切换至 "中华医学电子期刊资源库"

第五届中国出版政府奖音像电子网络出版物奖提名奖

中国科技核心期刊

中国科学引文数据库(CSCD)来源期刊

中华重症医学电子杂志 ›› 2021, Vol. 07 ›› Issue (02) : 97 -102. doi: 10.3877/cma.j.issn.2096-1537.2021.02.001

专家论坛

新型冠状病毒肺炎相关性急性胰腺炎:证据,挑战与思考
黄东亚1, 苗毅1, 蒋奎荣1, 彭云鹏1, 李强1,()   
  1. 1. 210029 南京医科大学第一附属医院胰腺中心
  • 收稿日期:2021-03-14 出版日期:2021-05-28
  • 通信作者: 李强
  • 基金资助:
    国家自然科学基金资助项目(81672449); 强卫工程医学杰出人才项目(JCRCA2016009); 江苏省重大疾病生物资源样本库项目(BM2015004); 江苏省高校优势学科和创新团队项目(JX10231802)

Acute pancreatitis related to COVID-19: evidence, challenge and reflection

Dongya Huang1, Yi Miao1, Kuirong Jiang1, Yunpeng Peng1, Qiang Li1()   

  1. 1. Department of Pancreas Center, First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, China
  • Received:2021-03-14 Published:2021-05-28
  • Corresponding author: Qiang Li
引用本文:

黄东亚, 苗毅, 蒋奎荣, 彭云鹏, 李强. 新型冠状病毒肺炎相关性急性胰腺炎:证据,挑战与思考[J]. 中华重症医学电子杂志, 2021, 07(02): 97-102.

Dongya Huang, Yi Miao, Kuirong Jiang, Yunpeng Peng, Qiang Li. Acute pancreatitis related to COVID-19: evidence, challenge and reflection[J]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), 2021, 07(02): 97-102.

由新型冠状病毒(SARS-CoV-2)感染引起的新型冠状病毒肺炎(COVID-19)自2019年12月发病以来,现已全球大流行。COVID-19除影响呼吸系统外,还可造成全身多系统、多脏器的损害。目前关于COVID-19累及胰腺的证据十分有限,COVID-19患者中急性胰腺炎(AP)的发病率存在不确定性,其临床特征和发病机制也存在诸多疑问。在全球COVID-19流行仍未得到完全控制的背景下,由于目前对COVID-19与AP之间相互作用知之甚少,我们必须警惕他们之间可能存在的联系。临床上诸多治疗程序需要合理化,应采取有效的防护措施,在科学诊治患者的同时有效避免医护人员SARS-CoV-2感染。

Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to a world-wide pandemic since its onset in December of 2019. Not only capable of cause pneumonia, COVID-19 may also damage other organs. The data about pancreatic indueced by COVID-19 was limited. The incidence, clinical course, pathogenesis and outcomes of acute pancreatitis in these patients remain uncertain. The interaction between SARS-CoV-2 and pancreas are also limited. Therefore, it is imperative for us to keep in mind the possible association between COVID-19 and acute pancreatitis. Hence, rational therapeutic procedures should performed during this pandemic. Effective protective measures should be taken to prevent SARS-CoV-2 infection among health care workers when take care these patients.

1
Guan WJ, Ni ZY, Hu Y, et al. Clinical characteristics of coronavirus disease 2019 in China [J]. N Engl J Med, 2020, 382(18): 1708-1720.
2
Xiao F, Tang M, Zheng X, et al. Evidence for gastrointestinal infection of SARS-CoV-2 [J]. Gastroenterology, 2020, 158(6): 1831-1833.
3
Aroniadis OC, Dimaio CJ, Dixon RE, et al. Current knowledge and research priorities in the digestive manifestations of COVID-19 [J]. Clin Gastroenterol Hepatol, 2020, 18(8): 1682-1684.
4
O'Brien CM, Jung K, Dang W, et al. Collateral damage: the impact of the COVID-19 pandemic on acute abdominal emergency presentations [J]. J Am Coll Radiol, 2020, 17(11): 1443-1449.
5
Mao R, Qiu Y, He JS, et al. Manifestations and prognosis of gastrointestinal and liver involvement in patients with COVID-19: a systematic review and meta-analysis [J]. Lancet Gastroenterol Hepatol, 2020, 5(7): 667-678.
6
Wang F, Wang H, Fan J, et al. Pancreatic injury patterns in patients with coronavirus disease 19 pneumonia [J]. Gastroenterology, 2020, 159(1): 367-370.
7
Liu F, Long X, Zhang B, et al. ACE2 expression in pancreas may cause pancreatic damage after SARS-CoV-2 infection [J]. Clin Gastroenterol Hepatol, 2020, 18(9): 2128-2130.
8
McNabb-Baltar J, Jin DX, Grover AS, et al. Lipase elevation in patients with COVID-19 [J]. Am J Gastroenterol, 2020, 115(8): 1286-1288.
9
Bruno G, Fabrizio C, Santoro CR, et al. Pancreatic injury in the course of coronavirus disease 2019: a not-so-rare occurrence [J]. J Med Virol, 2021, 93(1): 74-75.
10
Barlass U, Wiliams B, Dhana K, et al. Marked elevation of lipase in COVID-19 disease: a cohort study [J]. Clin Transl Gastroenterol, 2020, 11(7): e215.
11
Banks PA, Bollen TL, Dervenis C, et al. Classification of acute pancreatitis--2012: revision of the Atlanta classification and definitions by international consensus [J]. Gut, 2013, 62(1): 102-111.
12
Stephens JR, Wong J, Broomhead R, et al. Raised serum amylase in patients with COVID-19 may not be associated with pancreatitis [J]. Br J Surg, 2021, 108(4):e152-e153.
13
Wang K, Luo J, Tan F, et al. Acute pancreatitis as the initial manifestation in 2 cases of COVID-19 in Wuhan, China [J]. Open Forum Infect Dis, 2020, 7(9): a324.
14
Alloway BC, Yaeger SK, Mazzaccaro RJ, et al. Suspected case of COVID-19-associated pancreatitis in a child [J]. Radiol Case Rep, 2020, 15(8): 1309-1312.
15
Miao Y, Lidove O, Mauhin W. First case of acute pancreatitis related to SARS-CoV-2 infection [J]. Br J Surg, 2020, 107(8): e270.
16
Anand ER, Major C, Pickering O, et al. Acute pancreatitis in a COVID-19 patient [J]. Br J Surg, 2020, 107(7): e182.
17
Kumaran NK, Karmakar BK, Taylor OM. Coronavirus disease-19 (COVID-19) associated with acute necrotising pancreatitis (ANP) [J]. BMJ Case Rep, 2020, 13(9): e237903.
18
Elhence A, Mahapatra SJ, Vajpai T, et al. Acute pancreatitis and nosocomial COVID-19: cause specific host responses may determine lung injury [J]. Pancreatology, 2020, 20(7): 1258-1261.
19
Hadi A, Werge M, Kristiansen KT, et al. Coronavirus disease-19 (COVID-19) associated with severe acute pancreatitis: case report on three family members [J]. Pancreatology, 2020, 20(4): 665-667.
20
Aloysius MM, Thatti A, Gupta A, et al. COVID-19 presenting as acute pancreatitis [J]. Pancreatology, 2020, 20(5): 1026-1027.
21
Schepis T, Larghi A, Papa A, et al. SARS-CoV2 RNA detection in a pancreatic pseudocyst sample [J]. Pancreatology, 2020, 20(5): 1011-1012.
22
姚小红, 李廷源, 何志承, 等. 新型冠状病毒肺炎(COVID-19)三例遗体多部位穿刺组织病理学研究 [J]. 中华病理学杂志, 2020, 49(5): 411-417.
23
Lax SF, Skok K, Zechner P, et al. Pulmonary arterial thrombosis in COVID-19 with fatal outcome : results from a prospective, single-center, clinicopathologic case series [J]. Ann Intern Med, 2020, 173(5): 350-361.
24
Hanley B, Naresh KN, Roufosse C, et al. Histopathological findings and viral tropism in UK patients with severe fatal COVID-19: a post-mortem study [J]. Lancet Microbe, 2020, 1(6): e245-e253.
25
Gubatan J, Levitte S, Patel A, et al. Prevalence, risk factors and clinical outcomes of COVID-19 in patients with a history of pancreatitis in Northern California [J]. Gut, 2021, 70(2): 440-441.
26
Bonney GK, Gao Y, Chew CA, et al. SARS-COV-2 associated acute pancreatitis: cause, consequence or epiphenomenon? [J]. Pancreatology, 2020, 20(5): 1017-1018.
27
Inamdar S, Benias PC, Liu Y, et al. Prevalence, risk factors, and outcomes of hospitalized patients with coronavirus disease 2019 presenting as acute pancreatitis [J]. Gastroenterology, 2020, 159(6): 2226-2228.
28
Dirweesh A, Li Y, Trikudanathan G, et al. Clinical outcomes of acute pancreatitis in patients with coronavirus disease 2019 [J]. Gastroenterology, 2020, 159(5): 1972-1974.
29
Pandanaboyana S, Moir J, Leeds JS, al et; COVID PAN collaborative group. SARS-CoV-2 infection in acute pancreatitis increases disease severity and 30-day mortality: COVID PAN collaborative study [J]. Gut, 2021, 70(6): 1061-1069.
30
Rawla P, Bandaru SS, Vellipuram AR. Review of infectious etiology of acute pancreatitis [J]. Gastroenterol Res, 2017, 10(3): 153-158.
31
Hoffmann M, Kleine-Weber H, Schroeder S, et al. SARS-CoV-2 cell entry depends on ACE2 and TMPRSS2 and is blocked by a clinically proven protease inhibitor [J]. Cell, 2020, 181(2): 271-280.
32
Zhou P, Yang XL, Wang XG, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin [J]. Nature, 2020, 579(7798): 270-273.
33
Liu F, Long X, Zhang B, et al. ACE2 expression in pancreas may cause pancreatic damage after SARS-CoV-2 infection [J]. Clin Gastroenterol Hepatol, 2020, 18(9): 2128-2130.
34
Li H, Liu L, Zhang D, et al. SARS-CoV-2 and viral sepsis: observations and hypotheses [J]. Lancet, 2020, 395(10235): 1517-1520.
35
El-Kurdi B, Khatua B, Rood C, et al. Mortality from coronavirus disease 2019 increases with unsaturated fat and may be reduced by early calcium and albumin supplementation [J]. Gastroenterology, 2020, 159(3): 1015-1018.
36
Hegyi P, Szakacs Z, Sahin-Toth M. Lipotoxicity and cytokine storm in severe acute pancreatitis and COVID-19 [J]. Gastroenterology, 2020, 159(3): 824-827.
37
黄东亚, 苗毅, 蒋奎荣, 等. 重症患者伴高淀粉酶和/或高脂肪酶血症: 急性胰腺炎? [J/OL]. 中华重症医学电子杂志, 2017, 3(2): 138-142.
38
De-Madaria E, Siau K, Cardenas-Jaen K. Increased amylase and lipase in patients with COVID-19 pneumonia: don't blame the pancreas just yet! [J]. Gastroenterology, 2020, S0016-5085(20): 30561-30568.
39
Ashok A, Faghih M, Singh VK. Mild pancreatic enzyme elevations in COVID-19 pneumonia: synonymous with injury or noise? [J]. Gastroenterology, 2020, S0016-5085(20): 34778.
40
Mukherjee R, Smith A, Sutton R. Covid-19-related pancreatic injury [J]. Br J Surg, 2020, 107(7): e190.
41
Goyal H, Sachdeva S, Perisetti A, et al. Hyperlipasemia and potential pancreatic injury patterns in COVID-19: a marker of severity or innocent bystander? [J]. Gastroenterology, 2021, 160(3): 946-948.
42
Cerda-Contreras C, Nuzzolo-Shihadeh L, Camacho-Ortiz A, et al. Baricitinib as treatment for COVID-19: friend or foe of the pancreas? [J]. Clin Infect Dis, 2020: online ahead of print.
43
Khadka S, Williams K, Solanki S. "Remdesivir-Associated Pancreatitis" [J]. Am J Ther, 2021. Epub ahead of print.
44
Morrison AR, Johnson JM, Ramesh M, et al. Acute hypertriglyceridemia in patients with COVID-19 receiving tocilizumab [J]. J Med Virol, 2020, 92(10): 1791-1792.
45
Cao B, Wang Y, Wen D, et al. A trial of lopinavir-ritonavir in adults hospitalized with severe COVID-19 [J]. N Engl J Med, 2020, 382(19): 1787-1799.
46
Ng SC, Tilg H. COVID-19 and the gastrointestinal tract: more than meets the eye [J]. Gut, 2020, 69(6): 973-974.
47
Coccolini F, Tartaglia D, Puglisi A, et al. SARS-CoV-2 is present in peritoneal fluid in COVID-19 patients [J]. Ann Surg, 2020, 272(3): e240.
48
Stahel PF. How to risk-stratify elective surgery during the COVID-19 pandemic? [J]. Patient Saf Surg, 2020, 14: 8.
49
Zhou J, Li C, Liu X, et al. Infection of bat and human intestinal organoids by SARS-CoV-2 [J]. Nat Med, 2020, 26(7): 1077-1083.
[1] 张秋彬, 张楠, 林清婷, 徐军, 朱华栋, 姜辉. 急性胰腺炎合并急性肾损伤患者的预后评估[J]. 中华危重症医学杂志(电子版), 2023, 16(05): 382-389.
[2] 董晓燕, 赵琪, 唐军, 张莉, 杨晓燕, 李姣. 奥密克戎变异株感染所致新型冠状病毒感染疾病新生儿的临床特征分析[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(05): 595-603.
[3] 李安琪, 徐祎琳, 向天新. 新型冠状病毒感染后肺纤维化病变诊治进展[J]. 中华实验和临床感染病杂志(电子版), 2023, 17(05): 294-298.
[4] 吴令杰, 陈瑞烈, 陈桂佳, 肖湘明, 林钟滨. 两例获得性免疫缺陷综合征合并新型冠状病毒感染者抗病毒治疗并文献复习[J]. 中华实验和临床感染病杂志(电子版), 2023, 17(04): 282-286.
[5] 黄翠君, 张喜玲, 刘思嘉, 刘云建. 重症急性胰腺炎营养支持治疗研究进展[J]. 中华普通外科学文献(电子版), 2023, 17(05): 385-390.
[6] 戚若晨, 马帅军, 韩士超, 王国辉, 刘克普, 张小燕, 杨晓剑, 秦卫军. 肾移植术后新型冠状病毒感染单中心诊疗经验[J]. 中华移植杂志(电子版), 2023, 17(04): 232-239.
[7] 王红敏, 谢云波, 王彦虎, 王福生. 间充质干细胞治疗新冠病毒感染的临床研究进展[J]. 中华细胞与干细胞杂志(电子版), 2023, 13(04): 247-256.
[8] 李金璞, 饶向荣. 抗病毒药物和急性肾损伤[J]. 中华肾病研究电子杂志, 2023, 12(05): 287-290.
[9] 王小红, 钱晶, 翁文俊, 周国雄, 朱顺星, 祁小鸣, 刘春, 王萍, 沈伟, 程睿智, 秦璟灏. 巯基丙酮酸硫基转移酶调控核因子κB信号介导自噬对重症急性胰腺炎大鼠的影响及机制[J]. 中华消化病与影像杂志(电子版), 2023, 13(06): 422-426.
[10] 陆萍, 邹健. 凝血和纤维蛋白溶解标志物的动态变化对急性胰腺炎患者预后的评估价值[J]. 中华消化病与影像杂志(电子版), 2023, 13(06): 427-432.
[11] 吉茜茜, 田尧, 马林, 钱进. 红细胞分布宽度-白蛋白比值联合BISAP评分对急性胰腺炎严重程度及死亡率的预测价值[J]. 中华消化病与影像杂志(电子版), 2023, 13(06): 433-438.
[12] 黄岩, 刘晓巍, 杨春玲, 兰烨. 急性胰腺炎合并糖尿病患者的临床特征及血糖代谢与病情严重度的相关性[J]. 中华消化病与影像杂志(电子版), 2023, 13(06): 439-442.
[13] 孙旻. 血液淀粉酶、C反应蛋白、降钙素原及乳酸脱氢酶在急性胰腺炎患者病情评价及预后预测中的价值[J]. 中华消化病与影像杂志(电子版), 2023, 13(05): 331-336.
[14] 马强, 李军, 苟丽娟. 重症急性胰腺炎miR-21-3p、RUNX3表达水平及对病情发展程度的预测[J]. 中华消化病与影像杂志(电子版), 2023, 13(05): 337-341.
[15] 田丹阳, 刘小璇, 叶珊, 马新然, 樊东升, 傅瑜. 新型冠状病毒感染疫情对神经内科住院医师规范化培训的影响[J]. 中华脑血管病杂志(电子版), 2023, 17(05): 499-504.
阅读次数
全文


摘要