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Acute Pancreatitis as an Extrapulmonary Manifestation and Pulmonary Embolism as a Complication of COVID-19: A Case
Insights
This case report highlights that SARS-CoV-2 infection can cause rare extrapulmonary issues, including acute pancreatitis and thromboembolic events, beyond typical pneumonia. Early recognition of these unusual symptoms is crucial for effective patient management.
Area of Science:
- Infectious Diseases
- Gastroenterology
- Critical Care Medicine
Background:
- Coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, is primarily known for respiratory symptoms.
- Extrapulmonary manifestations, including coagulation abnormalities and thromboembolic events, are increasingly recognized.
- Mild acute pancreatitis has been anecdotally reported in COVID-19 patients.
Purpose of the Study:
- To report a rare case of SARS-CoV-2 infection presenting with extrapulmonary manifestations.
- To emphasize the pancreatic involvement as a rare complication of COVID-19.
- To raise awareness of non-respiratory symptoms for timely diagnosis.
Main Methods:
- Case report of a male patient with COVID-19 symptoms.
- Clinical assessment including fever, cough, and sore throat.
- Diagnostic workup included laboratory tests (amylase, lipase, leukocyte count) and imaging (ultrasonography).
Main Results:
- The patient presented with fever, cough, and developed pulmonary thromboembolism.
- Laboratory tests indicated elevated pancreatic enzymes and leukocytes.
- Abdominal ultrasonography confirmed mild acute pancreatitis.
Conclusions:
- SARS-CoV-2 infection can manifest with serious extrapulmonary complications.
- Thromboembolic events and mild acute pancreatitis are rare but possible complications.
- Clinicians should consider these rare manifestations for prompt diagnosis and treatment.
Abstract:
Introduction: Coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, first emerged in Wuhan, China, in late 2019. Besides respiratory involvement, COVID-19 may cause coagulation abnormalities, leading to thromboembolic events. Mild forms of acute pancreatitis have also been reported in patients with COVID-19 pneumonia. The aim of this case report is to highlight rare extrapulmonary manifestations of SARS-CoV-2 infection, with emphasis on pancreatic involvement. Case Report: A male patient was admitted with sore throat, dry cough, and fever up to 38.0°C. He had received the first dose of the Sinopharm COVID-19 vaccine three weeks prior and was obese (BMI 44.7 kg/m²). On admission, he developed pulmonary thromboembolism. Color Doppler ultrasonography of the lower extremities showed no signs of superficial or deep vein thrombosis. On the eleventh day of treatment, laboratory tests revealed elevated serum amylase, lipase, and leukocyte count. Abdominal ultrasonography demonstrated a hyperechoic, non-enlarged pancreas, consistent with mild acute pancreatitis. Given the widespread presence of endothelial cells, SARS-CoV-2 infection may affect multiple extrapulmonary organs, including the CNS, cardiovascular system, kidneys, pancreas, liver, and gastrointestinal tract. Conclusion: SARS-CoV-2 infection may lead not only to pneumonia but also to thromboembolic complications and mild acute pancreatitis. Awareness of such rare extrapulmonary manifestations is important for timely diagnosis and management.
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