Acute biliary pancreatitis management during the COVID-19 pandemic

  1. Elif Colak
  2. Ahmet Burak Ciftci

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Abstract

Objective

To analyze acute biliary pancreatitis (ABP) management during the COVID-19 pandemic.

Methods

This was a retrospective cohort study conducted with ABP patients during two discrete periods: a control period from March 16, 2019, through March 15, 2020 (period 1); and a COVID-19 era between March 16, 2020, and March 15, 2021 (period 2).

Results

A total of 89 patients with ABP were identified, 58 in period 1 and 31 in period 2, which equates to a 46.6% reduction. The mean age of the patients was 62.75±16.59 years, and 51 (57.3%) of the patients were female. qSOFA and WSES scores are significantly higher in the patients in period 2 ( p =0.031, p =0.032). There were no significant differences regarding hematological parameters except lactate. Lactate levels were significantly higher in period 2 ( p =0.012). Twenty-two patients (37.9%) in period 1 and six (19.3%) patients in period 2 underwent cholecystectomy ( p =0.072). Cholecystectomy was performed laparoscopically in 18 (81.8%) patients in period 1 and in five (83.3%) patients in period 2 ( p =0.932). There were no significant differences regarding surgical intervention between the two periods. Three patients were diagnosed COVID-19 in period 2. All of these patients died. The severity of ABP was significantly worse in SARS-CoV-2-positive patients, with over 100% of patients in this group developing severe pancreatitis. Six patients (10.3%) in period 1, 10 (32.2%) patients in period 2 were admitted in ICU ( p =0.010). The median length of stay was 5 (1-40) days in period 1 and 4 (2-75) days in period 2 ( p = 0.641). The hospital mortality rate was 3.4% and 19.3% in period l and period 2, respectively. Mortality was significantly higher in period 2 ( p =0.012).

Conclusion

During the COVID-19 outbreak, a significant decrease in the number of patients with ABP and increased severity was observed. Additionally, it can be said that SARS-CoV-2 infection has a mortal course in patients with ABP. Analysis and evaluation of ABP patients during the pandemic period is important to draw conclusions that will help confront future health crises.

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  1. ScreenIT

    SciScore for 10.1101/2021.05.08.21256726: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Ethicsnot detected.
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Statistical analysis: SPSS software (IBM version 20; IBM Corporation, Armonk, New York, USA) was used for statistical analysis.
    SPSS
    suggested: (SPSS, RRID:SCR_002865)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    The main limitation is that it is a retrospective study, where the electronic medical record was obtained retrospective data, and the interpretation of these data might suppose a bias. In addition, it has been influenced by interindividual variability in clinical decision-making. Despite many surgical societies’ recommendations about ABP management, there is no clear evidence about ABP management during the COVID-19 pandemic. In this paper, we describe and analyze ABP management in our center during the higher incidence period of the pandemic to draw conclusions that help to face future health crises in emergency surgical patient management. To our knowledge, this is the first study that analyzed the number, severity, and management of ABP during the COVID-19 pandemic.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

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  2. Version published to 10.1101/2021.05.08.21256726v1 on medRxiv