Acute Complicated Pancreatitis With COVID-19 Infection as a Potential Cause

The pandemic coronavirus disease 2019 (COVID-19), an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has led to a significant and dramatic worldwide increase in morbidity and mortality rates throughout the year 2020. Although most patients present with respiratory symptoms such as cough, fever and shortness of breath, gastrointestinal symptoms have increasingly been reported and recognized as a major element of patients' presentation. It was found that angiotensin-converting enzyme 2 receptors (the entry receptors for SARS-CoV-2) are expressed in the pancreas in addition to the lungs, kidneys and the rest of the gastrointestinal tract, which raises the hypothesis that COVID-19 can stand as an etiology for acute pancreatitis in certain circumstances. Herein, we present a case of a COVID-19 patient who presented to the emergency room with clinical, laboratory and radiological findings of acute pancreatitis several days after being diagnosed with COVID-19 infection. He was admitted and treated conservatively. Several weeks following the initial episode, the patient developed a huge pancreatic pseudocyst, which was treated successfully with endoscopic cyst-gastrostomy. To the best of our knowledge, following a meticulous review of the current English literature, this is the second case of pancreatic pseudocyst development following acute pancreatitis due to COVID-19 infection.