Report observes recurrent acute pancreatitis in patient with COVID-19 infection

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A new clinical report published in the American Journal of Case Reports highlights a patient with no precipitating risk factors for pancreatitis who presented with recurring acute pancreatitis following the diagnosis of SARS-CoV-2 infection, the virus the causes the novel coronavirus (COVID-19).

An otherwise healthy 38-year-old man presented to the emergency department (ED) with fever and epigastric pain. Laboratory testing revealed a lipase level of 10 255 ukat/L. An abdominal ultrasound showed no gallstones. After ruling out the possible causes of acute pancreatitis, a diagnosis of idiopathic acute pancreatitis was made. The patient received conservative management and was discharged home after being medically stabilized. The patient tested positive for SARS-CoV-2 infection at a local testing center one week prior to presenting to the ED, the report said.

One week following the discharge, the patient returned with recurrent severe epigastric pain. Laboratory testing showed a lipase level of 20 320 ukat/L. An abdominal computerized tomography (CT) scan revealed acute pancreatitis. Further workups, including abdominal ultrasound, hepatitis serology, and immunoglobulin G for autoimmune pancreatitis, were unrevealing, the researchers said. Repeated SARS-CoV-2 testing produced positive results, according to the study.

The researchers concluded the clinical presentation of acute pancreatitis and SARS-CoV-2 infection in a patient with no precipitating risk factors for pancreatitis suggests COVID-19-associated acute pancreatitis. The review of the literature found a handful of reported cases of acute pancreatitis in patients with coexisting SARS-CoV-2 infection, though the researchers said the new report presents the first presumptive case of COVID-19-associated recurring acute pancreatitis.

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