Acute biliary pancreatitis management during the COVID-19 pandemic

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.