COVID-19 Induced Acute Pancreatitis: A Case Report and Literature Review

Abstract

A 49-year-old female with no history of past medical illness presented to the emergency department with complaints of fever, dry cough, and shortness of breath. Initial evaluation revealed a temperature of 101°F, and on auscultation, the patient had scattered wheezing and rales in left lung fields. CT of the chest revealed pneumonic patches in the upper and lower segment of the left lung. Her COVID-19 testing came positive. On the second day of hospital admission, the patient experienced nausea, vomiting, and severe epigastric pain radiating to back. Laboratory analysis revealed a marked elevation of lipase and amylase. CT of the abdomen showed an edematous pancreas with diffuse enlargement. She was diagnosed with acute pancreatitis due to COVID-19 after carefully ruling out other causes. She was managed symptomatically, and improvement in her clinical condition was observed and was discharged with outpatient follow-up. Although acute pancreatitis is rare in patients with COVID-19, it should be considered as a differential diagnosis in patients with severe epigastric pain and respiratory symptoms.

Keywords: coronavirus; covid-19; pancreatitis.

Figure 1. Coronal (A) and axial (B) sections of CT chest showing infiltrates in the apico-posterior and posterior basal segments of the left lung.

Figure 2. Transverse section of CT abdomen showing diffuse enlargement of pancreas with ill-defined borders and surrounding peripancreatic fluid.