COVID-19 infection presenting as pancreatitis in a pregnant woman: A case report

Rabice, S.; Altshuler, Paulina C.; Bovet, Claire; Sullivan, Cathlyn; Gagnon, Amy J.

doi:10.1016/j.crwh.2020.e00228

Cited by 36 publications

(25 citation statements)

References 17 publications

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“…Pancreas 2020;49:e108–9. doi: 10.1097/MPA.0000000000001696) 5 , 6 of acute pancreatitis in the setting of COVID-19, with suggestion of pancreatic injury occurring in up to 17% of afflicted patients. 7 , 8 A review of PubMed using search terms “SARS-CoV-2,” “COVID-19,” “pregnancy,” and “pancreatitis” from inception through November 8, 2020, identified limited data on acute pancreatitis in a previously healthy pregnant patient with COVID-19 infection.…”

Section: Discussionmentioning

confidence: 99%

Acute Pancreatitis in a Pregnant Patient With Coronavirus Disease 2019 (COVID-19)

Narang

Szymanski

Kane

et al. 2020

Obstetrics &Amp; Gynecology

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Section: Discussionmentioning

confidence: 99%

Acute Pancreatitis in a Pregnant Patient With Coronavirus Disease 2019 (COVID-19)

Narang

Szymanski

Kane

et al. 2020

Obstetrics &Amp; Gynecology

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show abstract

“…[ 40 ](Iran) Case report ✚ ✚ Normal No respiratory symptoms Rabice et al. [ 44 ](USA) Case report ✚ ✚ Not done Pregnant female with Clinical AP Morrison et al. [ 55 ](USA) Case report ✚ — Not done Tocilizumab induced hypertriglyceridemia; 1 case had AP Szatmary et al.…”

Section: Real World Data Of Covid-19 and Pancreatic Injurymentioning

confidence: 99%

“…Rabice et al. [ 44 ] reported a case of a 36-yr-old pregnant female with respiratory symptoms followed by development of clinical AP and she was found to be COVID-19 positive. Cheung et al.…”

Section: Real World Data Of Covid-19 and Pancreatic Injurymentioning

confidence: 99%

Coronavirus disease 2019 and the pancreas

et al. 2020

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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. Although, a primary respiratory pathogen, over the ensuing period, its extra-pulmonary effects have come to the forefront. The virus, having multi-organ tropism, has been shown to affect a host of other organs beyond the lung, including the pancreas. The data on pancreatic involvement by COVID-19, however, have been limited. Moreover, whether the effects on the pancreas are due to the direct effects of the virus or is just an epi-phenomenon is debatable. The prevalence of pancreatic injury and degree of injury are the other issues that need to be addressed. Pancreatic cancer has a dismal prognosis and the management of the same in the COVID era needs to be tailored assessing the risk-benefit ratio for the same. Additionally, pancreatic surgery increases not only the morbidity of the patient, but also the risk of the operator and burden on the health care system. Hence, the decision for such major procedures needs to be rationalized for optimum benefit during this pandemic. Similarly, for the endoscopist, pancreatic endoscopy needs to be carefully regulated to reduce risk to both the patient and the physician and yet deliver optimum patient care. This review gives a concise summary of various aspects of pancreatic involvement and pancreatic disease management during this pandemic.

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“…While recent case reports of patients with COVID-19 have included mild elevations of amylase and lipase or frank pancreatitis (Karimzadeh et al, 2020;Meireles et al, 2020;Rabice et al, 2020;, the vast majority of patients with COVID-19 have neither elevated pancreatic enzymes nor frank pancreatitis (Ashok et al, 2020;Bonney et al, 2020;Bruno et al, 2020). Because rare cells in the exocrine compartment co-express ACE2 and TMPRSS2, it is possible that SARS-CoV-2 could infect those cells, induce pancreatitis, and consequently impact islet function.…”

Section: Both Ace2 and Tmprss2 Protein Are Present In Pancreatic Ductmentioning

confidence: 99%

SARS-CoV-2 Cell Entry Factors ACE2 and TMPRSS2 are Expressed in the Pancreas but are Not Enriched in Islet Endocrine Cells

Coate

Cha

Shrestha

et al. 2020

Preprint

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Summary/AbstractReports of new-onset diabetes and diabetic ketoacidosis in individuals with COVID-19 have led to the hypothesis that SARS-CoV-2, the virus that causes COVID-19, is directly cytotoxic to pancreatic islet β cells. This model would require binding and entry of SARS-CoV-2 into host cells via cell surface co-expression of ACE2 and TMPRSS2, the putative receptor and effector protease, respectively. To define ACE2 and TMPRSS2 expression in the human pancreas, we examined six transcriptional datasets from primary human islet cells and assessed protein expression by immunofluorescence in pancreata from donors with and without diabetes. ACE2 and TMPRSS2 transcripts were low or undetectable in pancreatic islet endocrine cells as determined by bulk or single cell RNA sequencing, and neither protein was detected in α or β cells from any of these donors. Instead, ACE2 protein was expressed in the islet and exocrine tissue microvasculature and also found in a subset of pancreatic ducts, whereas TMPRSS2 protein was restricted to ductal cells. The absence of ACE2 and TMPRSS2 co-expression in islet endocrine cells makes it unlikely that SARS-CoV-2 directly affects pancreatic islet β cells.

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COVID-19 infection presenting as pancreatitis in a pregnant woman: A case report

Cited by 36 publications

References 17 publications

Acute Pancreatitis in a Pregnant Patient With Coronavirus Disease 2019 (COVID-19)

Acute Pancreatitis in a Pregnant Patient With Coronavirus Disease 2019 (COVID-19)

Coronavirus disease 2019 and the pancreas

SARS-CoV-2 Cell Entry Factors ACE2 and TMPRSS2 are Expressed in the Pancreas but are Not Enriched in Islet Endocrine Cells

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