Characterizing COVID-19 in Relation to Acute Pancreatitis

Introduction: The purpose of this study is to evaluate the relationship between patients with a history acute pancreatitis and tested for COVID-19 across all of NYU Langone Health system from 2/28/2020 to 6/24/2020 in order to ascertain the following information in regards to the novel coronavirus (COVID-19) and to provide clinicians greater information with hope of improving clinical outcomes. Methods: Using billing codes, other patient demographics, and our COVID-19 Datamart we obtained a list of patients who had a history of acute pancreatitis and tested for COVID-19. Charts were reviewed manually to review various metrics. Descriptive statistics (medians [25th, 75th percentiles] for continuous variables and frequencies and percentages for categorical variables) were calculated separately for acute pancreatitis patients that were COVID positive vs COVID negative. The Mann-Whitney test was used to test for differences between the groups for continuous variables, and the chi-square or Fisher’s exact test was used for categorical variables. A result was considered statistically significant at the p< 0.05 level of significance. All analyses were performed using SAS version 9.4 (SAS Institute Inc., Cary, NC). Results: A total of 391 patients with a history of acute pancreatitis were tested for COVID in the inpatient setting. Our study contains the largest sample of patients to date. 74 patients were COVID positive (18.9%). Weighted Elixhauser score (AHRQ) and Charlson Comorbidity Index were equivocal when comparing the past medical histories of our two patient populations. Significant data was defined as p < 0.05. A significantly greater number of COVID negative patients were current smokers. However, COVID positive patients were more likely to have a history of diabetes with complications, coagulopathy, fluid and electrolyte disorders, and other neurological disorders. COVID positive patients took a higher percentage of steroid use (hydrocortisone and methylprednisolone). Length of stay and death rates were significantly worse for COVID positive patient. Inconsistent lab draws made comparisons challenging. Conclusion: Prevalence of COVID-19 among patients with prior acute pancreatitis is 18.9% which is significantly higher than the population-weighted prevalence of SARS-CoV-2 positive serology in our background population of 6.9. Need for further studies to be conducted in patients with pancreatitis and COVID to help risk stratify patients for improved clinical outcomes.