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. 2023 Jul 22;13(14):2446.
doi: 10.3390/diagnostics13142446.

The Impact of the COVID-19 Pandemic on Outcomes in Acute Pancreatitis: A Propensity Score Matched Study Comparing before and during the Pandemic

Patricia Mihaela Rădulescu  1 , Elena Irina Căluianu  2 , Emil Tiberius Traşcă  2 , Dorin Mercuţ  2 , Ion Georgescu  2 , Eugen Florin Georgescu  2 , Eleonora Daniela Ciupeanu-Călugăru  3 , Maria Filoftea Mercuţ  4 , Răzvan Mercuţ  5 , Vlad Padureanu  6 , Costin Teodor Streba  7 , Cristina Călăraşu  7 , Dumitru Rădulescu  2
Affiliations

The Impact of the COVID-19 Pandemic on Outcomes in Acute Pancreatitis: A Propensity Score Matched Study Comparing before and during the Pandemic

Patricia Mihaela Rădulescu et al. Diagnostics (Basel). .

Abstract

We aimed to evaluate the outcomes and survival of patients with acute pancreatitis who shared the same clinical form, age, and sex before the pandemic, during the pandemic, and among those with confirmed COVID-19 infection upon hospital admission. This consideration used the sparse data in the existing literature on the influence of the pandemic and COVID-19 infection on patients with acute pancreatitis. To accomplish this, we conducted a multicentric, retrospective case-control study using propensity score matching with a 2:1 match of 28 patients with SARS-CoV-2 infection and acute pancreatitis, with 56 patients with acute pancreatitis pre-pandemic, and 56 patients with acute pancreatitis during the pandemic. The study outcome demonstrated a six-fold relative risk of death in patients with acute pancreatitis and SARS-CoV-2 infection compared to those with acute pancreatitis before the pandemic. Furthermore, restrictive measures implemented during the pandemic period led to a partial delay in the care of patients with acute pancreatitis, which likely resulted in an impairment of their immune state. This, in certain circumstances, resulted in a restriction of surgical treatment indications, leading to a three-fold relative risk of death in patients with acute pancreatitis during the pandemic compared to those with acute pancreatitis before the pandemic.

Keywords: COVID-19; IIC; MCVL; NLR; acute pancreatitis; average crepuscular volume–lymphocyte ratio; cumulative inflammatory index; neutrophil–lymphocyte ratio; pandemic.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
Flow chart of patient inclusion.
Figure 2
Figure 2
Forest plot with univariate and multivariate analysis of clinical and biological parameters comparing the pre-COVID-19 and during-COVID-19 group; * p < 0.05—statistically significant; #—adjusted OR for age, sex, severity; MCV—mean corpuscular volume; AST—aspartate aminotransferase; ALT—alanine aminotransferase.
Figure 3
Figure 3
Forest plot with univariate and multivariate analysis of clinical and biological parameters comparing the pre-COVID-19 group and the AP group with COVID-19; * p < 0.05—statistically significant; #—adjusted OR for age, sex, severity; RDW—red cell distribution width; MCV—mean corpuscular volume; INR—international normalized ratio.
Figure 4
Figure 4
Forest plot with univariate and multivariate analysis of clinical and biological parameters comparing the during-COVID-19 group and the AP group with COVID-19; * p < 0.05—statistically significant; #—adjusted OR for age, sex, severity; RDW—red cell distribution width; INR—international normalized ratio.
Figure 5
Figure 5
Forest plot with univariate and multivariate analysis of clinical and biological parameters comparing mortality in the pre-COVID-19 group; * p < 0.05—statistically significant; #—adjusted OR for age, sex, severity; MSOF—Multiple organ failure; RDW—red cell distribution width; MCV—mean corpuscular volume; INR—international normalized ratio; IIC—cumulative inflammatory index.
Figure 6
Figure 6
Forest plot with univariate and multivariate analysis of clinical and biological parameters comparing mortality in the during-COVID-19 group; * p < 0.05—statistically significant; #—adjusted OR for age, sex, severity; MSOF—Multiple organ failure; MCV—mean corpuscular volume; AST—aspartate aminotransferase; INR—international normalized ratio; NLR—neutrophil-lymphocyte ratio; IIC—cumulative inflammatory index; MCVL—lymphocyte MCV ratio.
Figure 7
Figure 7
Forest plot with univariate and multivariate analysis of clinical and biological parameters comparing mortality in the group of patients with AP and COVID-19 disease; * p < 0.05—statistically significant; #—adjusted OR for age, sex, severity; RDW—red cell distribution width; MCV—mean corpuscular volume; Na—sodium; AST—aspartate aminotransferase; NLR—neutrophil lymphocyte ratio; IIC—cumulative inflammatory index; MCVL—lymphocyte MCV ratio.
Figure 8
Figure 8
The relative risk of death of patients with AP by comparison between the pre-COVID-19 and during-COVID-19, during-COVID-19 and AP with COVID-19, and pre-COVID-19 and AP with COVID-19 period.
See this image and copyright information in PMC

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