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

Abstract

Background: Since initially detected in late December 2019, the novel coronavirus disease 2019 (COVID-19) outbreak rapidly swept the world, which has profoundly affected healthcare system and clinical practice in the management of gastrointestinal diseases. Objectives: We aimed to evaluate the impact of COVID-19 pandemic on the pattern of hospital admissions and healthcare services for acute pancreatitis (AP). Design: We conducted a retrospective observational cohort study using the anonymized electronic medical records. Methods: This single-center, retrospective observational study from a regional medical center in the northeast of China included all consecutively admitted patients with AP from 23 January to 10 June 2020 (during the COVID-19 outbreak in Harbin), compared with the equivalent period of the previous year, in terms of demographics, clinical characteristics, and in-hospital outcomes. Results: In this article, we observed a reduction in AP admissions after the beginning of COVID-19 outbreak. With the prolonged time from symptom onset to hospitalization [32.0 (22.0–72.0) versus 18.0 (12.0–24.0) h; p < 0.001], a higher proportion of AP patients developed acute renal failure (14.0% versus 7.4%, p = 0.004) and acute necrotic collection (16.5% versus 11.2%; p = 0.038) in the COVID-19 era. The percentage of alcohol etiology significantly decreased after the implementation of social restriction measures (11.5% versus 20.4%; p = 0.002), whereas biliary etiology was numerically more common amidst the COVID-19 era (41.6% versus 32.6%; p = 0.014). No significant differences were found in the rates of intensive care unit admission and mortality between the two groups. Conclusion: This study preliminarily demonstrated the descending trend and delay in hospital presentations for AP during the outbreak of COVID-19. Given that the pandemic may persist for several years, adjustments of medical services according to the varying degrees of local breakouts are imperative to provide appropriate care for AP patients and diminish the risk of viral transmission. Registration: ClincialTrials.gov number ChiCTR2100043350.

What has changed? The impact of the COVID-19 pandemic on the management of acute biliary pancreatitis

“…Du et al reported that while admissions for AP were 279 patients during COVID-19, it was 457 patients in the equivalent period in 2019. [ 6 ] In our study, the number of patients admitted with ABP during COVID-19 decreased by 40.3% compared to the previous year, decreasing from 57 patients to 34 patients. In times of the highest number of new cases, the number of patients admitted to the ER decreased to one per month.…”

“…Studies have shown that timely initiation of ABP therapy is important for improving tissue hypoperfusion, reducing the inflammatory response, and minimizing mortality. [ 6 ] It was also reported that there was a decrease in the number of daily USG and computed tomography scans when the health system was locked down. [ 10 ] In our study of ABP patients, no statistical difference was found in the volume of USG, Ab-CT, and MRI in the COVID period compared to the pre-COVID period.…”

“…[ 4 , 5 ] Du et al detected that, although it was not statistically significant in the etiology of AP, while the biliary etiology increased during the COVID period, some other factors showed a decrease. [ 6 ] Acute biliary pancreatitis (ABP) is an inflammatory process with a clinical course ranging from mild interstitial edema to pancreatic necrosis. The inflammatory response that develops during ABP can lead to systemic inflammatory response syndrome (SIRS).…”

COVID-19 aus Sicht der Gastroenterologie

“…Während in der Konsequenz der Kontaktbeschränkungen aus China eine Abnahme der stationären Behandlungen wegen alkoholinduzierter akuter Pankreatitis berichtet wird [ 8 ], berichtet eine Studie aus den USA einen signifikanten Anstieg von Inzidenz und Mortalität alkoholinduzierter akuter Pankreatitiden [ 4 ]. Dies wird als eine Folge gestiegenen Alkoholkonsums und beeinträchtigter seelischer Gesundheit der Bevölkerung diskutiert.…”

Ethical Challenges Involved in COVID-19 Vaccine Mandates for Children: A Systematic Review

“…The first case of COVID-19 was reported in late December 2019 [ 1 ] in Wuhan, China [ 2 ]. Soon after, it became a global pandemic with 290,000,000 confirmed cases and 5,446,753 deaths over the past two years all over the world [ 3 ].…”