Impact of COVID-19 in individuals with and without pre-existent digestive disorders with a particular focus on elderly patients

Table 4 Evidence regarding pancreatic involvement in coronavirus disease 2019 patients

Ref.	Study design	No. of patients with pancreatic injury/total no. of patients	Remarks
Wang et al[122]	CHS	9/52 (4.68%)	Potential mild pancreatic involvement in patients with COVID-19 pneumonia
Bruno et al[124]	CHS	6/70 (8.5%)	Pancreatic involvement in hospitalized patients with documented COVID-19
Liu et al[125]	RS	13/121 (10.74%)	Pancreatic enzyme alteration incidence was higher in patients with severe COVID-19-related conditions than those with the non-severe disease. However, only a minority of patients with pancreatic enzyme alteration had a confirmed diagnosis of AP as defined by the AC
Stephens et al[126]	RS	158/234 (67.5%)	Raised serum amylase in patients with COVID-19 may not be associated with pancreatitis
Akkus et al[127]	RS	127/309 (15.7%)	Pancreatic injuries or AP are frequent during COVID-19 infection, especially in those with pre-existing DM
McNabb-Baltar et al[128]	RS	9/71 (12.1%)	Although a mild elevation in serum lipase was observed in some patients with COVID-19, acute clinical pancreatitis was not seen, according to the AC
Bansal et al[129]	RS	14/42 (33%), 7/29 patients (24.1%)	Pancreatic injury showed no statistically significant relation to the severity or outcome of COVID-19
Rasch et al[130]	CHS	22/38 (57.8%)	Patients with lipasemia needed more extended periods of mechanical ventilation than patients with COVID-19-associated ARDS
Barlass et al[131]	CCS	14/83 (16.8%)	Elevated lipase is associated with worse disease outcomes and increased ICU admission and intubation
Bacaksiz et al[132]	RS	316/1378 (23%)	Hyperamilasemia was significantly associated with COVID-19 severity
Magro et al[86]	Review	NA	Increased amylase or lipase levels might not be associated with AP in COVID-19 and may be a consequence of concurrent clinical conditions
Hunt et al[133]	Review	NA	No direct correlation between COVID-19 and pancreatic impairment could be established
Singh et al[134]	MS	1406/435731 (0.32%)	Worse clinical outcomes
Inamdar et al[135]	MS	189/11.883 (0.01%)	COVID-19 patients with pancreatitis were more likely to require mechanical ventilation and had a more extended hospital stay than patients without COVID-19
Karaali and Topal[136]	RS	189/562 (33.6%)	COVID-19 patients with AP had a higher rate of severe AP and a higher need for ICU admission
Dirweesh et al[137]	RS	75/339 (22.1%)	Higher mortality, MOF, and POF rates were registered in patients with AP and coexisting COVID-19
Pandanaboyana et al[138]	CHS	149/1777 (8.3%)	SARS-CoV-2 infection in acute pancreatitis increases 30-d mortality and disease severity
Mirò et al[140]	MS	45/63.822 (0.0007%)	Higher need for hospitalisation in COVID-19 patients with pancreatitis
Akarsu et al[141]	CCS	40/316 (12.6%)	Higher mortality rate and increased need for hospitalisation in COVID-19 patients with pancreatitis
Gubatan et al[62]	RS	100% total population 14235	Patients with a history of pancreatitis may be more susceptible to COVID-19
Huang et al[142]	RCS	4706/326993 (1.4%)	Pre-existing pancreatitis was associated with an increased risk of COVID-19–related hospitalisation and mortality
Hadi et al[143]	CS	2/3 (66.6%)	COVID-19 patients with CP bear higher hospitalisation rates
Georgakopoulou et al[144]	RS	100%	COVID-19-associated acute pancreatitis affected primarily females with a median age of 53.5 yr

CS: Case series; CR: Case reports; RS: Retrospective studies; RCS: Retrospective cohort study; MS: Multicentric study; CCS: Case-control study; CHS: Cohort study; CSS: Cross-sectional study; NA: Not available; SARS-CoV-2: Severe acute respiratory syndrome coronavirus 2; COVID-19: Coronavirus disease 2019; AC: Atlanta criteria; CP: Convalescent plasma; ICU: Intensive care unit; MOF: Multiple-organ failure; POF: Persistent organ failure; ARDS: Acute respiratory distress syndrome.