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. 2024 Feb 26;12(6):1104-1110.
doi: 10.12998/wjcc.v12.i6.1104.

Acute pancreatitis as a complication of acute COVID-19 in kidney transplant recipients

Nikolina Basic-Jukic  1   2 , Ivana Juric  1 , Lea Katalinic  1 , Vesna Furic-Cunko  1 , Vibor Sesa  3 , Anna Mrzljak  4   3
Affiliations

Acute pancreatitis as a complication of acute COVID-19 in kidney transplant recipients

Nikolina Basic-Jukic et al. World J Clin Cases. .

Abstract

Background: Acute pancreatitis is a rare extrapulmonary manifestation of coronavirus disease 2019 (COVID-19) but its full correlation with COVID-19 infection remains unknown.

Aim: To identify acute pancreatitis' occurrence, clinical presentation and outcomes in a cohort of kidney transplant recipients with acute COVID-19.

Methods: A retrospective observational single-centre cohort study from a transplant centre in Croatia for all adult renal transplant recipients with a functioning kidney allograft between March 2020 and August 2022 to record cases of acute pancreatitis during acute COVID-19. Data were obtained from hospital electronic medical records. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was proven by a positive SARS-CoV-2 real-time reverse transcriptase-polymerase chain reaction on the nasopharyngeal swab.

Results: Four hundred and eight out of 1432 (28.49%) patients who received a renal allograft developed COVID-19 disease. The analyzed cohort included 321 patients (57% males). One hundred and fifty patients (46.7%) received at least one dose of the anti-SARS-CoV-2 vaccine before the infection. One hundred twenty-five (39.1%) patients required hospitalization, 141 (44.1%) developed pneumonia and four patients (1.3%) required mechanical ventilation. Treatment included immunosuppression modification in 233 patients (77.1%) and remdesivir in 53 patients (16.6%), besides the other supportive measures. In the study cohort, only one transplant recipient (0.3%) developed acute pancreatitis during acute COVID-19, presenting with abdominal pain and significantly elevated pancreatic enzymes. She survived without complications with a stable kidney allograft function.

Conclusion: Although rare, acute pancreatitis may complicate the course of acute COVID-19 in kidney transplant recipients. The mechanism of injury to the pancreas and its correlation with the severity of the COVID-19 infection in kidney transplant recipients warrants further research.

Keywords: Acute pancreatitis; Angiotensin-converting enzyme-2 receptor; COVID-19; Immunosuppressive agents; Kidney transplant.

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Conflict of interest statement

Conflict-of-interest statement: We have no financial relationships to disclose.

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