Anonymous User
Login / Registration

Gastroenterologie
a hepatologie

Gastroenterology and Hepatology

Gastroent Hepatol 2023; 77(4): 307–314. doi: 10.48095/ccgh2023307.

Impact of the COVID-19 pandemic on acute pancreatitis in the Czech Republic – pilot data PANACOTA study (PANcreatitis Acuta in COVid Time Analysis)

Martin Harazim1, Radek Kroupa1, Jiří Jarkovský Orcid.org  2,3, Ondřej Šanca2,3, Tomáš Andrašina4, Vladimír Procházka5, Michal Šenkyřík Orcid.org  1

+ Affiliation

Summary

Introduction: The COVID-19 pandemic had a significant impact on health care. Previous studies point to a possible negative impact of COVID-19 infection on the development and severity of acute pancreatitis. The aim of this study is to analyze the impact of the COVID-19 pandemic on the epidemiology, treatment and prognosis of acute pancreatitis at the population level. Methods: Using data from the National Registry of Reimbursed Health Services (NRRHS) parameters of hospital admissions for acute pancreatitis, the provided health care and treatment outcomes in the pandemic period (2020 and 2021) with previous years (2010–2019) were compared. Results: The incidence during the pandemic was not significantly different from the previous period: 67 vs. 63 per 100,000 population. Hospitalizations for acute pancreatitis in each month of 2020 and 2021 did not correlate with the number of COVID-19 positive patients. The overall mortality rates for acute pancreatitis before and during the pandemic were almost identical – at 3.8% and 3.9%, respectively. There was a trend towards a decrease in the number of surgical procedures, a gradual decrease in ERCPs and an increase in endoscopic drainages throughout the 2010–2021 period. The crude mortality rate of patients hospitalized for COVID-19 and concomitant acute pancreatitis was 14.2% and these patients were operated in 4.7%. Conclusions: Based on pilot population data, the COVID-19 pandemic did not have an impact on the incidence of acute pancreatitis in the Czech Republic. A more severe course and prognosis of the disease was associated with near-term COVID-19 positivity. More frequent indication of surgical and other interventions for acute pancreatitis in COVID-19 positive individuals may have been related to the disruption of standard quality and availability of care.

Keywords

acute pancreatitis, COVID-19, epidemiology, endoscopic drainage, surgery, complication

To read this article in full, please register for free on this website.

Benefits for subscribers

Benefits for logged users

Literature

1. Iannuzzi JP, King JA, Leong JH et al. Global Incidence of Acute Pancreatitis Is Increasing Over Time: A Systematic Review and Meta-Analysis. Gastroenterology 2022; 162(1): 122–134. doi: 10.1053/j.gastro.2021.09.043.
2. Kroupa R, Kunovsky L. Akutní pankreatitida – etiologie, diferenciální diagnostika. In: Trna J, Kala Z. Kunovský L. Klinická pankreatologie. Praha: Maxdorf 2021: 44–60.
3. Boxhoorn L, Voermans RP, Bouwense SA et al. Acute pancreatitis. The Lancet 2020; 396(10252): 726–734. doi: 10.1016/S0140-6736(20)31310-6.
4. Correia de Sá T, Rocha M. The Pancreas in Coronavirus Disease 2019 Infection. Gastroenterol Clin North Am 2023; 52(1): 37–48. doi: 10.1016/ j.gtc.2022.12.002.
5. Pandanaboyana S, Moir J, Leeds JS et al. SARS-CoV-2 infection in acute pancreatitis increases disease severity and 30-day mortality: COVID PAN collaborative study. Gut 2021; 70(6): 1061–1069. doi: 10.1136/gutjnl-2020-323364.
6. Mutneja HR, Bhurwal A, Arora S et al. Acute pancreatitis in patients with COVID-19 is more severe and lethal: a systematic review and meta-analysis. Scand J Gastroenterol 2021; 56(12): 1467–1472. doi: 10.1080/00365521.2021.1971757.
7. Dítě P, Kunovský L, Kupka T et al. Infekce SARS-CoV-2 a postižení slinivky břišní. Gastroenterol Hepatol 2021; 75(4): 286–290. doi: 10.48095/ccgh2021286.
8. Teng TZJ, Chua BQY, Lim PK et al. Occam’s razor or Hickam’s dictum-COVID-19 is not a textbook aetiology of acute pancreatitis: A modified Naranjo Score appraisal. World J Gastroenterol 2023; 29(13): 2050–2063. doi: 10.3748/wjg.v29.i13.2050.
9. Varghese C, Nayar M, Pandanaboyana S. SARS-CoV-2 pandemic has impacted on patterns of aetiology for acute pancreatitis and management of gallstone pancreatitis in the UK. Gut 2022; 71(12): 2602–2605. doi: 10.1136/gut jnl-2021-326845.
10. Brisinda G, Chiarello MM, Tropeano G et al. SARS-CoV-2 and the pancreas: What do we know about acute pancreatitis in COVID-19 positive patients? World J Gastroenterol 2022; 28(36): 5240–5249. doi: 10.3748/wjg.v28.i36.5240.
11. Aziz AA, Aziz MA, Omar N et al. A Meta-analysis of the Severity of Acute Pancreatitis (AP) in COVID-19 Infection. Cureus 2023; 15(5): e38764. doi: 10.7759/cureus.38764.
12. Yang F, Huang Y, Li T et al. Prevalence and outcomes of acute pancreatitis in COVID-19: a meta-analysis. Gut 2022; 71(7): 1451–1453. doi: 10.1136/gutjnl-2021-325941.
13. Chaudhry H, Sohal A, Kohli I et al. The burden of acute pancreatitis on COVID-19 in the United States. Ann Gastroenterol 2023; 36(2): 208–215. doi: 10.20524/aog.2023.0782.
14. Kim S, Choi H, Sim JK et al. Comparison of clinical characteristics and hospital mortality in critically ill patients without COVID-19 before and during the COVID-19 pandemic: a multicenter, retrospective, propensity score-matched study. Ann Intensive Care 2022; 12(1): 57. doi: 10.1186/s13613-022-01028-2.
15. Kang D, Park SH, Oh C et al. Prevalence and prognosis of acute pancreatitis in critically ill patients with COVID-19. Hepatobiliary Pancreat Dis Int 2023; S1499–3872(23)00038-3. doi: 10.1016/j.hbpd.2023.03.004.
16. Bonney GK, Gao Y, Chew CA et al. SARS-COV-2 associated acute pancreatitis: Cause, consequence or epiphenomenon? Pancreatology 2020; 20(5): 1017–1018. doi: 10.1016/j.pan.2020.05.019.
17. Du ZC, Zhang J, Li XJ et al. Impact of COVID-19 pandemic on acute pancreatitis presentations, management, and in-hospital outcomes: a single-center, retrospective observational study from the northeast of China. Therap Adv Gastroenterol 2022; 15: 17562848221145552. doi: 10.1177/17562848221145552.
18. Boxhoorn L, van Dijk SM, van Grinsven J et al. Immediate versus Postponed Intervention for Infected Necrotizing Pancreatitis. N Engl J Med 2021; 385(15): 1372–1381. doi: 10.1056/NEJMoa2100826.
19. Sedláčková J, Zajak J, Jon B et al. Postavení chirurgické léčby v rámci step-up managementu těžké akutní pankreatitidy. Rozhl Chir 2023; 102(2): 64–74. doi: 10.33699/PIS.2023.102.2.64–74.
20. Baron TH, DiMaio CJ, Wang AY et al. American Gastroenterological Association Clinical Practice Update: Management of Pancreatic Necrosis. Gastroenterology 2020; 158(1): 67–75. doi: 10.1053/j.gastro.2019.07.064.
21. Maňák J. Těžká akutní pankreatitida [KDP-AZV-37] – Návrhy klinických doporučených postupů – KDP. 2022 [online]. Dostupné z: https: //kdp.uzis.cz/index.php?pg=kdp &id=44.
22. Xu E, Xie Y, Al-Aly Z. Long-term gastrointestinal outcomes of COVID-19. Nat Commun 2023; 14: 983. doi: 10.1038/s41467-023-36223-7.
23. Ministerstvo zdravotnictví ČR. COVID‑19: Přehled aktuální situace v ČR. 2023 [online]. Dostupné z: https: //onemocneni-aktualne.mzcr.cz/covid-19.

Credited self-teaching test