP], Hiroki Koda[SUP] 2 [/SUP], Wataru Hamamoto[SUP] 2 [/SUP], Shiho Kawahara[SUP] 2 [/SUP], Yuri Sakamoto[SUP] 2 [/SUP], Taro Yamashita[SUP] 2 [/SUP], Hiroki Kurumi[SUP] 2 [/SUP], Soichiro Kawata[SUP] 2 [/SUP], Yohei Takeda[SUP] 2 [/SUP], Kazuya Matsumoto[SUP] 2 [/SUP], Hajime Isomoto[SUP] 2 [/SUP]
Affiliations
- PMID: 35664035
- PMCID: PMC9134139
- DOI: 10.3748/wjg.v28.i19.2034
Abstract
The coronavirus disease 2019 (COVID-19) is known to cause gastrointestinal symptoms. Recent studies have revealed COVID-19-attributed acute pancreatitis (AP). However, clinical characteristics of COVID-19-attributed AP remain unclear. We performed a narrative review to elucidate relation between COVID-19 and AP using the PubMed database. Some basic and pathological reports revealed expression of angiotensin-converting enzyme 2 and transmembrane protease serine 2, key proteins that aid in the entry of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) into the pancreas. The experimental and pathological evaluation suggested that SARS-CoV-2 infects human endocrine and exocrine pancreas cells, and thus, SARS-CoV-2 may have a direct involvement in pancreatic disorders. Additionally, systemic inflammation, especially in children, may cause AP. Levels of immune mediators associated with AP, including interleukin (IL)-1β, IL-10, interferon-γ, monocyte chemotactic protein 1, and tumor necrosis factor-α are higher in the plasma of patients with COVID-19, that suggests an indirect involvement of the pancreas. In real-world settings, some clinical features of AP complicate COVID-19, such as a high complication rate of pancreatic necrosis, severe AP, and high mortality. However, clinical features of COVID-19-attributed AP remain uncertain due to insufficient research on etiologies of AP. Therefore, high-quality clinical studies and case reports that specify methods for differential diagnoses of other etiologies of AP are needed.
Keywords: COVID-19; Etiology; Pancreatitis; Prognosis; Revised atlanta classification; SARS-CoV-2.