SARS-CoV-2 infection in acute pancreatitis increases disease severity and 30-day mortality: COVID PAN collaborative study

Sanjay Pandanaboyana; John Moir; John S. Leeds; Kofi Oppong; Aditya Kanwar; Ahmed Marzouk; Ajay Belgaumkar; Ajay Gupta; Ajith K. Siriwardena; Ali Raza Haque; Altaf Awan; Anita Balakrishnan; Arab Rawashdeh; Bogdan Ivanov; Chetan Parmar; Christopher M Halloran; Clifford Caruana; Cynthia Michelle Borg; Dhanny Gomez; Dimitrios Damaskos; Dimitrios Karavias; Guy Finch; Husam Ebied; James K. Pine; James R.A. Skipworth; James Milburn; Javed Latif; Jeyakumar Ratnam Apollos; Jihène El Kafsi; John A. Windsor; Keith Roberts; Kelvin Wang; Krish Ravi; Maria V. Coats; Marianne Hollyman; Mary Phillips; Michael Okocha; Michael Sj Wilson; Nadeem A. Ameer; Nagappan Kumar; Nehal Shah; Pierfrancesco Lapolla; Connor Magee; Bilal Al-Sarireh; Raimundas Lunevicius; Rami Benhmida; Rishi Singhal; Srinivasan Balachandra; Semra Demirli Atlcl; Shameen Jaunoo; Simon Dwerryhouse; Tamsin Boyce; Vasileios Charalampakis; Venkat Kanakala; Zaigham Abbas; Manu Nayar

doi:10.1136/gutjnl-2020-323364

SARS-CoV-2 infection in acute pancreatitis increases disease severity and 30-day mortality: COVID PAN collaborative study

Sanjay Pandanaboyana, John Moir, John S. Leeds, Kofi Oppong, Aditya Kanwar, Ahmed Marzouk, Ajay Belgaumkar, Ajay Gupta, Ajith K. Siriwardena, Ali Raza Haque, Altaf Awan, Anita Balakrishnan, Arab Rawashdeh, Bogdan Ivanov, Chetan Parmar, Christopher M Halloran, Clifford Caruana, Cynthia Michelle Borg, Dhanny Gomez, Dimitrios DamaskosDimitrios Karavias, Guy Finch, Husam Ebied, James K. Pine, James R.A. Skipworth, James Milburn, Javed Latif, Jeyakumar Ratnam Apollos, Jihène El Kafsi, John A. Windsor, Keith Roberts, Kelvin Wang, Krish Ravi, Maria V. Coats, Marianne Hollyman, Mary Phillips, Michael Okocha, Michael Sj Wilson, Nadeem A. Ameer, Nagappan Kumar, Nehal Shah, Pierfrancesco Lapolla, Connor Magee, Bilal Al-Sarireh, Raimundas Lunevicius, Rami Benhmida, Rishi Singhal, Srinivasan Balachandra, Semra Demirli Atlcl, Shameen Jaunoo, Simon Dwerryhouse, Tamsin Boyce, Vasileios Charalampakis, Venkat Kanakala, Zaigham Abbas, Manu Nayar

Research output: Contribution to journal › Article › peer-review

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Abstract

Objective There is emerging evidence that the pancreas may be a target organ of SARS-CoV-2 infection. This aim of this study was to investigate the outcome of patients with acute pancreatitis (AP) and coexistent SARS-CoV-2 infection. Design A prospective international multicentre cohort study including consecutive patients admitted with AP during the current pandemic was undertaken. Primary outcome measure was severity of AP. Secondary outcome measures were aetiology of AP, intensive care unit (ICU) admission, length of hospital stay, local complications, acute respiratory distress syndrome (ARDS), persistent organ failure and 30-day mortality. Multilevel logistic regression was used to compare the two groups. Results 1777 patients with AP were included during the study period from 1 March to 23 July 2020. 149 patients (8.3%) had concomitant SARS-CoV-2 infection. Overall, SARS-CoV-2-positive patients were older male patients and more likely to develop severe AP and ARDS (p<0.001). Unadjusted analysis showed that SARS-CoV-2-positive patients with AP were more likely to require ICU admission (OR 5.21, p<0.001), local complications (OR 2.91, p<0.001), persistent organ failure (OR 7.32, p<0.001), prolonged hospital stay (OR 1.89, p<0.001) and a higher 30-day mortality (OR 6.56, p<0.001). Adjusted analysis showed length of stay (OR 1.32, p<0.001), persistent organ failure (OR 2.77, p<0.003) and 30-day mortality (OR 2.41, p<0.04) were significantly higher in SARS-CoV-2 co-infection. Conclusion Patients with AP and coexistent SARS-CoV-2 infection are at increased risk of severe AP, worse clinical outcomes, prolonged length of hospital stay and high 30-day mortality.

Original language	English
Pages (from-to)	1061-1069
Number of pages	9
Journal	Gut
Volume	70
Issue number	6
DOIs	https://doi.org/10.1136/gutjnl-2020-323364
Publication status	Published - 1 Jun 2021
Externally published	Yes

Keywords

COVID-19
acute pancreatitis
pancreatitis

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10.1136/gutjnl-2020-323364

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Pandanaboyana, S., Moir, J., Leeds, J. S., Oppong, K., Kanwar, A., Marzouk, A., Belgaumkar, A., Gupta, A., Siriwardena, A. K., Haque, A. R., Awan, A., Balakrishnan, A., Rawashdeh, A., Ivanov, B., Parmar, C., M Halloran, C., Caruana, C., Borg, C. M., Gomez, D., ... Nayar, M. (2021). SARS-CoV-2 infection in acute pancreatitis increases disease severity and 30-day mortality: COVID PAN collaborative study. Gut, 70(6), 1061-1069. https://doi.org/10.1136/gutjnl-2020-323364

@article{7fcf42a901af48b793f2e6c5a34fb7c9,

title = "SARS-CoV-2 infection in acute pancreatitis increases disease severity and 30-day mortality: COVID PAN collaborative study",

abstract = "Objective There is emerging evidence that the pancreas may be a target organ of SARS-CoV-2 infection. This aim of this study was to investigate the outcome of patients with acute pancreatitis (AP) and coexistent SARS-CoV-2 infection. Design A prospective international multicentre cohort study including consecutive patients admitted with AP during the current pandemic was undertaken. Primary outcome measure was severity of AP. Secondary outcome measures were aetiology of AP, intensive care unit (ICU) admission, length of hospital stay, local complications, acute respiratory distress syndrome (ARDS), persistent organ failure and 30-day mortality. Multilevel logistic regression was used to compare the two groups. Results 1777 patients with AP were included during the study period from 1 March to 23 July 2020. 149 patients (8.3%) had concomitant SARS-CoV-2 infection. Overall, SARS-CoV-2-positive patients were older male patients and more likely to develop severe AP and ARDS (p<0.001). Unadjusted analysis showed that SARS-CoV-2-positive patients with AP were more likely to require ICU admission (OR 5.21, p<0.001), local complications (OR 2.91, p<0.001), persistent organ failure (OR 7.32, p<0.001), prolonged hospital stay (OR 1.89, p<0.001) and a higher 30-day mortality (OR 6.56, p<0.001). Adjusted analysis showed length of stay (OR 1.32, p<0.001), persistent organ failure (OR 2.77, p<0.003) and 30-day mortality (OR 2.41, p<0.04) were significantly higher in SARS-CoV-2 co-infection. Conclusion Patients with AP and coexistent SARS-CoV-2 infection are at increased risk of severe AP, worse clinical outcomes, prolonged length of hospital stay and high 30-day mortality.",

keywords = "COVID-19, acute pancreatitis, pancreatitis",

author = "Sanjay Pandanaboyana and John Moir and Leeds, {John S.} and Kofi Oppong and Aditya Kanwar and Ahmed Marzouk and Ajay Belgaumkar and Ajay Gupta and Siriwardena, {Ajith K.} and Haque, {Ali Raza} and Altaf Awan and Anita Balakrishnan and Arab Rawashdeh and Bogdan Ivanov and Chetan Parmar and {M Halloran}, Christopher and Clifford Caruana and Borg, {Cynthia Michelle} and Dhanny Gomez and Dimitrios Damaskos and Dimitrios Karavias and Guy Finch and Husam Ebied and Pine, {James K.} and Skipworth, {James R.A.} and James Milburn and Javed Latif and {Ratnam Apollos}, Jeyakumar and {El Kafsi}, Jih{\`e}ne and Windsor, {John A.} and Keith Roberts and Kelvin Wang and Krish Ravi and Coats, {Maria V.} and Marianne Hollyman and Mary Phillips and Michael Okocha and Wilson, {Michael Sj} and Ameer, {Nadeem A.} and Nagappan Kumar and Nehal Shah and Pierfrancesco Lapolla and Connor Magee and Bilal Al-Sarireh and Raimundas Lunevicius and Rami Benhmida and Rishi Singhal and Srinivasan Balachandra and {Demirli Atlcl}, Semra and Shameen Jaunoo and Simon Dwerryhouse and Tamsin Boyce and Vasileios Charalampakis and Venkat Kanakala and Zaigham Abbas and Manu Nayar",

note = "Publisher Copyright: {\textcopyright} 2021 Author(s) (or their employer(s)).",

year = "2021",

month = jun,

day = "1",

doi = "10.1136/gutjnl-2020-323364",

language = "English",

volume = "70",

pages = "1061--1069",

journal = "Gut",

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publisher = "BMJ Publishing Group",

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Pandanaboyana, S, Moir, J, Leeds, JS, Oppong, K, Kanwar, A, Marzouk, A, Belgaumkar, A, Gupta, A, Siriwardena, AK, Haque, AR, Awan, A, Balakrishnan, A, Rawashdeh, A, Ivanov, B, Parmar, C, M Halloran, C, Caruana, C, Borg, CM, Gomez, D, Damaskos, D, Karavias, D, Finch, G, Ebied, H, Pine, JK, Skipworth, JRA, Milburn, J, Latif, J, Ratnam Apollos, J, El Kafsi, J, Windsor, JA, Roberts, K, Wang, K, Ravi, K, Coats, MV, Hollyman, M, Phillips, M, Okocha, M, Wilson, MS, Ameer, NA, Kumar, N, Shah, N, Lapolla, P, Magee, C, Al-Sarireh, B, Lunevicius, R, Benhmida, R, Singhal, R, Balachandra, S, Demirli Atlcl, S, Jaunoo, S, Dwerryhouse, S, Boyce, T, Charalampakis, V, Kanakala, V, Abbas, Z & Nayar, M 2021, 'SARS-CoV-2 infection in acute pancreatitis increases disease severity and 30-day mortality: COVID PAN collaborative study', Gut, vol. 70, no. 6, pp. 1061-1069. https://doi.org/10.1136/gutjnl-2020-323364

TY - JOUR

T1 - SARS-CoV-2 infection in acute pancreatitis increases disease severity and 30-day mortality

T2 - COVID PAN collaborative study

AU - Pandanaboyana, Sanjay

AU - Moir, John

AU - Leeds, John S.

AU - Oppong, Kofi

AU - Kanwar, Aditya

AU - Marzouk, Ahmed

AU - Belgaumkar, Ajay

AU - Gupta, Ajay

AU - Siriwardena, Ajith K.

AU - Haque, Ali Raza

AU - Awan, Altaf

AU - Balakrishnan, Anita

AU - Rawashdeh, Arab

AU - Ivanov, Bogdan

AU - Parmar, Chetan

AU - M Halloran, Christopher

AU - Caruana, Clifford

AU - Borg, Cynthia Michelle

AU - Gomez, Dhanny

AU - Damaskos, Dimitrios

AU - Karavias, Dimitrios

AU - Finch, Guy

AU - Ebied, Husam

AU - Pine, James K.

AU - Skipworth, James R.A.

AU - Milburn, James

AU - Latif, Javed

AU - Ratnam Apollos, Jeyakumar

AU - El Kafsi, Jihène

AU - Windsor, John A.

AU - Roberts, Keith

AU - Wang, Kelvin

AU - Ravi, Krish

AU - Coats, Maria V.

AU - Hollyman, Marianne

AU - Phillips, Mary

AU - Okocha, Michael

AU - Wilson, Michael Sj

AU - Ameer, Nadeem A.

AU - Kumar, Nagappan

AU - Shah, Nehal

AU - Lapolla, Pierfrancesco

AU - Magee, Connor

AU - Al-Sarireh, Bilal

AU - Lunevicius, Raimundas

AU - Benhmida, Rami

AU - Singhal, Rishi

AU - Balachandra, Srinivasan

AU - Demirli Atlcl, Semra

AU - Jaunoo, Shameen

AU - Dwerryhouse, Simon

AU - Boyce, Tamsin

AU - Charalampakis, Vasileios

AU - Kanakala, Venkat

AU - Abbas, Zaigham

AU - Nayar, Manu

PY - 2021/6/1

Y1 - 2021/6/1

N2 - Objective There is emerging evidence that the pancreas may be a target organ of SARS-CoV-2 infection. This aim of this study was to investigate the outcome of patients with acute pancreatitis (AP) and coexistent SARS-CoV-2 infection. Design A prospective international multicentre cohort study including consecutive patients admitted with AP during the current pandemic was undertaken. Primary outcome measure was severity of AP. Secondary outcome measures were aetiology of AP, intensive care unit (ICU) admission, length of hospital stay, local complications, acute respiratory distress syndrome (ARDS), persistent organ failure and 30-day mortality. Multilevel logistic regression was used to compare the two groups. Results 1777 patients with AP were included during the study period from 1 March to 23 July 2020. 149 patients (8.3%) had concomitant SARS-CoV-2 infection. Overall, SARS-CoV-2-positive patients were older male patients and more likely to develop severe AP and ARDS (p<0.001). Unadjusted analysis showed that SARS-CoV-2-positive patients with AP were more likely to require ICU admission (OR 5.21, p<0.001), local complications (OR 2.91, p<0.001), persistent organ failure (OR 7.32, p<0.001), prolonged hospital stay (OR 1.89, p<0.001) and a higher 30-day mortality (OR 6.56, p<0.001). Adjusted analysis showed length of stay (OR 1.32, p<0.001), persistent organ failure (OR 2.77, p<0.003) and 30-day mortality (OR 2.41, p<0.04) were significantly higher in SARS-CoV-2 co-infection. Conclusion Patients with AP and coexistent SARS-CoV-2 infection are at increased risk of severe AP, worse clinical outcomes, prolonged length of hospital stay and high 30-day mortality.

AB - Objective There is emerging evidence that the pancreas may be a target organ of SARS-CoV-2 infection. This aim of this study was to investigate the outcome of patients with acute pancreatitis (AP) and coexistent SARS-CoV-2 infection. Design A prospective international multicentre cohort study including consecutive patients admitted with AP during the current pandemic was undertaken. Primary outcome measure was severity of AP. Secondary outcome measures were aetiology of AP, intensive care unit (ICU) admission, length of hospital stay, local complications, acute respiratory distress syndrome (ARDS), persistent organ failure and 30-day mortality. Multilevel logistic regression was used to compare the two groups. Results 1777 patients with AP were included during the study period from 1 March to 23 July 2020. 149 patients (8.3%) had concomitant SARS-CoV-2 infection. Overall, SARS-CoV-2-positive patients were older male patients and more likely to develop severe AP and ARDS (p<0.001). Unadjusted analysis showed that SARS-CoV-2-positive patients with AP were more likely to require ICU admission (OR 5.21, p<0.001), local complications (OR 2.91, p<0.001), persistent organ failure (OR 7.32, p<0.001), prolonged hospital stay (OR 1.89, p<0.001) and a higher 30-day mortality (OR 6.56, p<0.001). Adjusted analysis showed length of stay (OR 1.32, p<0.001), persistent organ failure (OR 2.77, p<0.003) and 30-day mortality (OR 2.41, p<0.04) were significantly higher in SARS-CoV-2 co-infection. Conclusion Patients with AP and coexistent SARS-CoV-2 infection are at increased risk of severe AP, worse clinical outcomes, prolonged length of hospital stay and high 30-day mortality.

KW - COVID-19

KW - acute pancreatitis

KW - pancreatitis

UR - http://www.scopus.com/inward/record.url?scp=85100727553&partnerID=8YFLogxK

U2 - 10.1136/gutjnl-2020-323364

DO - 10.1136/gutjnl-2020-323364

M3 - Article

C2 - 33547182

AN - SCOPUS:85100727553

SN - 0017-5749

VL - 70

SP - 1061

EP - 1069

JO - Gut

JF - Gut

IS - 6

ER -

SARS-CoV-2 infection in acute pancreatitis increases disease severity and 30-day mortality: COVID PAN collaborative study

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