Impact of COVID-19 Infection on Pancreato-Biliary Diseases Requiring Endoscopic Retrograde Cholangiopancreatography

期刊论文
发表日期：

2024年5月7日

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Briette Karanfilian,
Amy Tyberg,
Avik Sarkar,
Haroon M. Shahid,
Alexa Simon,
Karoline Reinoso,
Amol Bapaye,
Ashish Gandhi,
Harshal P. Gadhikar,
Shivangi Dorwat,
Hameed Raina,
Jaseem Ansari,
Jose Nieto,
Nadim Qadir,
Maria G. Porfilio,
Martha Arevalo-Mora,
Miguel Puga-Tejada,
Juan Alcivar-Vasquez,
Carlos Robles-Medranda,
Jose Celso Ardengh,
Romy Bareket,
Kelvin Liao,
Roohi Patel,
Sophia Pimpinelli,
Monica Gaidhane,
Michel Kahaleh

摘要

Background

Viral infections are known to impact the pancreato-biliary system; however, there are limited data showing that the same is true of COVID-19. Endoscopic retrograde cholangiopancreatography (ERCP) can safely be performed in patients with COVID-19 infection, but outcomes of patients with COVID-19 infections and concomitant pancreatic and biliary disease requiring endoscopic intervention are unknown.

Aims

This study aims to evaluate the severity of pancreaticobiliary diseases and post-ERCP outcomes in COVID-19 patients.

Methods

Patients with pancreato-biliary disease that required inpatient ERCP from five centers in the United States and South America between January 1, 2020, and October 31, 2020 were included. A representative cohort of patients from each month were randomly selected from each site. Disease severity and post-ERCP outcomes were compared between COVID-19 positive and COVID-19 negative patients.

Results

A total of 175 patients were included: 95 COVID positive and 80 COVID negative. Mean CTSI score for the patients who had pancreatitis was higher in COVID-positive cohort by 3.2 points (p < .00001). The COVID-positive group had more cases with severe disease (n = 41) versus the COVID-negative group (n = 2) (p < .00001). Mortality was higher in the COVID-19 positive group (19%) compared to COVID-negative group (7.5%) even though the COVID-19-negative group had higher incidence of malignancy (n = 17, 21% vs n = 7, 7.3%) (p = 0.0455).

Conclusions

This study shows that patients with COVID infection have more severe pancreato-biliary disease and worse post-ERCP outcomes, including longer length of stay and higher mortality rate. These are important considerations when planning for endoscopic intervention.

Clinicaltrials.gov: (NCT05051358).

Graphical Abstract