Severe COVID-19 infection linked to Acute pancreatitis: Case Reports

The first cases of COVID-19 were reported in Wuhan, China in December 2019. By March 2020, it evolved into a global pandemic and prompted a worldwide lockdown. The gastrointestinal involvement in COVID-19 has been extensively studied and it has been noticed that there have been a few cases of acute pancreatitis associated with COVID-19. Acute Pancreatitis is defined as the inflammatory process of the pancreas and has the following diagnostic criteria: i) Upper Abdominal Pain ii) Elevated Serum Lipase and Amylase. The most common cause of Pancreatitis is alcohol use although viral infections have also been implicated. There may be a link between COVID-19 Infection and Acute Pancreatitis.

The first case was that of a 28-year-old male with no previous history of substance abuse, who presented with fever, cough, and difficulty in breathing for a period of five days. He tested positive for SARS-CoV-2 and was admitted to the ICU. On the third day, the patient developed severe upper abdominal pain that radiated to the back along with vomiting and stopped the passage of flatus and stool. Abdominal pain worsened and abdominal distension developed. CT scan revealed acute necrotizing pancreatitis and chest radiographs indicated a progressively worsening pneumonia. The patient also developed Acute Kidney Failure and metabolic acidosis and was scheduled for a Sustained Low-Efficiency Dialysis. However, shortly after initiating ventilatory support, the patient went into cardiac arrest and succumbed to death. Acute Respiratory Distress Syndrome and Sepsis were implicated as the cause of death.