Acute pancreatitis in COVID-19 patients: true risk?

Scand J Gastroenterol. 2021 May;56(5):585-587. doi: 10.1080/00365521.2021.1896776. Epub 2021 Mar 14.


Background: A relation between coronavirus disease 2019 (COVID-19) and acute pancreatitis has been suggested. However, the incidence and clinical relevance of this relation remain unclear.

Objective: We aimed to investigate the incidence, severity and clinical impact of acute pancreatitis in patients with COVID-19.

Methods: This is a cross-sectional study of a prospective, observational cohort concerning all COVID-19 patients admitted to two Dutch university hospitals between 4 March 2020 and 26 May 2020. Primary outcome was acute pancreatitis potentially related to COVD-19 infection. Acute pancreatitis was defined according to the revised Atlanta Classification. Potential relation with COVID-19 was defined as the absence of a clear aetiology of acute pancreatitis.

Results: Among 433 patients with COVID-19, five (1.2%) had potentially related acute pancreatitis according to the revised Atlanta Classification. These five patients suffered from severe COVID-19 infection; all had (multiple) organ failure and 60% died. None of the patients developed necrotizing pancreatitis. Moreover, development of acute pancreatitis did not lead to major treatment consequences.

Conclusions: In contrast with previous research, our study demonstrated that COVID-19 related acute pancreatitis is rare and of little clinical impact. It is therefore debatable if acute pancreatitis in COVID-19 patients requires specific screening. We hypothesize that acute pancreatitis occurs in patients with severe illness due to COVID-19 infection as a result of transient hypoperfusion and pancreatic ischemia, not as a direct result of the virus.

Keywords: Acute pancreatitis; COVID-19; coronavirus disease.

Publication types

  • Observational Study

MeSH terms

  • COVID-19* / epidemiology
  • COVID-19* / physiopathology
  • COVID-19* / therapy
  • Cross-Sectional Studies
  • Female
  • Humans
  • Incidence
  • Intensive Care Units / statistics & numerical data
  • Ischemia / etiology
  • Ischemia / physiopathology
  • Length of Stay / statistics & numerical data
  • Male
  • Middle Aged
  • Multiple Organ Failure* / diagnosis
  • Multiple Organ Failure* / etiology
  • Multiple Organ Failure* / physiopathology
  • Netherlands / epidemiology
  • Outcome and Process Assessment, Health Care
  • Pancreas* / blood supply
  • Pancreas* / physiopathology
  • Pancreatitis* / diagnosis
  • Pancreatitis* / epidemiology
  • Pancreatitis* / etiology
  • Pancreatitis* / physiopathology
  • Severity of Illness Index