Epidemiological trends in acute pancreatitis:A retrospective cohort in a tertiary center over a seven year period

BACKGROUND Acute pancreatitis(AP)remains a major cause of hospitalization and mortality with important health-related costs worldwide.Using an electronic database of a large tertiary center,we estimated the incidence,etiology,severity and costs of hospitalized AP cases in southern Romania.AIM To estimate the incidence,cost and tobacco usage of hospitalized AP cases in southern Romania and to update and upgrade the knowledge we have on the etiology,severity(in regard to Revised Atlanta Classification),outcome,morphology and local complications of AP.METHODS We performed an electronic health care records search on AP patients treated at Emergency University Hospital of Bucharest(Spitalul Universitar de UrgențăBucurești)between 2015 and 2022.The incidence,etiology,and severity were calculated;potential risk factors were evaluated,and the hospitalization costs of AP were documented and analyzed.The cohort of this study is part of the BUCharest-Acute Pancreatitis Index registry.RESULTS A total of 947 consecutive episodes of AP where the patients were hospitalized in the gastroenterology department were analyzed,with 79.45%as 1st episode and the rest recurrent.The majority of the patients were males(68.9%).Alcoholic(45.7%),idiopathic(16.4%)and biliary(15.2%)were the main causes.The incidence was estimated at 29.2 episodes/100000 people.The median length of stay was 7 d.The median daily cost was 747.96 RON(165 EUR).There was a high prevalence of active tobacco smokers(68.5%).The prevalence of severe disease was 11.1%.The admission rate to the intensive care unit was 4.6%,with a mortality rate of 38.6%.The overall mortality was 5.5%.CONCLUSION We estimated the incidence of AP at 29.2 episodes that required hospitalization per 100000 people.The majority of our cases were found in males(68.9%)and were related to alcohol abuse(45.7%).Out of the cases we were able to find data regarding tobacco usage,the majority were active smokers(68.5%).Most patients had a mild course(54.4%),with a mortality rate of 5.5%.Interstitial AP prevailed(45.3%).The median daily cost of hospitalization was 747.96 RON(165 EUR).

Review on acute pancreatitis attributed to COVID-19 infection

The coronavirus disease 2019(COVID-19)is known to cause gastrointestinal symptoms.Recent studies have revealed COVID-19-attributed acute pancreatitis(AP).However,clinical characteristics of COVID-19-attributed AP remain unclear.We performed a narrative review to elucidate relation between COVID-19 and AP using the PubMed database.Some basic and pathological reports revealed expression of angiotensin-converting enzyme 2 and transmembrane protease serine 2,key proteins that aid in the entry of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)into the pancreas.The experimental and pathological evaluation suggested that SARS-CoV-2 infects human endocrine and exocrine pancreas cells,and thus,SARS-CoV-2 may have a direct involvement in pancreatic disorders.Additionally,systemic inflammation,especially in children,may cause AP.Levels of immune mediators associated with AP,including interleukin(IL)-1β,IL-10,interferon-γ,monocyte chemotactic protein 1,and tumor necrosis factor-αare higher in the plasma of patients with COVID-19,that suggests an indirect involvement of the pancreas.In real-world settings,some clinical features of AP complicate COVID-19,such as a high complication rate of pancreatic necrosis,severe AP,and high mortality.However,clinical features of COVID-19-attributed AP remain uncertain due to insufficient research on etiologies of AP.Therefore,high-quality clinical studies and case reports that specify methods for differential diagnoses of other etiologies of AP are needed.