Acute pancreatitis in a COVID-19 patient in Brazil: a case report

• Published in: Journal of medical case reports 2021-10, Vol.15 (1), p.1-541, Article 541
• Main Authors: da Costa Ferreira, Caroline Petersen, Marques, Kalynne Rodrigues, de Mattos, Gustavo Henrique Ferreira, de Campos, Tércio
• Format: Article
• Language: English
• Subjects: Abdomen; Acute pancreatitis; Alcohol; Amylases; Body mass index; Case Report; Case reports; Coronaviruses; COVID-19; Development and progression; Disease transmission; Endoscopy; Epidemics; Etiology; Gallbladder; Gallstones; Health aspects; Hypercalcemia; Intensive care; Literature reviews; Medical research; Medicine, Experimental; Pain; Pancreas; Pancreatic involvement in COVID-19; Pancreatitis; Pancreatitis in COVID-19; Pandemics; Patients; Respiratory diseases; Severe acute respiratory syndrome; Severe acute respiratory syndrome coronavirus 2; Trauma; Viruses
• ISSN: 1752-1947; 1752-1947
• DOI: 10.1186/s13256-021-02911-5

Background The consequences of the coronavirus disease 2019 pandemic have already exceeded 10 million infected and more than 560,000 deaths worldwide since its inception. Currently, it is known that the disease affects mainly the respiratory system; however, recent studies have shown an increase in the number of patients with manifestations in other systems, including gastrointestinal manifestations. There is a lack of literature regarding the development of acute pancreatitis as a complication of coronavirus disease 2019. Case report We report a case of acute pancreatitis in a white male patient with coronavirus disease 2019. A 35-year-old man (body mass index 31.5) had acute epigastric pain radiating to his back, dyspnea, nausea, and vomiting for 2 days. The patient was diagnosed with severe acute pancreatitis (AP)-APACHE II: 5, SOFA: 3, Marshall: 0; then he was transferred from ED to the semi-intensive care unit. He tested positive for severe acute respiratory syndrome coronavirus 2 on reverse transcription-polymerase chain reaction, and his chest computed tomography findings were compatible with coronavirus disease 2019. Treatment was based on bowel rest, fluid resuscitation, analgesia, and empiric antibiotic therapy. At day 12, with resolution of abdominal pain and improvement of the respiratory condition, the patient was discharged. Conclusion Since there is still limited evidence of pancreatic involvement in severe acute respiratory syndrome coronavirus 2 infection, no definite conclusion can be made. Given the lack of other etiology, we consider the possibility that the patient's acute pancreatitis could be secondary to coronavirus disease 2019 infection, and we suggest investigation of pancreas-specific plasma amylase in patients with coronavirus disease 2019 and abdominal pain. Keywords: Acute pancreatitis, Pancreatitis in COVID-19, Pancreatic involvement in COVID-19, Case report