Skip to main content
NCBI home page
Elsevier - PMC COVID-19 Collection logoLink to Elsevier - PMC COVID-19 Collection
. 2022 Apr 4;364(3):257–263. doi: 10.1016/j.amjms.2022.03.007

Hyperlipidemia, COVID-19 and acute pancreatitis: A tale of three entities

Qiuyi Tang 1,2,†, Lin Gao 2,†, Zhihui Tong 2,⁎, Weiqin Li 1,2,⁎
PMCID: PMC8977370  PMID: 35381217

Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused the ongoing pandemic of coronavirus disease 2019 (COVID-19), which presented as not only respiratory symptoms, but various digestive manifestations including pancreatic injury and acute pancreatitis (AP). The underlying mechanism is still unclear. Hypertriglyceridemia has become one of the leading causes of AP in recent years and hyperlipidemia is highly reported in COVID-19 cases. The current narrative review aimed to explore the associations between AP, COVID-19 and hyperlipidemia. Substantial cases of COVID-19 patients complicated with AP were reported, while the incidence of AP in the COVID-19 population was relatively low. Hyperlipidemia was common in COVID-19 patients with a pooled incidence of 32.98%. Hyperlipidemia could be a mediating factor in the pathogenesis of AP in COVID-19 patients. Further studies are warranted to clarify the relationship among AP, lipid metabolism disorders and COVID-19.

Key Indexing Terms: COVID-19, SARS-CoV-2, Hyperlipidemia, Acute pancreatitis, Pancreatic injury

Introduction

The ongoing pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection-induced coronavirus disease 2019 (COVID-19) has led to over 164 million infected cases and 3 million deaths worldwide by May 20, 2021. Although most of the infected adults have self-limited disease courses, about 5% of infections may progress to critical illness, featured as severe acute respiratory distress syndrome (ARDS), thrombosis complications, myocardial dysfunction, acute kidney injury, gastrointestinal symptoms, hyperlipidemia, and even multiple organ dysfunction syndrome (MODS).1 , 2 Amongst, the gastrointestinal symptoms mainly include anorexia, nausea, vomiting, diarrhea, and abdominal pain, which have been observed at disease onset or prior to respiratory symptoms in patients diagnosed with COVID-19.

Acute pancreatitis (AP) is the inflammatory disease of the exocrine pancreas characterized by severe abdominal pain and elevated pancreatic enzymes (amylase and lipase), the incidence of which is increasing rapidly in recent years.3 In published literature, numerous cases of COVID-19 complicated with AP have been reported (Table 1 ).4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46 However, no robust causative relationship has been established between them.

TABLE 1.

Reported cases of COVID-19 patients with acute pancreatitis.

Author Age Gender TG BMI Outcome
Wifi, M. N. 72 F 81mg/dL 33.14 Discharged
Tollard, C. 32 F Normal 40.4 Died
Sandhu, H. 25 F Discharged
Samies, N. L. 15 M 34.4 Discharged
Samies, N. L. 11 M 251 mg/dL 29.5 Discharged
Samies, N. L. 16 F Normal 18.7 Discharged
Narang, K. 20 F Normal 36.1 Discharged
Mohammadi Arbati, M. 28 M 122 mg/dL Discharged
Maalouf, R. G. 62 M Normal Discharged
Bouali, M. 60 F 24 Died
Bineshfar, N. 14 M Discharged
Ali, E. 53 M 1.4 mmol/L Died
AlHarmi, R. A. R. 52 F 3.4 mmol/L Discharged
Abraham, G. 61 F Discharged
Abbas, M. 14 M 5.5 mmol/L 21.6 Discharged
Zielecki, P. 38 M Discharged
Wang, K. 42 M 3.2 mmol/L Died
Wang, K. 35 M 3.97 mmol/L Discharged
Szatmary, P. 29 M 2.7 mmol/L 32.9 Discharged
Szatmary, P. 41 M 2.7mmol/L 35.8 Discharged
Szatmary, P. 42 M 2.7mmol/L 29.7 Discharged
Szatmary, P. 47 M 2.7mmol/L 25.7 Discharged
Szatmary, P. 53 M 2.7mmol/L 30 Discharged
Simou, E. M. 67 2.40 mmol/L 34 Died
Shinohara, T. 58 M Normal Discharged
Rabice, S. R. 36 F 44 Discharged
Purayil, N. 58 M Discharged
Pinte, L. 47 M Discharged
Patnaik, R. N. K. 29 M 84 mg/dL Discharged
Miao, Y. 26 F Normal Discharged
Meyers, M. H. 67 M Normal Discharged
Meireles, P. A. 36 F TC:119 mg/dL Discharged
Mazrouei, S. S. A. 24 M Discharged
Lakshmanan, S. 68 M Discharged
Kurihara, Y. 55 M 185 mg/dL Discharged
Kumaran, N. K. 67 F 27.5 Discharged
Kataria, S. 49 F Discharged
Karimzadeh, S. 65 F 80 mg/dL Discharged
Kandasamy, S. 45 F Discharged
Hassani, A. H. 78 F Died
Hadi, A. 47 F Normal Discharged
Hadi, A. 68 F Normal Discharged
Gonzalo-Voltas, A. 76 F Discharged
Gadiparthi, C. 40 M 4245 mg/dL 38.8 Discharged
Cheung, S. 38 M Normal Discharged
Brikman, S. 61 M 3.18mmol/L Discharged
Bokhari, S. 32 M 150 mg/dL Discharged
Anand, E. R. 59 F Discharged
Alwaeli, H. 30 M 133 mg/dL 21.4 Discharged
Alves, A. M. 56 F 209 mg/dL Discharged
Alloway, B. C. 7 F Discharged
Open in a new tab

Abbreviations: TC, total cholesterol; TG, total glycerides

Given the considerable presence of hyperlipidemia in COVID-19 cases, we postulated that hyperlipidemia might play a potential role between COVID-19 and AP. Hence, this narrative review aimed to accumulate evidence on the incidence of hyperlipidemia and AP in the COVID-19 population, and demonstrate whether hyperlipidemia acted as a mediating factor in COVID-19 patients combined with AP.

The correlation between AP and COVID-19

We used “COVID-19” and “acute pancreatitis” as search terms to retrieve related articles in PubMed database. The results of different studies were controversial. An epidemiological study from Spain including 63,822 COVID-19 patients showed that the incidence of AP in COVID-19 patients was 0.71% compared with 1.59% in the non-COVID-19 population (OR 0.44, 95% CI 0.33–0.60).47 In another study which included 74,814 COVID-19 patients, 54 patients were complicated with AP (0.72%) and the incidence rate was lower than that in the non-COVID-19 population (1.61%).48 However, a case-control study that included 112 COVID-19 children and 8047 non-COVID-19 children came to the opposite conclusion, the incidences of AP in two groups were 1.8% and 0.14%, respectively.49 In addition, another study reported that 1.25% of 398 pediatric COVID-19 patients were complicated with AP.50 It seems that AP was more prevalent in pediatric COVID-19 patients than in adult patients. It was shown in one study that almost no AP occurred in COVID-19 patients with mild disease courses, while most of AP cases were present in critically ill COVID-19 patients.51

For AP patients, the coexistence of COVID-19 could lead to a worse prognosis of AP. A prospective multicenter cohort study compared the outcomes of AP patients with or without COVID-19, with the results showing that AP patients infected by SARS-CoV-2 were more likely to develop local complications, persistent organ failure, have prolonged hospital stay, higher 30-day mortality, and require ICU admission.52 A retrospective observational study included 189 AP cases, 32 of them were COVID-19 positive and these patients required more mechanical ventilation and had a longer length of hospital stay (OR=5.65, 3.22, respectively).53

The correlation between hyperlipidemia and COVID-19

We used “COVID-19” and “hyperlipidemia” as search terms to retrieve related articles in PubMed database. Thirty-four papers were reviewed after screening, which reported the incidence of hyperlipidemia in COVID-19 patients (Table 2 ).54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88 The incidence of hyperlipidemia ranged from 0.30% to 81.82% in COVID-19 patients among different studies. Potential reasons for the variations could be: (1) Regional factors led to the difference in baseline lipids levels; (2) The definition of hyperlipidemia varied in different studies. An epidemiological study in Iran focusing on COVID-19 patients with diabetes reported that only 49 cases of hyperlipidemia presenting in 16,391 COVID-19 patients (0.30%), however, the incidences of hyperlipidemia in COVID-19 patients from other studies were all much higher than those in the normal population. The aggregated incidence was 32.98% in pooled COVID-19 patients.

TABLE 2.

Incidence of hyperlipidemia in Covid-19 patients in different studies.

Author Specific Population Total Hyperlipidemia Rate
Wu, B. COVID-19 9822 6309 64.23%
Wang, D. COVID-19 patients in Fangcang hospital 349 32 9.17%
Tzur Bitan, D. COVID-19 with schizophrenia 25539 10981 43.00%
Spoulou, V. Newborns with COVID-19 14 6 42.86%
Qureshi, A.I. COVID-19 with stroke 7709 2613 33.90%
Pérez-García, C.N. COVID-19 died in hospital 324 187 57.72%
Pareek, M. COVID-19 586 226 38.57%
Moftakhar, L. COVID-19 with diabetes 16391 49 0.30%
Karimi, F. COVID-19 with AIDS 252 49 19.44%
Mirzaei, H. COVID-19 164 10 6.10%
Giannis, D. COVID-19 with venous thrombosis 146 21 14.38%
Chetboun, M. COVID-19 1461 423 28.95%
Aldhaeefi, M. COVID-19 530 204 38.49%
Xu, H. COVID-19 with pulmonary embolism 101 32 31.68%
Wong, K. COVID-19 with pneumothorax 75 24 32.00%
Wei, Z.Y. COVID-19 with myocardial injury 400 11 2.75%
Wang, B. COVID-19 with multiple myeloma 58 36 62.07%
Tee, L.Y. COVID-19 in immigrant workers 240 11 4.58%
Tan, W.Y.T. COVID-19 717 156 21.76%
Shady, A. COVID-19 admitted in community hospital 371 102 27.49%
Rameez, F. COVID-19 with stroke 11 9 81.82%
Piazza, G. COVID-19 1114 319 28.64%
Palaiodimos, L. COVID-19 200 92 46.00%
Nimkar, A. COVID-19 with AKI 327 114 34.86%
Newton, S. COVID-19 991 224 22.60%
Nakanishi, H. COVID-19 60 13 21.67%
Mori, S. COVID-19 45 8 17.78%
Kenes, M.T. COVID-19 with propofol infusion 27 9 33.33%
He, S. COVID-19 420 45 10.71%
Gómez Antúnez, M. COVID-19 with COPD 10385 4071 39.20%
Fernandes, N.D. COVID-19 37 15 40.54%
Ebert, T.J. COVID-19 95 53 55.79%
Dashti, H.T. COVID-19 4140 1530 36.96%
Best, J.H. COVID-19 3471 566 16.31%
Miguel León Sanz ARDS-COVID-19 receiving parental nutrition 87 32 36.78%
Open in a new tab

Abbreviations: AKI, acute kidney injury; ARDS, acute respiratory distress syndrome; COPD, chronic obstructive pulmonary disease.

Hyperlipidemia was commonly presented in critically ill COVID-19 patients and the potential causes for it could be: hemophagocytic lymphohistiocytosis, medication and acute liver injury.89 For instance, some studies suggested that ARDS patients with COVID-19 experienced a higher rate of propofol-associated hypertriglyceridemia than non-COVID-19 induced ARDS patients, even after adjusting for propofol administration doses.81 It was reported that the incidence of propofol-associated hypertriglyceridemia was 18%-45% in the non-COVID-19 population, but could be as high as 56.6% in COVID-19 patients.90 Besides, there was a case report presenting 2 cases of tocilizumab-induced hypertriglyceridemia during the treatment of COVID-19, and one of them developed into AP in the later disease course.

It is unclear whether hyperlipidemia leads to deterioration of disease course and prognosis of COVID-19 patients. Previous research has showed that patients older than 50 were prone to have hyperlipidemia,76 which led to an increased risk of hospital admission (OR=1.8) 78 and disease deterioration (OR=2.15).91 In addition, previous reviews suggested that patients with hypercholesterolemia had increased risk for COVID-19 and the related complications.92 , 93 However, one study compared between two cohorts, namely COVID-19 patients discharged alive and those that died, and multiple regression analysis showed that hyperlipidemia had a protective effect on reducing the likelihood of death (OR=0.75).94 Another study carried out cluster analysis in a large cohort of 12,066 COVID-19 patients, and the results showed that hyperlipidemia had no significant effects on COVID-19 prognosis.95

The correlation between acute pancreatitis and hyperlipidemia

In the general population

It is widely acknowledged that gallstones and alcohol intake are two major causes of AP followed by hypertriglyceridemia (HTG) and others. HTG has been a major cause of AP over the last decade and accounts for about 10% of total AP worldwide.96 , 97 Especially in East Asia, HTG has become the second leading cause of total AP and the incidence of HTG-AP could reach up to 15–25%.98, 99, 100

HTG is one of the predominant subtypes of hyperlipidemia, and it has been reported to deteriorate disease severity, progression, and outcomes of AP. A meta-analysis of 15 studies compared 1,564 HTG-AP patients to 5,721 AP cases with other etiologies, the results showed that the occurrence of renal failure, respiratory failure, shock, and mortality was significantly higher in HTG-AP patients.101 A retrospective study classified AP patients into a normal triglyceride group or mild HTG (<200 mg/dL) group, a moderate HTG (200-749 mg/dL) group, and a severe HTG (>750 mg/dL) group, and demonstrated that higher serum triglyceride level was independently associated with a more severe disease course of AP.102

Previous studies suggested that the potential mechanisms of the deteriorating effects of HTG on AP may lie in the accumulation of free fatty acid and thereafter, activation of inflammatory response in the pancreas.103 Free fatty acid has been reported to cause the increase in the levels of inflammatory mediators, such as TNF-alpha, interleukin-6, interleukin-10, which might strengthen the systemic inflammatory response and local pancreatic injury. Moreover, in vitro experiments also presented that free fatty acid had direct cytotoxic effects on acinar cells and vascular endothelial cells.

In the COVID-19 population

When it comes to the causes of AP in the COVID-19 population, some studies suggested that SARS-CoV-2 could cause pancreatic injury and AP directly. Angiotensin-converting enzyme 2 (ACE2) is widely expressed in human vascular endothelium, respiratory endothelium, and other cell types, which is thought to be a primary mechanism of SARS-CoV-2 entry and infection.104 An inflamed/injured endothelium promotes neutrophilia and systemic inflammatory cascades, leading to involvement of multi-organs. A review concerning the role of endothelium in COVID-19 suggested that endothelial cells were a crucial link between SARS-CoV-2 and host immune responses and thus may serve many roles in determining the disease severity and mortality in COVID-19.105 Receptor proteins of SARS-CoV-2 including ACE2 were also highly expressed in the epithelial cells of gastrointestinal tract, so do the pancreatic duct epithelium, pancreatic acinar cell, and islet cell. SARS-CoV-2 could infect the gastrointestinal epithelial cells through the gastrointestinal tract and spread into the pancreas. This hypothesis was supported by a few studies, one study showed the existence of SARS-CoV-2 in gastrointestinal tract epithelium, and RNA of the virus could be detected by real-time reverse transcriptase polymerase chain reaction from feces.106 Furthermore, SARS-CoV-2 was also isolated from pancreatic pseudocyst tissue.107 However, this hypothesis was not validated by robust evidence and it is unable to explain the relatively low incidence of AP in COVID-19 patient in some large epidemiological researches.47 , 48

Taking into consideration of the high incidence of hyperlipidemia in COVID-19 patients, we hypothesized that hyperlipidemia could also be a mediator in the pathogenesis of pancreatic injury and AP in COVID-19 patients besides direct virus infection. The detrimental effects of HTG mentioned above should also exist in COVID-19 patients combined with AP. To support the hypothesis, we wondered whether the incidence of AP was higher in patients with hyperlipidemia compared to patients without hyperlipidemia in the COVID-19 population. However, no well-designed study has yet to report the related data, we thereby retrospectively collected the information of all case reports of AP with COVID-19 (Table 1). From the retrospective analysis, the levels of total triglycerides and total cholesterol increased slightly in COVID-19 patients complicated with AP, which suggested that hyperlipidemia may be the reason for the occurrence of AP.

Concluding remarks

  • (1)

    A small portion of COVID-19 patients presented with acute pancreatitis, but the underlying mechanism was still unknown.

  • (2)

    The occurrence of hyperlipidemia was high in the COVID-19 population.

  • (3)

    In general population, hyperlipidemia has become one of the major causes of AP. And in the COVID-19 population, presuming the detrimental effects of hyperlipidemia still exist, hyperlipidemia could also be a mediating factor in the pathogenesis of pancreatic injury and AP.

  • (4)

    Further studies are warranted to clarify the relationship between AP, hyperlipidemia, and COVID-19.

Source of funding

This study was supported by National Natural Science Foundation of China (No. 82070669).

CRediT authorship contribution statement

Qiuyi Tang: Conceptualization, Visualization, Data curation, Formal analysis, Writing – review & editing. Lin Gao: Conceptualization, Visualization, Writing – original draft, Writing – review & editing. Zhihui Tong: Writing – review & editing. Weiqin Li: Writing – review & editing.

Declaration of Competing Interest

The authors declare that there is no conflict of interest regarding the research, authorship, and/or publication of this paper.

References

  • 1.Gupta A., Madhavan M.V., Sehgal K., et al. Extrapulmonary manifestations of COVID-19. Nat Med. 2020;26(7):1017–1032. doi: 10.1038/s41591-020-0968-3. [DOI] [PubMed] [Google Scholar]
  • 2.Berlin D.A., Gulick R.M., Martinez F.J. Severe COVID-19. N Engl J Med. 2020;383(25):2451–2460. doi: 10.1056/NEJMcp2009575. [DOI] [PubMed] [Google Scholar]
  • 3.van Dijk S.M., Hallensleben N.D.L., van Santvoort H.C., et al. Acute pancreatitis: recent advances through randomised trials. Gut. 2017;66(11):2024–2032. doi: 10.1136/gutjnl-2016-313595. [DOI] [PubMed] [Google Scholar]
  • 4.Wifi M.N., Nabil A., Awad A., Eltatawy R. COVID-induced pancreatitis: case report. Egypt J Intern Med. 2021;33(1):10. doi: 10.1186/s43162-021-00039-y. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 5.Tollard C., Champenois V., Delemer B., Carsin-Vu A., Barraud S. An inaugural diabetic ketoacidosis with acute pancreatitis during COVID-19. Acta Diabetol. 2021;58(3):389–391. doi: 10.1007/s00592-020-01624-3. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 6.Sandhu H., Mallik D., Lokavarapu M.J., Huda F., Basu S. Acute recurrent pancreatitis and COVID-19 infection: a case report with literature review. Cureus. 2021;13(2):e13490. doi: 10.7759/cureus.13490. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 7.Samies N.L., Yarbrough A., Boppana S. Pancreatitis in pediatric patients with COVID-19. J Pediatric Infect Dis Soc. 2021;10(1):57–59. doi: 10.1093/jpids/piaa125. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 8.Narang K., Szymanski L.M., Kane S.V., Rose C.H. Acute pancreatitis in a pregnant patient with coronavirus disease 2019 (COVID-19) Obstet Gynecol. 2021;137(3):431–433. doi: 10.1097/aog.0000000000004287. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 9.Mohammadi Arbati M., Molseghi M.H. COVID-19 presenting as acute necrotizing pancreatitis. J Investig Med High Impact Case Rep. 2021;9 doi: 10.1177/23247096211009393. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 10.Maalouf R.G., Kozhaya K., El Zakhem A. SARS-CoV-2 induced necrotizing pancreatitis. Med Clin (Barc) 2021;156:629–630. doi: 10.1016/j.medcli.2021.01.005. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 11.Bouali M., Ouchane M., Elbakouri A., Bensardi F., Elhattabi K., Fadil A. Total gastric necrosis following acute pancreatitis in a patient with COVID -19: case report and literature review. Ann Med Surg (Lond) 2021;62:362–364. doi: 10.1016/j.amsu.2021.01.061. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 12.Bineshfar N., Mirahmadi A., Karbasian F., Pourbakhtyaran E., Karimi A., Sarafi M. Acute pancreatitis as a possible unusual manifestation of COVID-19 in children. Case Rep Pediatr. 2021;2021 doi: 10.1155/2021/6616211. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 13.Ali E., Badawi M., Ahmed A., Abdelmahmuod E., Ibrahim W. Severe SARS-CoV-2 infection presenting with acute kidney injury and diabetic ketoacidosis complicated by pancreatitis in a 53-year man with hypertension. Clin Case Rep. 2021;9(3):1202–1206. doi: 10.1002/ccr3.3731. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 14.AlHarmi R.A.R., Fateel T., Sayed Adnan J., AlAwadhi K. Acute pancreatitis in a patient with COVID-19. BMJ Case Rep. 2021;14(2) doi: 10.1136/bcr-2020-239656. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 15.Abraham G., Rohit A., Mathew M., Parthasarathy R. Successful automated peritoneal dialysis (APD) in a COVID-19 patient with acalculous pancreatitis with no detectable virus in the dialysate effluent. Indian J Med Microbiol. 2021;39(1):128–129. doi: 10.1016/j.ijmmb.2020.10.010. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 16.Abbas M., Törnhage C.J. Family transmission of COVID-19 including a child with MIS-C and acute pancreatitis. Int Med Case Rep J. 2021;14:55–65. doi: 10.2147/imcrj.S284480. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 17.Zielecki P., Kaniewska M., Furmanek M., Bulski T., Rydzewska G. Effective treatment of severe acute pancreatitis and COVID-19 pneumonia with tocilizumab. Prz Gastroenterol. 2020;15(3):267–272. doi: 10.5114/pg.2020.99042. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 18.Wang K., Luo J., Tan F., et al. Acute pancreatitis as the initial manifestation in 2 Cases of COVID-19 in Wuhan, China. Open Forum Infect Dis. 2020;7(9):ofaa324. doi: 10.1093/ofid/ofaa324. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 19.Szatmary P., Arora A., Thomas Raraty M.G., Joseph Dunne D.F., Baron R.D., Halloran C.M. Emerging phenotype of severe acute respiratory syndrome-coronavirus 2-associated pancreatitis. Gastroenterology. 2020;159(4):1551–1554. doi: 10.1053/j.gastro.2020.05.069. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 20.Simou E.M., Louardi M., Khaoury I., et al. Coronavirus disease-19 (COVID-19) associated with acute pancreatitis: case report. Pan Afr Med J. 2020;37:150. doi: 10.11604/pamj.2020.37.150.25873. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 21.Shinohara T., Otani A., Yamashita M., et al. Acute pancreatitis during COVID-19 pneumonia. Pancreas. 2020;49(10):e106–e108. doi: 10.1097/mpa.0000000000001695. [DOI] [PubMed] [Google Scholar]
  • 22.Rabice S.R., Altshuler P.C., Bovet C., Sullivan C., Gagnon A.J. COVID-19 infection presenting as pancreatitis in a pregnant woman: a case report. Case Rep Womens Health. 2020;27:e00228. doi: 10.1016/j.crwh.2020.e00228. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 23.Purayil N., Sirajudeen J., Va N., Mathew J. COVID-19 presenting as acute abdominal pain: a case report. Cureus. 2020;12(8):e9659. doi: 10.7759/cureus.9659. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 24.Pinte L., Baicus C. Pancreatic involvement in SARS-CoV-2: case report and living review. J Gastrointestin Liver Dis. 2020;29(2):275–276. doi: 10.15403/jgld-2618. [DOI] [PubMed] [Google Scholar]
  • 25.Patnaik R.N.K., Gogia A., Kakar A. Acute pancreatic injury induced by COVID-19. IDCases. 2020;22:e00959. doi: 10.1016/j.idcr.2020.e00959. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 26.Miao Y., Lidove O., Mauhin W. First case of acute pancreatitis related to SARS-CoV-2 infection. Br J Surg. 2020;107(8):e270. doi: 10.1002/bjs.11741. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 27.Meyers M.H., Main M.J., Orr J.K., Obstein K.L. A case of COVID-19-induced acute pancreatitis. Pancreas. 2020;49(10):e108–e109. doi: 10.1097/mpa.0000000000001696. [DOI] [PubMed] [Google Scholar]
  • 28.Meireles P.A., Bessa F., Gaspar P., et al. Acalculous acute pancreatitis in a COVID-19 patient. Eur J Case Rep Intern Med. 2020;7(6) doi: 10.12890/2020_001710. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 29.Mazrouei S.S.A., Saeed G.A., Al Helali A.A. COVID-19-associated acute pancreatitis: a rare cause of acute abdomen. Radiol Case Rep. 2020;15(9):1601–1603. doi: 10.1016/j.radcr.2020.06.019. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 30.Lakshmanan S., Malik A. Acute pancreatitis in mild COVID-19 infection. Cureus. 2020;12(8):e9886. doi: 10.7759/cureus.9886. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 31.Kurihara Y., Maruhashi T., Wada T., et al. Pancreatitis in a patient with severe coronavirus disease pneumonia treated with veno-venous extracorporeal membrane oxygenation. Intern Med. 2020;59(22):2903–2906. doi: 10.2169/internalmedicine.5912-20. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 32.Kumaran N.K., Karmakar B.K., Taylor O.M. Coronavirus disease-19 (COVID-19) associated with acute necrotising pancreatitis (ANP) BMJ Case Rep. 2020;13(9) doi: 10.1136/bcr-2020-237903. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 33.Kataria S., Sharif A., Ur Rehman A., Ahmed Z., Hanan A. COVID-19 induced acute pancreatitis: a case report and literature review. Cureus. 2020;12(7):e9169. doi: 10.7759/cureus.9169. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 34.Karimzadeh S., Manzuri A., Ebrahimi M., Huy N.T. COVID-19 presenting as acute pancreatitis: lessons from a patient in Iran. Pancreatology. 2020;20(5):1024–1025. doi: 10.1016/j.pan.2020.06.003. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 35.Kandasamy S. An unusual presentation of COVID-19: acute pancreatitis. Ann Hepatobiliary Pancreat Surg. 2020;24(4):539–541. doi: 10.14701/ahbps.2020.24.4.539. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 36.Hassani A.H., Beheshti A., Almasi F., KetabiMoghaddam P., Azizi M., Shahrokh S. Unusual gastrointestinal manifestations of COVID-19: two case reports. Gastroenterol Hepatol Bed Bench. 2020;13(4):410–414. [PMC free article] [PubMed] [Google Scholar]
  • 37.Hadi A., Werge M., Kristiansen K.T., et al. Coronavirus Disease-19 (COVID-19) associated with severe acute pancreatitis: case report on three family members. Pancreatology. 2020;20(4):665–667. doi: 10.1016/j.pan.2020.04.021. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 38.Gonzalo-Voltas A., UxiaFernández-Pérez-Torres C., Baena-Díez J.M. Acute pancreatitis in a patient with COVID-19 infection. Med Clin (Engl Ed) 2020;155(4):183–184. doi: 10.1016/j.medcle.2020.05.010. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 39.Gadiparthi C., Bassi M., Yegneswaran B., Ho S., Pitchumoni C.S. Hyperglycemia, hypertriglyceridemia, and acute pancreatitis in COVID-19 infection: clinical implications. Pancreas. 2020;49(7):e62–e63. doi: 10.1097/mpa.0000000000001595. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 40.Cheung S., Delgado F.A., Fetterman A.D. Recurrent acute pancreatitis in a patient with COVID-19 infection. Am J Case Rep. 2020;21 doi: 10.12659/ajcr.927076. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 41.Brikman S., Denysova V., Menzal H., Dori G. Acute pancreatitis in a 61-year-old man with COVID-19. Cmaj. 2020;192(30):E858–e859. doi: 10.1503/cmaj.201029. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 42.Bokhari S., Mahmood F. Case report: novel coronavirus-a potential cause of acute pancreatitis? Am J Trop Med Hyg. 2020;103(3):1154–1155. doi: 10.4269/ajtmh.20-0568. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 43.Anand E.R., Major C., Pickering O., Nelson M. Acute pancreatitis in a COVID-19 patient. Br J Surg. 2020;107(7):e182. doi: 10.1002/bjs.11657. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 44.Alwaeli H., Shabbir M., KhamissiSobi M., Alwaeli K. A case of severe acute pancreatitis secondary to COVID-19 infection in a 30-year-old male patient. Cureus. 2020;12(11):e11718. doi: 10.7759/cureus.11718. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 45.Alves A.M., Yvamoto E.Y., Marzinotto M.A.N., Teixeira A.C.S., Carrilho F.J. SARS-CoV-2 leading to acute pancreatitis: an unusual presentation. Braz J Infect Dis. 2020;24(6):561–564. doi: 10.1016/j.bjid.2020.08.011. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 46.Alloway B.C., Yaeger S.K., Mazzaccaro R.J., Villalobos T., Hardy S.G. Suspected case of COVID-19-associated pancreatitis in a child. Radiol Case Rep. 2020;15(8):1309–1312. doi: 10.1016/j.radcr.2020.06.009. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 47.Miró Ò., Llorens P., Jiménez S., et al. Frequency of five unusual presentations in patients with COVID-19: results of the UMC-19-S(1) Epidemiol Infect. 2020;148:e189. doi: 10.1017/s0950268820001910. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 48.Miró Ò., Llorens P., Jiménez S., et al. A case-control emergency department-based analysis of acute pancreatitis in COVID-19: results of the UMC-19-S(6) J Hepatobiliary Pancreat Sci. 2021;28:953–966. doi: 10.1002/jhbp.873. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 49.Suchman K., Raphael K.L., Liu Y., Wee D., Trindade A.J. Acute pancreatitis in children hospitalized with COVID-19. Pancreatology. 2021;21(1):31–33. doi: 10.1016/j.pan.2020.12.005. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 50.Saleh N.Y., Aboelghar H.M., Salem S.S., et al. The severity and atypical presentations of COVID-19 infection in pediatrics. BMC Pediatr. 2021;21(1):144. doi: 10.1186/s12887-021-02614-2. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 51.Akarsu C., Karabulut M., Aydin H., et al. Association between acute pancreatitis and COVID-19: could pancreatitis be the missing piece of the puzzle about increased mortality rates? J Invest Surg. 2020:1–7. doi: 10.1080/08941939.2020.1833263. [DOI] [PubMed] [Google Scholar]
  • 52.Pandanaboyana S., Moir J., Leeds J.S., et al. SARS-CoV-2 infection in acute pancreatitis increases disease severity and 30-day mortality: COVID PAN collaborative study. Gut. 2021;70:1061–1069. doi: 10.1136/gutjnl-2020-323364. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 53.Inamdar S., Benias P.C., Liu Y., Sejpal D.V., Satapathy S.K., Trindade A.J. Prevalence, risk factors, and outcomes of hospitalized patients with coronavirus disease 2019 presenting as acute pancreatitis. Gastroenterology. 2020;159(6):2226–2228. doi: 10.1053/j.gastro.2020.08.044. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 54.Moftakhar L., Moftakhar P., Piraee E., Ghaem H., Valipour A., Azarbakhsh H. Epidemiological characteristics and outcomes of COVID-19 in diabetic versus non-diabetic patients. Int J Diabetes Dev Ctries. 2021:1–6. doi: 10.1007/s13410-021-00930-y. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 55.Wu B., Zhou J.H., Wang W.X., et al. Association analysis of hyperlipidemia with the 28-day all-cause mortality of COVID-19 in hospitalized patients. Chin Med Sci J. 2021;36(1):17–26. doi: 10.24920/003866. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 56.Wang D., Liu Y., Zeng F., et al. Evaluation of the role and usefulness of clinical pharmacists at the Fangcang hospital during COVID-19 outbreak. Int J Clin Pract. 2021:e14271. doi: 10.1111/ijcp.14271. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 57.Tzur B.D, Krieger I., Kridin K., et al. COVID-19 prevalence and mortality among schizophrenia patients: a large-scale retrospective cohort study. Schizophr Bull. 2021 doi: 10.1093/schbul/sbab012. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 58.Spoulou V., Noni M., Koukou D., Kossyvakis A., Michos A. Clinical characteristics of COVID-19 in neonates and young infants. Eur J Pediatr. 2021:1–5. doi: 10.1007/s00431-021-04042-x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 59.Qureshi A.I., Baskett W.I., Huang W., et al. Acute ischemic stroke and COVID-19: an analysis of 27 676 patients. Stroke. 2021;52(3):905–912. doi: 10.1161/strokeaha.120.031786. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 60.Pérez-García C.N., Enríquez-Vázquez D., Méndez-Bailón M., et al. The SADDEN DEATH study: results from a pilot study in non-ICU COVID-19 Spanish patients. J Clin Med. 2021;10(4) doi: 10.3390/jcm10040825. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 61.Pareek M., Singh A., Vadlamani L., et al. Relation of cardiovascular risk factors to mortality and cardiovascular events in hospitalized patients with coronavirus disease 2019 (from the Yale COVID-19 cardiovascular registry) Am J Cardiol. 2021;146:99–106. doi: 10.1016/j.amjcard.2021.01.029. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 62.Mirzaei H., McFarland W., Karamouzian M., Sharifi H. COVID-19 among people living with HIV: a systematic review. AIDS Behav. 2021;25(1):85–92. doi: 10.1007/s10461-020-02983-2. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 63.Karimi F., Vaezi A.A., Qorbani M., et al. Clinical and laboratory findings in COVID-19 adult hospitalized patients from Alborz province /Iran: comparison of rRT-PCR positive and negative. BMC Infect Dis. 2021;21(1):256. doi: 10.1186/s12879-021-05948-5. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 64.Giannis D., Barish M.A., Goldin M., et al. Incidence of venous thromboembolism and mortality in patients with initial presentation of COVID-19. J Thromb Thrombolysis. 2021;51(4):897–901. doi: 10.1007/s11239-021-02413-7. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 65.Chetboun M., Raverdy V., Labreuche J., et al. BMI and pneumonia outcomes in critically ill COVID-19 patients: an international multicenter study. Obesity (Silver Spring) 2021 doi: 10.1002/oby.23223. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 66.Aldhaeefi M., Tahir Z., Cote D.J., Izzy S., El Khoury J. Comorbidities and age are associated with persistent COVID-19 PCR positivity. Front Cell Infect Microbiol. 2021;11 doi: 10.3389/fcimb.2021.650753. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 67.Xu H., Martin A., Singh A., et al. Pulmonary embolism in patients hospitalized with COVID-19 (from a New York health system) Am J Cardiol. 2020;133:148–153. doi: 10.1016/j.amjcard.2020.07.036. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 68.Wong K., Kim D.H., Iakovou A., et al. Pneumothorax in COVID-19 acute respiratory distress syndrome: case series. Cureus. 2020;12(11):e11749. doi: 10.7759/cureus.11749. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 69.Wei Z.Y., Qiao R., Chen J., et al. Pre-existing health conditions and epicardial adipose tissue volume: potential risk factors for myocardial injury in COVID-19 patients. Front Cardiovasc Med. 2020;7 doi: 10.3389/fcvm.2020.585220. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 70.Wang B., Van Oekelen O., Mouhieddine T.H., et al. A tertiary center experience of multiple myeloma patients with COVID-19: lessons learned and the path forward. J Hematol Oncol. 2020;13(1):94. doi: 10.1186/s13045-020-00934-x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 71.Tee L.Y., Alhamid S.M., Tan J.L., et al. COVID-19 and undiagnosed pre-diabetes or diabetes mellitus among international migrant workers in Singapore. Front Public Health. 2020;8 doi: 10.3389/fpubh.2020.584249. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 72.Tan W.Y.T., Young B.E., Lye D.C., Chew D.E.K., Dalan R. Statin use is associated with lower disease severity in COVID-19 infection. Sci Rep. 2020;10(1):17458. doi: 10.1038/s41598-020-74492-0. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 73.Shady A., Singh A.P., Gbaje E., et al. Characterization of patients with COVID-19 admitted to a community hospital of east Harlem in New York City. Cureus. 2020;12(8):e9836. doi: 10.7759/cureus.9836. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 74.Rameez F., McCarthy P., Cheng Y., et al. Impact of a stay-at-home order on stroke admission, subtype, and metrics during the COVID-19 pandemic. Cerebrovasc Dis Extra. 2020;10(3):159–165. doi: 10.1159/000512742. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 75.Piazza G., Campia U., Hurwitz S., et al. Registry of arterial and venous thromboembolic complications in patients with COVID-19. J Am Coll Cardiol. 2020;76(18):2060–2072. doi: 10.1016/j.jacc.2020.08.070. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 76.Palaiodimos L., Kokkinidis D.G., Li W., et al. Severe obesity, increasing age and male sex are independently associated with worse in-hospital outcomes, and higher in-hospital mortality, in a cohort of patients with COVID-19 in the Bronx, New York. Metabolism. 2020;108 doi: 10.1016/j.metabol.2020.154262. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 77.Nimkar A., Naaraayan A., Hasan A., et al. Incidence and risk factors for acute kidney injury and its effect on mortality in patients hospitalized from COVID-19. Mayo Clin Proc Innov Qual Outcomes. 2020;4(6):687–695. doi: 10.1016/j.mayocpiqo.2020.07.003. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 78.Newton S., Zollinger B., Freeman J., et al. Factors associated with clinical severity in emergency department patients presenting with symptomatic SARS-CoV-2 infection. medRxiv. 2020 doi: 10.1101/2020.12.08.20246017. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 79.Nakanishi H., Suzuki M., Maeda H., et al. Differential diagnosis of COVID-19: importance of measuring blood lymphocytes, serum electrolytes, and olfactory and taste functions. Tohoku J Exp Med. 2020;252(2):109–119. doi: 10.1620/tjem.252.109. [DOI] [PubMed] [Google Scholar]
  • 80.Mori S., Ai T., Otomo Y. Characteristics, laboratories, and prognosis of severe COVID-19 in the Tokyo metropolitan area: a retrospective case series. PLoS One. 2020;15(9) doi: 10.1371/journal.pone.0239644. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 81.Kenes M.T., McSparron J.I., Marshall V.D., Renius K., Hyzy R.C. Propofol-associated hypertriglyceridemia in coronavirus disease 2019 versus noncoronavirus disease 2019 acute respiratory distress syndrome. Crit Care Explor. 2020;2(12):e0303. doi: 10.1097/cce.0000000000000303. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 82.He S., Tian J., Li X., et al. Positive RT-PCR test results in 420 patients recovered from COVID-19 in Wuhan: an observational study. Front Pharmacol. 2020;11 doi: 10.3389/fphar.2020.549117. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 83.Gómez Antúnez M., Muiño Míguez A., Bendala Estrada A.D., et al. Clinical characteristics and prognosis of COPD patients hospitalized with SARS-CoV-2. Int J Chron Obstruct Pulmon Dis. 2020;15:3433–3445. doi: 10.2147/copd.S276692. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 84.Fernandes N.D., Cummings B.M., Naber C.E., et al. Adult COVID-19 patients cared for in a pediatric ICU embedded in a regional biothreat center: disease severity and outcomes. Health Secur. 2020 doi: 10.1089/hs.2020.0225. [DOI] [PubMed] [Google Scholar]
  • 85.Ebert T.J., Dugan S., Barta L., Gordon B., Nguyen-Ho C., Pagel P.S. Clinical features of COVID-19 infection in patients treated at a large veterans affairs medical center. Wmj. 2020;119(4):248–252. [PubMed] [Google Scholar]
  • 86.Dashti H.T., Bates D., Fiskio J.M., Roche E.C., Mora S., Demler O. Clinical characteristics and severity of COVID-19 disease in patients from Boston area hospitals. medRxiv. 2020 doi: 10.1101/2020.07.27.20163071. [DOI] [Google Scholar]
  • 87.Best J.H., Mohan S.V., Kong A.M., et al. Baseline demographics and clinical characteristics among 3471 US patients hospitalized with COVID-19 and pulmonary involvement: a retrospective study. Adv Ther. 2020;37(12):4981–4995. doi: 10.1007/s12325-020-01510-y. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 88.Villa López G., Valero Zanuy M.A., González Barrios I., Maíz Jiménez M., Gomis Muñóz P., León Sanz M. Acute hypertriglyceridemia in patients with COVID-19 receiving parenteral nutrition. Nutrients. 2021;13(7) doi: 10.3390/nu13072287. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 89.Thomas C.M., Vicent M., Moore S., Ali F., Wooten L., Louzon P.R. Treatment of severe hypertriglyceridemia with insulin infusions in severe COVID-19: a case series. J Pharm Pract. 2021 doi: 10.1177/08971900211010473. [DOI] [PubMed] [Google Scholar]
  • 90.Kovacevic M.P., Dube K.M., Lupi K.E., Szumita P.M., DeGrado J.R. Evaluation of hypertriglyceridemia in critically Ill patients with coronavirus disease 2019 receiving propofol. Crit Care Explor. 2021;3(1):e0330. doi: 10.1097/cce.0000000000000330. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 91.Ma Y., Zhu D.S., Chen R.B., et al. Association of overlapped and un-overlapped comorbidities with COVID-19 severity and treatment outcomes: a retrospective cohort study from nine provinces in China. Biomed Environ Sci. 2020;33(12):893–905. doi: 10.3967/bes2020.123. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 92.Vuorio A., Raal F., Kaste M., Kovanen P.T. Familial hypercholesterolaemia and COVID-19: a two-hit scenario for endothelial dysfunction amenable to treatment. Atherosclerosis. 2021;320:53–60. doi: 10.1016/j.atherosclerosis.2021.01.021. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 93.Tang Y., Hu L., Liu Y., et al. Possible mechanisms of cholesterol elevation aggravating COVID-19. Int J Med Sci. 2021;18(15):3533–3543. doi: 10.7150/ijms.62021. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 94.Smith A.A., Fridling J., Ibrahim D., Porter P.S. Identifying patients at greatest risk of mortality due to COVID-19: a New England Perspective. West J Emerg Med. 2020;21(4):785–789. doi: 10.5811/westjem.2020.6.47957. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 95.Rubio-Rivas M., Corbella X., Mora-Luján J.M., et al. Predicting clinical outcome with phenotypic clusters in COVID-19 pneumonia: an analysis of 12,066 Hospitalized patients from the Spanish registry SEMI-COVID-19. J Clin Med. 2020;9(11) doi: 10.3390/jcm9113488. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 96.Carr R.A., Rejowski B.J., Cote G.A., Pitt H.A., Zyromski N.J. Systematic review of hypertriglyceridemia-induced acute pancreatitis: a more virulent etiology? Pancreatol Off J Int Assoc Pancreatol(IAP) [et al] 2016;16(4):469–476. doi: 10.1016/j.pan.2016.02.011. [DOI] [PubMed] [Google Scholar]
  • 97.Valdivielso P., Ramírez-Bueno A., Ewald N. Current knowledge of hypertriglyceridemic pancreatitis. Eur J Int Med. 2014;25(8):689–694. doi: 10.1016/j.ejim.2014.08.008. [DOI] [PubMed] [Google Scholar]
  • 98.Huang Y.X., Jia L., Jiang S.M., Wang S.B., Li M.X., Yang B.H. Incidence and clinical features of hyperlipidemic acute pancreatitis from Guangdong, China: a retrospective multicenter study. Pancreas. 2014;43(4):548–552. doi: 10.1097/mpa.0000000000000069. [DOI] [PubMed] [Google Scholar]
  • 99.Yin G., Cang X., Yu G., et al. Different clinical presentations of hyperlipidemic acute pancreatitis: a retrospective study. Pancreas. 2015;44(7):1105–1110. doi: 10.1097/mpa.0000000000000403. [DOI] [PubMed] [Google Scholar]
  • 100.Zhu Y., Pan X., Zeng H., et al. A study on the etiology, severity, and mortality of 3260 patients with acute pancreatitis according to the revised atlanta classification in jiangxi, china over an 8-year period. Pancreas. 2017;46(4):504–509. doi: 10.1097/mpa.0000000000000776. [DOI] [PubMed] [Google Scholar]
  • 101.Wang Q., Wang G., Qiu Z., He X., Liu C. Elevated serum triglycerides in the prognostic assessment of acute pancreatitis: a systematic review and meta-analysis of observational studies. J Clin Gastroenterol. 2017;51(7):586–593. doi: 10.1097/mcg.0000000000000846. [DOI] [PubMed] [Google Scholar]
  • 102.Pascual I., Sanahuja A., García N., et al. Association of elevated serum triglyceride levels with a more severe course of acute pancreatitis: cohort analysis of 1457 patients. Pancreatology. 2019;19(5):623–629. doi: 10.1016/j.pan.2019.06.006. [DOI] [PubMed] [Google Scholar]
  • 103.Yang A.L., McNabb-Baltar J. Hypertriglyceridemia and acute pancreatitis. Pancreatology. 2020;20(5):795–800. doi: 10.1016/j.pan.2020.06.005. [DOI] [PubMed] [Google Scholar]
  • 104.Amraei R., Rahimi N. COVID-19, renin-angiotensin system and endothelial dysfunction. Cells. 2020;9(7) doi: 10.3390/cells9071652. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 105.Kaur S., Tripathi D.M., Yadav A. The enigma of endothelium in COVID-19. Front Physiol. 2020;11:989. doi: 10.3389/fphys.2020.00989. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 106.Xiao F., Tang M., Zheng X., Liu Y., Li X., Shan H. Evidence for gastrointestinal infection of SARS-CoV-2. Gastroenterology. 2020;158(6):1831–1833. doi: 10.1053/j.gastro.2020.02.055. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 107.Schepis T., Larghi A., Papa A., et al. SARS-CoV2 RNA detection in a pancreatic pseudocyst sample. Pancreatology. 2020;20(5):1011–1012. doi: 10.1016/j.pan.2020.05.016. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from The American Journal of the Medical Sciences are provided here courtesy of Elsevier

RESOURCES