Pancreatitis in a Patient with Severe Coronavirus Disease Pneumonia Treated with Veno-venous Extracorporeal Membrane Oxygenation

Abstract

Severe coronavirus disease (COVID-19) can induce serious complications, including acute respiratory distress syndrome, septic shock, and acute kidney injury. However, few reports have associated COVID-19 with pancreatitis. We herein report the case of a 55-year-old patient who developed acute pancreatitis associated with severe COVID-19 pneumonia and was successfully treated with veno-venous extracorporeal membrane oxygenation (ECMO). Elevated pancreatic enzymes levels and computed tomography findings led to the diagnosis of acute pancreatitis due to COVID-19. Although we found that severe COVID-19 pneumonia can lead to pancreatitis, the underlying pathophysiology remains unknown.

Keywords: COVID-19; coronavirus disease; pancreatitis.

Figure 1.

The patient's clinical course and pancreatic enzyme levels. CRP: C-reactive protein, T. Bil: total bilirubin, VV-ECMO: veno-venous extracorporeal membrane oxygenation, CRRT: continuous renal replacement therapy

Figure 2.

Contrast-enhanced computed tomography scan of the patient's pancreas. (A) Pancreas without stones or tumors on the first day in our hospital. (B) Pancreas with diffuse parenchymal enlargement (arrowhead) and stranding of the surrounding retroperitoneal fat (arrow). We believe these findings to be changes subsequent to acute pancreatitis.