Pancreatic Injury in Severe SARS-CoV-2 Infection: A Retrospective Study Across Three Pandemic Waves

Area of Science:

• Infectious Diseases
• Gastroenterology
• Critical Care Medicine

Background:

• Acute pancreatitis (AP) is a recognized complication in COVID-19 patients.
• The mechanisms linking viral infection, systemic inflammation, and pancreatic injury are not fully understood.

Purpose of the Study:

• To evaluate the characteristics and risk factors of AP in severe COVID-19 pneumonia patients.
• To identify predictors for AP development in this population.

Main Methods:

• Retrospective, single-center analysis of 405 hospitalized COVID-19 patients.
• Analysis of laboratory markers (CRP, ESR, fibrinogen, LDH, D-dimers, WBC, neutrophils, potassium, glucose), imaging, and clinical data.
• Statistical analysis to identify associations with AP occurrence.

Main Results:

• Elevated inflammatory markers (CRP, ESR), coagulation markers (fibrinogen, D-dimers), leukocytosis with neutrophilia, hyperglycemia, hypokalemia, and severe lung involvement were significantly associated with AP.
• LDH and inflammatory markers showed strong predictive value.
• D-dimers and lung injury severity also aided in risk stratification.

Conclusions:

• Systemic inflammation, endothelial dysfunction, immunothrombosis, and metabolic disturbances increase pancreatic vulnerability in COVID-19.
• Early identification of risk factors like elevated LDH and inflammatory markers can guide monitoring and interventions.
• Prospective studies are needed for validation.