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SAR Journal of Medical Biochemistry
Volume-1 | Issue-03
Case Report
COVID-19 Induced Pancreatitis Leading to Moderate Respiratory Support a Case Report
Dale Ventour, Rheana Sieunarine
Published : June 30, 2020
DOI : 10.36346/sarjmb.2020.v01i03.001
Abstract
Introduction: There have been multiple case reports of gastrointestinal involvement in patients who are Covid 19 positive. These patients usually present with elevated liver enzymes (transaminitis) especially with the ‘cytokine storm’. There is a paucity of cases presenting with Covid-19 pancreatitis, the author presents two (2) cases of Covid-19 induced pancreatitis and the resulting inflammation leading to the patients needing additional respiratory support. These patients were initially asymptomatic but quarantined in hospital which is the country’s policy; they later developed abdominal pain and required supplementary oxygen in the High Dependency unit. They exhibited ‘mild’ pancreatitis with associated vomiting and increase oxygen requirements which resolved once the pancreatitis abated. Case presentation: Two (2) cases of Covid 19 induced pancreatitis in patients aged 43 and 64 years, who were initially asymptomatic but subsequently presented with vomiting, abdominal pains and a relative decrease in their platelet count. Serology revealed elevation in lipase>amylase and they were treated as pancreatitis. Both cases were managed with intravenous fluids, analgesia and keeping nil per oral. They both recovered after 96 hours but required High Dependency care as their oxygen requirements increased during their abdominal pain phase. Conclusion: This is an unusual presentation of Covid 19 complications. Both patients resolved with conservative management of intravenous fluids and keeping nil per oral. Neither received hydroxychloroquine or any medication causing pancreatitis and serologically the pancreatitis appeared to be mild. However, with the onset of abdominal pains they both needed supplementary oxygen and High Dependency care. This pro-inflammatory condition seems to aggravate the respiratory symptomology of Covid-19 in these patients. There needs to be a low threshold to investigate all Covid-19 patients with abdominal pain as they may need a higher level of medical care.

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