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Background: Viral infections can cause acute pancreatitis. Idiopathic pancreatitis has an important proportion in the etiology of acute pancreatitis., Objective: To investigate the rate of development of acute pancreatitis (AP) in COVID-19 patients and to determine the rate of idiopathic pancreatitis in the etiology of this pancreatitis., Methods: A total of 6.467 patients hospitalized with the COVID-19 diagnosis were included in the study. Patients diagnosed with AP based on the Atlanta criteria were identified. Etiological factors were determined in patients who developed acute pancreatitis and compared with the etiological factors in 315 patients with non-COVID-19, hospitalized with the diagnosis of AP before the COVID-19 pandemic. AP was detected in 0.1% of patients with COVID-19. While gallstone was the etiologic factor in 2 (28.6%) of seven patients who developed acute pancreatitis during COVID-19, hyperlipidemia was the factor for 1 (14.3%) patient. Moreover, the etiologic factor could not be determined in 4 (57.1%) patients, and they were regarded as idiopathic pancreatitis patients. Biliary pancreatitis was the most common etiologic factor in 315 (78.4%) patients admitted to the hospital for AP before the COVID-19 pandemic. Idiopathic pancreatitis was ranked second with 16.8%., Conclusion: It was observed that there was a significant difference in the incidence of idiopathic pancreatitis between patients with COVID-19 and non-COVID-19 (P=0.015). Results suggest that the SARS-Cov-2 virus may be among the factors leading to AP.

Object: We aimed to evaluate the elevation of amylase and lipase enzymes in coronavirus disease 2019 (COVID-19) patients and their relationship with the severity of COVID-19., Method: In this study, 1378 patients with COVID-19 infection were included. Relation of elevated amylase and lipase levels and comorbidities with the severity of COVID-19 was analysed. The effects of haemodynamic parameters and organ failure on pancreatic enzymes and their relations with prognosis were statistically analysed., Results: The 1378 patients comprised of 700 (51.8%) men and 678 (%49.2) women. Of all patients, 687 (49.9%) had mild and 691 (50.1%) patients had severe COVID-19 infection. Amylase elevation at different levels occurred in 316 (%23) out of 1378 patients. In these patients, the amylase levels increased one to three times in 261 and three times in 55 patients. Pancreatitis was detected in only six (%1.89) of these patients according to the Atlanta criteria. According to univariate and multivariate analyses, elevated amylase levels were significantly associated with the severity of COVID-19 (odds ratio [OR]: 4.37; P < .001). Moreover, diabetes mellitus (DM; OR: 1.82; P = .001), kidney failure (OR: 5.18; P < .001), liver damage (OR: 6.63; P < .001), hypotension (OR: 6.86; P < .001) and sepsis (OR: 6.20; P = .008) were found to be associated with mortality from COVID-19., Conclusion: Elevated pancreatic enzyme levels in COVID-19 infections are related to the severity of COVID-19 infection and haemodynamic instability. In a similar way to other organs, the pancreas can be affected by severe COVID-19 infection., (© 2021 John Wiley & Sons Ltd.)

BACKGROUND Oxidative stress have been shown to play a role in the pathogenesis of acute pancreatitis. The aim of this study was to investigate the potential effect of silybin, a potent antioxidant, on L-arginine-induced acute pancreatitis in an experimental rat model. MATERIAL AND METHODS Forty female Wistar Albino rats were divided into 5 groups as follows: Group 1 (C): control group (n=8), Group 2 (SL): silybin group (n=8), Group 3 (LA): acute pancreatitis group (n=8), Group 4 (SLLA): prophylaxis group (n=8), and Group 5 (LASL): treatment group (n=8). Group C (control) received 2 intraperitoneal (i.p.) injections of physiological saline at an interval of 1 h. Group SL received only a single i.p. injection of silybin. The SLLA group received a single i.p. injection of silybin before the induction of acute pancreatitis with L-arginine, whereas the LASL group received the same injection after the induction of acute pancreatitis with L-arginine. Pancreatic tissues were histopathologically examined. Levels of amylase and oxidative stress markers (total oxidant status and total anti-oxidant status) were determined in the blood samples. Oxidative stress index was calculated. RESULTS In comparison to the LA, the prophylaxis and treatment groups showed significant improvements in serum oxidative stress parameters (p=0.001 and p=0.005, respectively). Histopathological analysis showed that the treatment group had significant improvements in edema scores only (p=0.006), whereas the prophylaxis group had the same improvements in inflammation and necrosis scores as well as in total scores (p=0.004, 0.006, and 0.004, respectively). CONCLUSIONS When used for prophylactic rather than therapeutic purposes, silybin ameliorates serum oxidative stress parameters and improves histopathological results via its antioxidant and anti-inflammatory properties., Competing Interests: None.

Aim: Neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), mean platelet volume (MPV) and erythrocyte distribution width (RDW) are considered to be associated with systemic inflammation. In this study, it was aimed to evaluate NLR, PLR, MPV and RDW as prognostic factors in acute pancreatitis (AP). Material and Methods: A total of 315 patients admitted to Health Sciences University Gazi Yaşargil Training and Research Hospital between May 2016 and May 2019 and diagnosed with AP were included in the study. Data of the patients were analyzed retrospectively. Laboratory values of the patients at the time of admission to the hospital were recorded and the Ranson score was calculated. Patients were divided into two groups as Ranson score <3 (mild AP) and ≥3 (severe AP). NLR, PLR, MPV and RDW parameters were compared between these groups. Results: Of the patients, 103 (32.7%) were males and 212 (67.3%) were females, and mean age was 57.2±19.5. According to the Ranson criteria, number of patients with a score below 3 was 274 (87.0%), and number of patients with a score of 3 or above was 41 (13.0%). In the severe AP group, NLR and PLR were significantly higher than in the mild AP group (16.2±14.3 vs. 8.2±7.7, p<0.001 and 283.7±223.0 vs. 195.5±139.3, p=0.004 respectively), but there was no statistically significant difference in terms of RDW-CV and MPV (13.7±1.0 vs. 13.9±1.9, p=0.849 and 9.7±1.3 vs. 9.5±1.1, p=0.201, respectively). Conclusion: NLR and PLR are simple and safe tests that can be used to determine the severity of AP. [ABSTRACT FROM AUTHOR]