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Table 2 Published cases of acute pancreatitis associated with SARS-CoV-2 infection

From: Acute pancreatitis associated with severe acute respiratory syndrome coronavirus-2 infection: a case report and review of the literature

Author Country Age Sex Pulmonary symptoms Extra-pulmonary symptoms Physical examination findings Chest CT Abdominal CT Serum lipase and serum amylase SARS-CoV-2 RT-PCR Other laboratory test performed to exclude other etiologies Outcome
Myeres et al. [13] USA 67 Male Acute hypoxic respiratory failure Acute onset epigastric abdominal discomfort and fever Epigastric tenderness Ground-glass opacity in the right lung apex Acute interstitial edematous pancreatitis with moderate peripancreatic stranding and edema L: 5295 U/L
A: not reported
Not done; only SARS-CoV-2 rapid test was positive
3 days after onset of abdominal pain and 2 days after hospitalization
Liver chemistry tests, serum triglycerides, serum immunoglobulin G4 Alive
Samies et al. [14] USA 15 Male Nasal congestion Anosmia, ageusia, vomiting, and abdominal pain Epigastric tenderness Scattered ground-glass opacities in bilateral lung fields Mild stranding around the head of the pancreas L: 233 U/L
(4–39 U/L)
A: not reported
Positive
2 days after onset of abdominal pain and 1 day after hospitalization
Liver chemistry tests, serum triglycerides. Alive
Samies et al. [14] USA 11 Male None reported Headache, chills, tactile fever, abdominal pain, hematochezia, and epistaxis Epigastric tenderness Interstitial opacities with peribronchial thickening Fatty infiltration of the liver, enlarged appendix, and normal pancreas L: 582 U/L
(4–39 U/L)
A: 156 U/L
Positive on the same day of onset of abdominal pain and 2 days prior to hospitalization Liver chemistry tests, serum triglycerides (elevated to 251 mg/dl), cholesterol (normal) Alive
Samies et al. [14] USA 16 Female Cough Subjective fever, nausea, and abdominal pain Epigastric tenderness Not evaluated Hepatomegaly, single gallstone, and prominence of the pancreas L: 1909 U/L
(4–39 U/L)
A: not reported
Positive 1 week prior to onset of abdominal pain Liver chemistry tests, serum triglycerides, cholesterol Alive
Fernandes et al. [15] Brazil 36 Female Dyspnea Fever, headache, and abdominal pain Not reported Bilateral pulmonary opacities Acute interstitial pancreatitis with acute peripancreatic fluid collection L: 640 U/L
A: 710 U/L
Positive None reported Alive
Lakshmanan et al. [16] USA 68 Male None reported Loss of appetite, anorexia, nausea, and vomiting Dehydration, lethargy, and soft, nontender abdomen Not evaluated Peripancreatic fat stranding, most remarkable around the tail, with mild duodenal wall thickening and adjacent fat stranding, likely from pancreatitis. The gallbladder appeared normal, without wall thickening or surrounding inflammatory changes, and the common bile duct was not dilated L: 2035 U/L
A: 1030 U/L
Positive 2 days prior to hospitalization and 7 days prior to diagnosis of pancreatitis Liver chemistry tests, total bilirubin, serum triglycerides, serum calcium Alive
Kurihara et al. [17] Japan 55 Male Severe respiratory distress necessitated intubation and ECMO Could not be evaluated due to sedation Could not be evaluated due to sedation Not evaluated Pancreas with diffuse parenchymal enlargement and stranding of the surrounding retroperitoneal fat L: 263 U/L
(16–55 U/L)
A: 252 U/L
(44–132 U/L)
Positive on day 8 after respiratory symptom onset Serum triglycerides (mild elevation), serum calcium Alive
Alves et al. [18] Brazil 56 Female Dry cough and dyspnea General malaise and epigastric pain Not reported Multiple ground-glass opacities, interlobular septal thickening, and consolidation areas Heterogeneously enhancing and edematous pancreas L: 2993 U/L
A: 544 U/L
Positive Serum triglycerides (209 mg/dl), serum calcium (1.24 mg/dl) Alive
Wang et al. [19] China 42 Male Chest discomfort and shortness of breath Nausea and persistent upper abdominal pain with radiation to the back for 3 days Not reported Multiple ground-glass opacities in both lungs The prominence of the pancreas and peripancreatic fluid accumulation, without biliary dilatation or microlithiasis L: 382 U/L
(0–180 U/L)
A: 132 U/L
(0–180)
Positive on day 5 of abdominal pain Serum triglycerides: 3.2 mmol/L
( < 1.7 mmol/L),
Serum calcium
Dead
Wang et al. [19] China 35 Male None reported Five days of persistent upper abdominal pain with radiation to the back, nausea, and vomiting Not reported Patchy shadows in the lower right lung and bilateral pleural effusion Pancreatic swelling, peripancreatic fluid accumulation, and prerenal fascial thickening without biliary dilatation or microlithiasis L: 1042 U/L
(0–180 U/L)
A: normal
Positive on day 6 of abdominal pain Serum triglycerides: 3.97 mmol/l
( < 1.7 mmol/l),
Serum calcium
Alive
Patnaik et al. [20] India 29 Male Dyspnea Acute diffused abdominal pain of 5 days duration that radiated to the back and progressively worsened and low-grade fever Abdominal tenderness maximal in the umbilical region Not evaluated Swollen pancreas L: 1650 U/L
A: 2861 U/L
Positive Serum triglycerides, serum calcium Alive
Kumaran et al. [21] UK 67 Female None reported Epigastric pain, diarrhea, and vomiting Not reported Not evaluated Necrotizing pancreatitis L: not evaluated
A: 1483 U/L
Positive Liver chemistry tests, serum triglycerides, serum calcium, immunoglobulin G4 Alive
Gonzalo-Voltas et al. [22] Spain 76 Female None reported Epigastric pain, fever, vomiting, and diarrhea Not reported Not evaluated Interstitial edematous pancreatitis L: not evaluated
A: 3568 IU/L
Positive None reported Alive
Cheung et al. [23] USA 38 Male None reported Fever and epigastric pain Not reported Not evaluated Not evaluated L: 10,255 ukat/L Positive 1 week prior to presenting in the emergency department Liver chemistry tests, serum triglycerides, serum calcium, serum bilirubin Alive
Kataria et al. [24] USA 49 Female Dry cough, shortness of breath, and hypoxic respiratory failure Fever, nausea, vomiting, and severe abdominal pain radiating to the back Not reported Multifocal infiltrates involving the posterior basal segment of the left lower lobe and an apical–posterior segment of the left upper lobe Diffuse enlargement of pancreas with ill-defined borders and surrounding peripancreatic fluid L: 1451 IU/L
(0–160)
A: 501 IU/L
(30–110)
Positive on the second day of hospitalization Liver chemistry tests, serum triglycerides, serum cholesterol, serum calcium, total bilirubin Alive
Brikman et al. [25] Israel 61 Male Cough, dyspnea, and hypoxemia Fever, weight loss, and diffuse abdominal tenderness Soft abdomen with no signs of peritoneal irritation Not evaluated Focal parenchymal enhancement of the pancreas head with inflammatory changes in peripancreatic fat L: 203 U/L
(21–67 U/L)
A: 142 U/L
(28–100 U/L)
Positive Serum triglycerides: 3.18 mmol/L
(1.8 mmol/L), direct bilirubin
Alive
Mazrouei et al. [26] UAE 24 Male Mild upper respiratory tract symptoms Nonradiating epigastric pain, nausea, and vomiting Epigastric discomfort on palpation Not evaluated Edema of the distal pancreas with surrounding fluid L: 578 IU/L
A: 391 U/L
Positive 1 day prior to presenting to the emergency department None reported Alive
Bokhari et al. [27] Pakistan 32 Male Sore throat and productive cough High fever, chills, severe epigastric pain radiating to back, and nonbilious vomiting Not reported Not evaluated Bulky and swollen pancreas with significant peripancreatic inflammatory changes and fluid collection along the gastrosplenic ligament L: 721 IU/L
A: 672 IU/L
Positive 8 days after onset of symptoms. Liver chemistry tests, serum triglycerides, serum calcium Alive
Alloway et al. [28] USA 7 Female None reported Fever and abdominal pain Distension and tenderness to palpation in the left upper and left lower quadrant, and the epigastric regions Not evaluated in the second attack
(the first attack showed small bilateral pleural effusion)
Not evaluated in the second attack
(the first attack showed necrotizing pancreatitis)
L: 676 U/L in the first attack
1672 U/L in the second attack
(80–360 U/L)
A: not reported
Not done in the first attack
Positive in the second attack
Serum LDH Alive
Rabice et al. [29] USA 36 Female (33 weeks pregnant) Dry cough and dyspnea Nausea, vomiting, and epigastric pain Epigastric tenderness Not evaluated Not evaluated L: 875 U/L
A: 88 U/L
Positive Liver chemistry tests. Serum triglycerides (210 mg/dl) Alive
Pinte et al. [30] Romania 47 Male Dry cough Severe epigastric pain with radiation to the back, nausea,
constipation, and lack of flatus
Epigastric tenderness Scattered bilateral subpleural ground-
glass opacities
Blurring of the pancreatic contours due to the
edema of the surrounding adipose tissue
L: 22× upper limit of normal
A: 6× upper limit of normal
Positive Serum triglycerides, serum calcium, gamma-glutamyltranspeptidase Alive
Meireles et al. [31] Portugal 36 Female Dry cough, breathlessness, and fever Nausea, vomiting, and epigastric pain No physical findings Bilateral ground-glass opacities with 75–100% lung involvement No pancreatic abnormalities L: 631 U/L
A: 718 U/L
Positive 4 days after onset of cough Serum triglycerides, serum cholesterol, serum calcium, ANA screening. Anti-HIV 1 and 2, HBs antigen, anti-HCV antibody, anti-Coxsackie antibody (IgM/IgG), anti-herpes virus 1 antibody (IgM/IgG), anti-herpes virus 2 antibody (IgM/IgG), anti-CMV antibody (IgM/IgG) Alive
Miao et al. [32] France 26 Female None reported Fever, epigastric pain, and severe vomiting Not reported Bilateral basal condensations and pleural effusions Enlarged pancreas gland without any structural abnormality L: 211 U/L
A: not reported
Positive Liver chemistry tests, serum triglycerides, serum calcium, serological tests for human immunodeficiency virus, hepatitis B and C, Coxsackie viruses, Chlamydia, Mycoplasma, antinuclear and anti-DNA antibodies Alive
Aloysius et al. [33] USA 36 Female Dry cough and progressive dyspnea Fever, stabbing epigastric pain, vomiting, and diarrhea Severe epigastric tenderness Multifocal bilateral ground-glass opacities Normal L: 627 U/L
A: 325 U/L
Positive Liver chemistry test, serum triglycerides, serum procalcitonin, total and direct bilirubin Unknown
Hadi et al. [34] Denmark 47 Female Acute respiratory distress None reported Not reported Not evaluated Not evaluated L: not evaluated
A: more than 1500 U/L
Positive Serum triglycerides, serum calcium Still in ICU
Hadi et al. [34] Denmark 68 Female Dyspnea and hypoxia that necessitated intubation and mechanical ventilation Abdominal pain Epigastric tenderness Not evaluated Not evaluated L: not evaluated
A: 934 U/L
Positive Serum triglycerides, serum calcium Still in ICU
Anand et al. [35] UK 59 Female Cough and sore throat Fever, myalgia, abdominal pain, and constipation Not reported Not evaluated A previously atrophic pancreas that had increased markedly in size and had features of diffuse edematous changes, suspicious for acute pancreatitis L: not evaluated
A: not evaluated
Positive None reported Alive
Hassani et al. [36] Iran 78 Female None reported Severe positional epigastric pain precipitated by lying supine, nausea, vomiting, and chills with no fever Epigastric tenderness Patchy peripheral ground glass infiltrations in both lungs Not evaluated L: 230 IU/L
A: 185 IU/L
Positive Liver chemistry tests, lipids profile, serum electrolytes Alive
Kandasamy et al. [37] India 45 Female None reported Severe sharp epigastric pain radiating to the back Severe epigastric tenderness Multifocal areas of ground-glass opacities, consistent with CO-RADS score of 5 Diffusely enlarged pancreas with acute peripancreatic and pararenal collections L: 293 IU/L
A: 364 IU/L
Positive Liver chemistry, total bilirubin, gamma-glutamyltransferase, alkaline phosphatase Alive
  1. L, serum lipase; A, serum amylase.