From the Research
Pancreatitis is a potential complication of COVID-19 infection, and patients with COVID-19 who develop pancreatitis typically present with abdominal pain, nausea, vomiting, and elevated pancreatic enzymes. The management of COVID-19-associated pancreatitis primarily involves supportive care, including IV fluids, pain control, and bowel rest 1. In mild cases, feeding can be resumed once pain improves and inflammatory markers decrease, while severe cases may require intensive care monitoring, nutritional support via enteral feeding, and treatment of complications 2. It is essential to evaluate any patient with COVID-19 presenting with abdominal pain for pancreatitis using lipase/amylase testing and appropriate imaging such as abdominal ultrasound or CT scan 3. The presence of COVID-19 can increase the severity and mortality of acute pancreatitis, and patients with COVID-19-associated pancreatitis should receive appropriate COVID-19 treatment based on current guidelines 4. A systematic review of the literature revealed a growing body of evidence on SARS-CoV-2-induced pancreatic lesions, including direct virus-mediated injury, systemic inflammatory response, and drug-induced injury 5. Key considerations in the management of COVID-19-associated pancreatitis include:
- Supportive care with IV fluids and pain control
- Bowel rest and nutritional support via enteral feeding in severe cases
- Evaluation for pancreatitis in patients with COVID-19 presenting with abdominal pain
- Appropriate COVID-19 treatment based on current guidelines
- Monitoring for complications and adjusting management accordingly. The most recent and highest quality study 1 suggests that acute pancreatitis can present before, after, or concomitant with COVID-19, and appropriate investigations should be performed in cases with suspicious clinical presentations.