Review
Copyright ©The Author(s) 2022.
World J Gastroenterol. May 21, 2022; 28(19): 2034-2056
Published online May 21, 2022. doi: 10.3748/wjg.v28.i19.2034
Table 1 Demographic characteristic of cases with suspected coronavirus disease 2019-attributed acute pancreatitis
Patient characteristics
Value
Age, median (range, yr)42.0 (6-87)
Gender, male/female/NA37/44/1
Comorbidities
Hypertension22
Diabetes15
Dyslipidemia4
Heart disease3
Cerebrovascular0
Respiratory disease4
Renal dysfunction5
Obesity16
Pregnancy2
Malignancy2
History of abdominal surgery13
Others10
Alcohol consumption, none/low/heavy/NA53/9/0/20
History of smoking, never/experience/current/NA32/2/0/48
Severity of COVID-19
Non-severe/severe/critical/NA35/23/20/4
Symptoms
Fever49
Breath shortness16
Cough28
Dyspnea18
Sore throat18
Fatigue9
Headache7
Myalgia10
Anorexia13
Diarrhea16
Abdominal pain75
Nausea 39
Vomiting48
Others23
Blood test
WBC, median (range, × 103/mm3)13.10 (3.40-230.00)
PLT, median (range, × 103/mm3)235.5 (52.0-502.0)
D-Dimer, median (range, μg/mL)4.9 (0.3-17.7)
Amylase, median (range, U/L)635 (47-4530)
Lipase, median (range, U/L)895.5 (35.6-11920.0)
LDH, median (range, U/L)366.0 (170-3553)
CRP, median (range, mg/dL)8.5 (0.3-59.7)
Imaging findings (n = 75)
Pancreatic enlargement42
Peripancreatic fluid collection33
Peripancreatic inflammatory change48
Pancreatic ischemic change12
No change of pancreas6
Not visualized2
Severity of acute pancreatitis
Mild/moderate/severe/NA28/20/28/6
Therapy for COVID-19
Lopinavir/ritonavir4
Favipiravir4
Umifenovir2
Remdesivir8
Hydroxychloroquine2
Tocilizumab2
Corticosteroid (n = 53)21
Oxygen therapy (n = 69)42
Mechanical ventilation19
Therapy for acute pancreatitis
Conservative therapy/surgical drainage/NA72/4/6
Period of hospitalization, median (range, day)7.5 (2-76)
Prognosis
Alive/death/NA69/10/3
Table 2 Baseline characteristics of cases with coronavirus disease 2019 and acute pancreatitis coexistent
Case No.
Ref.
Age
Gender
Diagnostic evidence for SARS-CoV-2
Severity of COVID-19
Abdominal pain
Amylase/lipase (IU/L)
Abdominal image findings
Modality of image
Severity of acute pancreatitis
Treatment for pancreatitis
Prognosis
1Anand et al[70]59FemaleRT-PCRNon-severePresenceNA/NADiffuse pancreatic enlargementCTMildConservativeAlive
2Hadi et al[71]47FemaleRT-PCRCriticalAbsence1500/NADiffuse pancreatic enlargementAUSSevereNANA
3Hadi et al[71]68FemaleRT-PCRCriticalPresence934/NANANASevereNANA
4Aloysius et al[72]36FemaleRT-PCRCriticalPresence325/627No changeCTSevereConservativeAlive
5Miao et al[73]26FemaleRT-PCRNon-severePresenceNA/430Diffuse pancreatic enlargementCTNANAAlive
6Szatmary et al[74]29MaleRT-PCRNon-severePresence77/NADiffuse pancreatic enlargement, peripancreatic inflammatory change, fluid collectionCTModerateConservativeAlive
7Szatmary et al[74]47MaleRT-PCRNon-severePresence211/NADiffuse pancreatic enlargement, peripancreatic inflammatory change, fluid collectionCTModerateConservativeAlive
8Rabice et al[75]36FemaleRT-PCRSeverePresence88/875Not visualizedAUSMildConservativeAlive
9Alloway et al[76]7FemaleRT-PCRNon-severePresenceNA/1672Diffuse pancreatic enlargementAUS and CTMildConservativeAlive
10Karimzadeh et al[77]65FemaleRT-PCRSeverePresence285/294No changeCTMildConservativeAlive
11Gonzalo-Voltas et al[78]76MaleRT-PCRNon-severePresence3568/NADiffuse pancreatic enlargementCTModerateConservativeAlive
12Bokhari et al[79]32MaleRT-PCRNon-severePresence672/721Diffuse pancreatic enlargement, peripancreatic inflammatory change, fluid collectionCTMildConservativeAlive
13Mazrouei et al[80]24MaleRT-PCRNon-severePresence391/578Enlargement of pancreatic tail, peripancreatic fluid collectionCTMildConservativeAlive
14Ahmed et al[81]47MaleRT-PCRSeverePresence349/NAPeripancreatic inflammatory changeCTSevereNAAlive
15Brikman et al[82]61MaleRT-PCRSeverePresence142/203Peripancreatic inflammatory changeCTMildConservativeAlive
16Kataria et al[83]49FemaleRT-PCRSeverePresence501/1541Diffuse pancreatic enlargement, peripancreatic fluid collectionCTMildConservativeAlive
17Cerda-Contreras et al[84]72FemaleRT-PCRSevereAbsence1789/1247Diffuse pancreatic enlargement, peripancreatic inflammatory change, fluid collectionCTSevereConservativeDead
18Cheung et al[85]38MaleRT-PCRNon-severePresenceNA/338.7Acute pancreatitisCTNAConservativeAlive
19Kumaran et al[86]67FemaleRT-PCRSeverePresence1483/NAPeripancreatic inflammatory change and fluid collection, non-enhancement of most of the head and proximal bodyCTSevereConservativeAlive
20Purayil et al[87]58MaleRT-PCRNon-severePresence249/NANot visualizedAUSMildConservativeAlive
21Dietrich et al[88]72MaleRT-PCRCriticalPresenceNA/185Normal pancreasCTMildNAAlive
22Patnaik et al[89]29MaleRT-PCRNon-severePresence2861/1650Diffuse pancreatic enlargement, peripancreatic fluid collectionCTMildConservativeAlive
23Wang et al[90]42MaleRT-PCRCriticalPresence132/382Pancreatic enlargement, peripancreatic fluid collectionCTModerateConservativeDead
24Wang et al[90]35MaleRT-PCRNon-severePresenceNA/1042Pancreatic enlargement, peripancreatic fluid collectionCTModerateConservativeAlive
25Alves et al[91]56FemaleRT-PCRCriticalPresence544/2993Dffuse pancreatic enlargement, peripancreatic inflammatory changeCT and MRISevereConservativeAlive
26Kurihara et al[92]55MaleRT-PCRCriticalAbsence252/263Pancreatic enlargement, peripancreatic inflammatory changeCTSevereConservativeAlive
27Lakshmanan and Malik[93]68MaleRT-PCRNon-severeAbsence1030/2035Peripancreatic inflammatory changeCTMildConservativeAlive
28Samies et al[94]15MaleRT-PCRNon-severePresenceNA/233Peripancreatic inflammatory changeCTMildConservativeAlive
29Samies et al[94]11MaleRT-PCRNon-severePresence215/953No changeCTMildConservativeAlive
30Samies et al[94]16FemaleRT-PCRNon-severePresenceNA/1909Pancreatic enlargementCTMildConservativeAlive
31Fernandes et al[95]36FemaleRT-PCRNAPresence710/640Pancreatic enlargement, peripancreatic fluid collectionCTModerateConservativeAlive
32Stevens et al[55]10FemaleSerological IgGSeverePresenceNA/1371Peripancreatic inflammatory changeCTSevereConservativeAlive
33Shinohara et al[96]58MaleRT-PCRCriticalPresence795/NADiffuse pancreatic enlargement peripancreatic inflammatory changeCTModerateConservativeAlive
34Meyers et al[97]67MaleRT-PCRNAPresenceNA/5295Interstitial edematous pancreatitis peripancreatic inflammatory changeCTModerateNANA
35Ghosh et al[98]63MaleRT-PCRSevereAbsence58/412Focal pancreatic enlargement, peripancreatic fluid collectionCTNAConservativeAlive
36Tollard et al[99]32FemaleRT-PCRCriticalPresenceNA/321Diffuse pancreatic enlargement peripancreatic inflammatory changeCTSevereConservativeDead
37Kandasamy et al[100]45FemaleRT-PCRSeverePresence364/293Diffuse pancreatic enlargement, peripancreatic inflammatory change and fluid collectionCTModerateConservativeAlive
38Hassani et al[101]78FemaleRT-PCRCriticalPresence1200/1450Pancreatic enlargement necrotizing pancreatitisAUS and CTSevereConservativeDead
39Suchman et al[56]10FemaleRT-PCRNon-severePresenceNA/365.7NANAModerateConservativeAlive
40Suchman et al[56]16MaleRT-PCRCriticalPresenceNA/233.3NANASevereConservativeAlive
41Narang et al[102]20FemaleRT-PCRSeverePresence1168/916Acute pancreatitisMRISevereConservativeAlive
42Acherjya et al[103]57FemaleRT-PCRSeverePresence80/8352Diffuse pancreatic enlargement, peripancreatic inflammatory changeCTModerateConservativeAlive
43Alwaeli et al[104]30MaleRT-PCRCriticalPresence151/1022Diffuse pancreatic enlargement, peripancreatic inflammatory changeCTSevereConservativeAlive
44Simou et al[105]67NART-PCRSevereAbsenceNA/576Diffuse pancreatic enlargement, peripancreatic inflammatory changeCTSevereConservativeDead
45Jespersen Nizamic et al[106]49FemaleRT-PCRNon-severePresenceNA/2864Peripancreatic inflammatory change, fluid collectionCTModerateConservativeAlive
46Abraham et al[107]61FemaleRT-PCRNon-severePresenceNA/1018NANAMildConservativeAlive
47Abhinay et al[108]13FemaleRT-PCRNAPresence217/365Peripancreatic inflammatory change, fluid collectionCTModerateConservativeAlive
48Bouali et al[109]60FemaleRT-PCRCriticalPresenceNA/627Peripancreatic fluid collectionCTSevereDrainage of abdominal cavity, total gasterectomyDead
49Alharmi et al[110]52FemaleRT-PCRNon-severePresence47/NAAtrophic pancreas, peripancreatic inflammatory change, peripancreatic fluid collectionCTModerateConservativeAlive
50Abbas et al[57]13FemaleRT-PCRCriticalPresence217.8/NAFluid collectionCTSevereConservativeAlive
51Bineshfar et al[111]14MaleRT-PCRNon-severePresence1914/NADiffuse pancreatic enlargement, peripancreatic inflammatory changeCTMildConservativeAlive
52Paz et al[112]14MaleRT-PCRNon-severePresence196/247Peripancreatic inflammatory change, fluid collectionMRIMildConservativeAlive
53Wifi et al[113]72FemaleRT-PCRNon-severePresence1667/710No changeCTMildConservativeAlive
54Sandhu et al[114]25FemaleRT-PCRCriticalPresence350/35.6Diffuse pancreatic enlargementCTSevereConservativeDead
55Mohammadi Arbati et al[115]28MaleRT-PCRCriticalPresence1273/758Peripancreatic inflammatory change, fluid collection, acute necrotic pancreatitisCTSevereConservativeAlive
56Amé et al[116]42FemaleRT-PCRNAPresence2263/2799Pancreatic enlargement, peripancreatic inflammatory change, fluid collectionCTNAConservativeAlive
57Gupta et al[117]25FemaleRT-PCRSeverePresence1814/11920Diffuse pancreatic enlargement, peripancreatic inflammatory change, fluid collectionCTSevereConservativeAlive
58Muhammad Abrar Jeelani et al[118]24MaleRT-PCRNon-severePresenceNA/4174Peripancreatic inflammatory change, fluid collectionCTModerateConservativeAlive
59Maalouf et al[119]62MaleRT-PCRNon-severePresenceNA/4361Peripancreatic inflammatory change, necrotic collectionMRIModerateConservativeAlive
60Sanchez et al[120]16MaleRT-PCRSeverePresenceNA/961Peripancreatic inflammatory change, fluid collectionCTModerateConservativeAlive
61Ehsan et al[121]13FemaleRT-PCRSeverePresence598/2331Peripancreatic inflammatory change, fluid collectionCTModerateConservativeAlive
62Hanif et al[122]30FemaleRT-PCRSeverePresence820/626Diffuse pancreatic enlargement, peripancreatic inflammatory changeCTSevereConservativeAlive
63Chandra et al[123]53MaleRT-PCRCriticalPresenceNA/1200Peripancreatic inflammatory changeCTSevereConservativeAlive
64Alfishawy et al[124]17MaleRT-PCRSevereAbsence285/273Pancreatic loculationsCTModerateConservativeAlive
65Berrichi et al[125]36FemaleRT-PCRCriticalPresenceNA/2570Diffuse pancreatic enlargement, peripancreatic inflammatory changeCTSevereConservativeDead
66Berrichi et al[125]51FemaleRT-PCRSeverePresenceNA/676Diffuse pancreatic enlargementCTMildConservativeAlive
67Kripalani et al[126]79FemaleRT-PCRCriticalPresence1075/6178Diffuse pancreatic enlargement, peripancreatic inflammatory change, acute necrotic pancreatitisCTSevereCycto-jejunostomyAlive
68Narayan et al[127]28MaleRT-PCRCriticalPresenceElevated/elevatedDiffuse pancreatic enlargement, peripancreatic inflammatory change and acute necrotic pancreatitisCTSevereConservativeDead
69Narayan et al[127]45FemaleRT-PCRSeverePresenceElevated/elevatedPeripancreatic inflammatory changeCTMildConservativeAlive
70Eldaly et al[128]44MaleRT-PCRNon-severePresence773/286Diffuse pancreatic enlargementCTMildConservativeAlive
71Basukala et al[129]49FemaleRT-PCRNon-severePresence1563/568Diffuse pancreatic enlargement, peripancreatic inflammatory change, fluid collection, necrotic pancreatitisCTSevereGastrocolic ligament and followed by necrotic debridement, and drainage placementDead
72Schembri Higgans et al[130]63FemaleRT-PCRNon-severePresence1079/NAAfter Whipple surgeryCTMildConservativeAlive
73Schembri Higgans et al[130]87FemaleRT-PCRNon-severePresence499/NAPeripancreatic inflammatory changeCTMildConservativeAlive
74Schembri Higgans et al[130]64FemaleRT-PCRNon-severePresence2141/NAPeripancreatic inflammatory changeCTMildConservativeAlive
75Kopiczko et al[131]6FemaleRT-PCRNon-severePresence1124/4250Diffuse pancreatic enlargement, peripancreatic inflammatory change, fluid collectionCTMildConservativeAlive
76Kareva et al[58]11MaleSerological IgGNon-severePresence489/576Edematous appendix no change of pancreasAUSNAConservativeAlive
77da Costa Ferreira et al[132]35MaleRT-PCRSeverePresence1669/NADiffuse pancreatic enlargement, peripancreatic inflammatory change, fluid collection normal gallbladder and biliary tractCTSevereConservativeAlive
78Sánchez-Gollarte et al[133]60MaleSerological IgGSeverePresence4530/2220Diffuse pancreatic enlargement, peripancreatic inflammatory change, fluid collection, necrotic pancreatitisCTSevereDrainage of abdominal cavityAlive
79Sudarsanam et al[134]35MaleRT-PCRNon-severePresenceNormal/normalPeripancreatic inflammatory change, fluid collection, necrotic pancreatitis of tailCTNAConservativeAlive
80Faghih Dinevari et al[135]18FemaleRT-PCRNon-severePresence1288/1541Diffuse pancreatic enlargement, peripancreatic inflammatory change, fluid collectionCTMildConservativeAlive
81Goldstein et al[136]11MaleSerological IgGSeverePresence1607/2434Peripancreatic inflammatory change, fluid collection, necrotic pancreatitisMRIModerateConservativeAlive
82Gadiparthi et al[137]74FemaleRT-PCRNon-severePresence229/7550Peripancreatic inflammatory changeCTMildConservativeAlive
Table 3 The probability of other etiologies of acute pancreatitis in cases with coronavirus disease 2019 and acute pancreatitis coexistent
Case No.
Alcohol
Biliary
Hypertriglyceridemia
Drug
Acute aggravation on chronic pancreatitis
Hypercalcemia
Infections
Ischemia/reperfusion
Trauma/ anatomy
Genetics
MIS-C/PIMS
1N??YN??NN--
2NN1N?NN?YN--
3??N?NN?YN--
4NNNNN??NN--
5NNNNNNN2NN--
6NNNNN???N--
7NNNNN???N--
8NNNNN??NN--
9N??NN??NN?N
10?NNNNN?NN--
11NN?YN??NN--
12NNNNNN?NN--
13NN?NN??NN--
14?Y?YN??NN--
15NNNYNN?NN--
16NNNYNN?NN--
17??NYNN?YN--
18NNNNNN?NN--
19NNNNNN?NN--
20NN?NN??NN--
21NN?NN??NN--
22NNNNNN?NN--
23NNNNNN?NN--
24NNNNNN?NN--
25NNNNNN?NN--
26?NNYNN?YN--
27NNNNNN?NN--
28N?NNN??NNNN
29NNNNN??NNN?
30NYNNY??NNNN
31NN1?NN??NN--
32NYNNN??NN?Y
33NNNYNN?YN--
34NNNNN??NN--
35N???N??NN--
36NYNNNN?YN--
37NN?NN??NN--
38NNNNNN?NN--
39N???N?????Y
40N???N?????N
41NNNYN??YN--
42NNNYNN?NN--
43NNNNNNN2NN--
44NNNYNNN2YN--
45N??NN??NN--
46???NNN?NN--
47???NN??NN?N
48???NN??NN--
49NNNYNN?NN--
50NNNYN?N2NNNY
51NN?NN??NN?N
52?NNNN??NNNN
53?NNNNN?NN--
54NYNNNN?NN--
55NNNNNN?NN--
56NNNNNN?NN--
57NNN?NN?NN--
58NNNNNN?NN--
59NNNNN??NN--
60NN?NNN?NNNN
61NNNNN??NN??
62N?NYNNNYN--
63NNNNN??NN--
64NYYNN??NN??
65?N?NN??NN--
66?N?NN??NN--
67NN?NN??NN--
68?NNYN??NN--
69???YN??YN--
70NNNNN??NN--
71NNNNNN?NN--
72NN?NN??NY--
73?NNNN??NN--
74?Y?NN??NN--
75NNNNNNNNN?N
76NN?NNN?NN?Y
77NYNNNN?NN--
78?N??NN?NN--
79NNNNNN?NN--
80NNNNNN?NNNN
81???YN?N2NN?Y
82NNNNNN?NN--