Insufficient etiological workup of COVID-19-associated acute pancreatitis: A systematic review

World J Gastroenterol. 2020 Oct 28;26(40):6270-6278. doi: 10.3748/wjg.v26.i40.6270.


Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, mostly causing respiratory symptoms, is also known to affect the gastrointestinal tract. Several case reports hypothesize that SARS-CoV-2 could be an etiological factor in acute pancreatitis (AP).

Aim: To assess all the available evidence in the literature relating to coronavirus disease 2019 (COVID-19) and AP.

Methods: We performed a systematic review of the available literature on the topic. The systematic search was conducted on 15 May 2020 on MEDLINE, EMBASE, CENTRAL, Web of Science and Scopus with a search key using the terms "amylase," "lipase," "pancr*," "COVID-19" and synonyms. Due to the low quality and poor comparability of the studies, a meta-analysis was not performed.

Results: Six case reports and two retrospective cohorts were included, containing data on eleven COVID-19 patients with AP. Five patients had AP according to the Atlanta classification. Other publications did not provide sufficient information on the diagnostic criteria. Most cases were considered SARS-CoV-2-induced, while several established etiological factors were not investigated. We were able to identify other possible causes in most of them.

Conclusion: We strongly highlight the need for adherence to the guidelines during a diagnostic and etiological workup, which could alter therapy.

Keywords: Amylase; COVID-19; Lipase; Pancreas; Pancreatic involvement; Pancreatitis.

Publication types

  • Systematic Review

MeSH terms

  • Acute Disease
  • Betacoronavirus / isolation & purification*
  • COVID-19
  • COVID-19 Testing
  • Clinical Laboratory Techniques / methods*
  • Clinical Laboratory Techniques / standards
  • Coronavirus Infections / complications
  • Coronavirus Infections / diagnosis*
  • Guideline Adherence
  • Humans
  • Pancreatitis / virology*
  • Pandemics
  • Pneumonia, Viral / complications
  • Pneumonia, Viral / diagnosis*
  • Practice Guidelines as Topic
  • SARS-CoV-2