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  • SARS-CoV-2 pandemic has impacted on patterns of aetiology for acute pancreatitis and management of gallstone pancreatitis in the UK

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SARS-CoV-2 pandemic has impacted on patterns of aetiology for acute pancreatitis and management of gallstone pancreatitis in the UK
  1. Chris Varghese1,
  2. Manu Nayar2,
  3. Sanjay Pandanaboyana3,4
  4. On behalf of The COVIDPAN Collaborative
  1. 1 Department of Surgery, The University of Auckland Faculty of Medical and Health Sciences, Auckland, Auckland, New Zealand
  2. 2 HPB Unit, Freeman Hospital, Newcastle upon Tyne, UK
  3. 3 Newcastle University, Newcastle upon Tyne, UK
  4. 4 HPB and Transplant Unit, Freeman Hospital, Newcastle Upon Tyne, UK
  1. Correspondence to Sanjay Pandanaboyana, Hepatobiliary and Transplant Unit, Freeman Hospital, Newcastle Upon Tyne, UK; s.pandanaboyana{at}nhs.net

https://doi.org/10.1136/gutjnl-2021-326845

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    We recently published the COVIDPAN study1 and follow-up data2 in Gut, which explored the association between concomitant SARS-CoV-2 infection and acute pancreatitis (AP).1 2 We would like to further report the impact of SARS-CoV-2 pandemic on aetiology and management of patients presenting with AP, particularly those with gallstone pancreatitis (GSP) in a cohort of patients who did not have SARS-CoV-2 infection.

    Between 1 March 2020 and 23 July 2020, 1628 patients presenting with AP were included in the analysis with median age of 54 years (IQR 40–69). Gallstones were the predominant aetiology of AP (43.6%), followed by alcohol-related AP (25.8%) and idiopathic AP (21.5%). The idiopathic group was further followed for 12 months, and after completion of appropriate investigations, 14.4% of the cohort remain to have an idiopathic aetiology. Most patients had mild AP (1244, 77.8%), 256 (16%) had moderate to severe AP and 100 (6.3%) severe AP according to Revised Atlanta Criteria ( table 1 ).

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    Table 1

    Baseline characteristics by AP severity

    Follow-up data were available for 1358 patients for a period of 12 months of which 187/1358 patients were readmitted with AP. Seventy-seven (41.2%) patients had alcohol-related pancreatitis and 54 (28.9%) GSP, while 22 (11.8%) patients had idiopathic AP and 4 (2.1%) had post-Endoscopic Retrograde CholangioPancreatography associated AP. One hundred and thirteen of 187 patients were readmitted during the ‘second wave’ of SARS-CoV-2 pandemic (after September 2020) with predominantly alcohol-related AP aetiology (49, 43.3%). Patients that were readmitted during the ‘second wave’ more commonly had alcoholic AP compared with the index cohort (43.4% of readmitted cohort vs 23.5% of non-readmitted cohort; p<0.001); however, there were no significant differences in AP severity (p=0.268).

    In the cohort of 1358 patients with complete follow-up data, 620 (45.7%) presented with GSP, of which only 66 (10.6%) underwent an index cholecystectomy …

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    Footnotes

    • Twitter @chrisvarghese98, @drmanuknayar, @sanjay_HPB

    • Collaborators COVIDPAN Collborative Group: Aditya Kanwar (University Hospitals Plymouth NHS Trust, Plymouth, UK); Ajith K Siriwardena (Manchester Royal Infirmary, Manchester, UK); Ali Raza Haque (Frimley Park Hospital, Camberley, UK); Altaf Awan (Derby hospital, Derby, UK); Anita Balakrishnan (Addenbrooke’s hospital, Cambridge, UK); Arab Rawashdeh (Heartland hospital, Birmingham, UK); Bogdan Ivanov (Princess Alexandra Hospital, Harlow, Essex, UK); Chetan Parmar (Whittington Hospital, London, UK); Christopher M Halloran (The Royal Liverpool Hospital, Liverpool, UK); Clifford Caruana (Mater Dei Hospital, Malta); Cynthia-Michelle Borg (University Hospital Lewisham, Lewisham, UK); Dhanny Gomez (Nottingham City Hospital, Nottingham, UK); Dimitrios Damaskos (Royal Infirmary of Edinburgh, Edinburgh, UK); Dimitrios Karavias (Southampton General hospital, Southampton, UK); Guy Finch (Northampton General Hospital, Northampton, UK); Husam Ebied (St Thomas Hospital, London, UK); James K Pine (St James’s University Hospital, Leeds, UK); James R A Skipworth (Bristol Royal Infirmary, Bristol, UK); James Milburn (Aberdeen Royal Infirmary, Aberdeen, UK); Javed Latif (Derby Hospital, Derby, UK); Jeyakumar Apollos (Dumfries and Galloway Royal Infirmary, Dumfries, UK); Jihène El Kafsi (Wexham Park Hospital, Camberley, UK); John A Windsor (Auckland City Hospital, Auckland, New Zealand); Keith Roberts (Queen Elizabeth Hospital, Birmingham, UK); Kelvin Wang (Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan, UK); Krish Ravi (Chesterfield Royal Hospital NHS Trust, Chesterfield, UK); Maria V Coats (Glasgow Royal Infirmary, Glasgow, UK); Marianne Hollyman (Musgrove Park Hospital, Taunton, UK); Mary Phillips (Royal Surrey County Hospital, Surrey, UK); Michael Okocha (Southmead Hospital, North Bristol NHS Trust, UK); Michael SJ Wilson; Nadeem A Ameer (University Hospital of Coventry and Warwickshire, Coventry, UK); Nagappan Kumar (University Hospital of Wales, Cardiff, UK); Nehal Shah (Northern General Hospital, Sheffield, UK); Pierfrancesco Lapolla (Policlinico Umberto I, Sapienza University of Rome, Italy); Connor Magee (Arrowe Park Hospital, Wirral, UK); Bilal Al-Sarireh (Morriston Hospital, Swansea, UK); Raimundas Lunevicius (Aintree Hospital, Liverpool, UK); Rami Benhmida (Whittington Hospital, London, UK); Rishi Singhal (University Hospital Birmingham NHS Foundation Trust, Birmingham, UK); Srinivasan Balachandra (Doncaster Royal Infirmary, Doncaster, UK); Semra Demirli Atıcı (Department of General Surgery, University of Health Sciences Tepecik Training and Research Hospital, İzmir, Turkey); Shameen Jaunoo (Brighton and Sussex University Hospitals NHS Trust, UK); Simon Dwerryhouse (Gloucestershire Hospitals NHS Foundation Trust, Gloucester, UK); Tamsin Boyce (The Royal Gwent Hospital, Newport, Wales, UK); Vasileios Charalampakis (South Warwickshire NHS Foundation Trust, Warwick, UK); Venkat Kanakala (James Cook University Hospital, Middlesborough, UK); Zaigham Abbas (Dr. Ziauddin University Hospital, Clifton Karachi, Pakistan); Nilanjana Tewari (University Hospitals Coventry & Warwickshire, Coventry, UK); Abeer Altaf (Department of Gastroenterology, Dr. Ziauddin University Hospital, Clifton Karachi, Pakistan); Alexandra Bell (Northern General Hospital, Sheffield, UK); Aleg Aliosin (Klaipeda University Hospital, Klaipeda, Lithuania.); Zahid Bahli (Altnagelvin Area Hospital, Londonderry, UK); Aman Ahmad (St. James University Hospital, Leeds, UK); Anantha Madhavan (James cook university hospital, Middlesbrough, UK); Andrea Mingoli (Policlinico Umberto I, Sapienza University of Rome, Italy); Angus White (The Royal Gwent Hospital, Newport, Wales); Arthur Cotton (Gloucestershire Hospitals NHS Foundation Trust, Gloucestershire, UK); Ashiv Patel (East surrey hospital, Surrey, UK); AyoBobola A Apampa (Royal Liverpool hospital, Liverpool, UK); Bakhat Yawar (Western Health and Social Care Trust, Altnagelvin, Northern Ireland, UK); Bamidele Famokunwa (Wexham Park Hospital, Slough, UK); Blazej Rybinski (University Hospitals Plymouth NHS Trust, Plymouth, UK); Bruno Cirillo (Policlinico Umberto I, Sapienza University of Rome, Italy); Bryony Ford (University Hospitals Plymouth NHS Trust, Plymouth, UK); Caitlin Jordan (Musgrove Park Hospital, Taunton, UK); Catrin Jones (Glasgow Royal Infirmary, Glasgow, UK); Chris Varghese (Auckland University, Auckland, New Zealand); Charalampos Konstantinou (Warwick Hospital, Warwick, UK); Charles Geoffrey, Dermot Stewart (Musgrove Park Hospital, Taunton, UK); Daniel Marshall (St James’ University Hospital, Leeds, UK); David Bourne (Freeman hospital, Newcastle upon Tyne, UK); Danny Chandla (University Hospital Coventry and Warwickshire, Coventry, UK); Değercan Yeşilyurt (University of Health Sciences Tepecik Training and Research Hospital, Department of General Surgery, İzmir, Turkey); Dharmadev Trivedi (Southampton general hospital, Southampton, UK); Duncan Rutherford (Forth Valley Royal Hospital, Larbert, UK); Ebru Sezen Freed (Northampton General Hospital, Northampton, UK); Eleanor Massie (Forth Valley Royal Hospital, Larbert, UK); Elizabeth Ward (Royal Infirmary of Edinburgh, Edinburgh, UK); Ellen Murgitroyd (Royal Infirmary of Edinburgh, Edinburgh, UK); Emily Britton (Gloucestershire Hospitals NHS Foundation Trust, Gloucester, UK); Euan J Dickson (Glasgow Royal Infirmary, Glasgow, UK); Evripidis Tokidis (Chesterfield Royal Hospital NHS Trust, Chesterfield, UK); Faris Soliman (Morriston Hospital, Swansea, Wales, UK); Francesco Abbadessa (Freeman hospital, Newcastle UK); Gautam Singh (Frimley Park Hospital, Camberley, UK); Ghazaleh MOHAMMADI-ZANIANI (Freeman Hospital, Newcastle Upon Tyne, UK); Gordon Gregory (Nottingham city hospital, Nottingham, UK); George Ugwu (Doncaster Royal Infirmary, Doncaster, UK); George Brown (St James Hospital,Leeds, UK); Gioia Brachini (Policlinico Umberto I, Sapienza University of Rome, Italy); James Walmsley (Northampton General Hospital, Northampton, UK); Shabuddin Khan (Northampton General Hospital, Northampton, UK); Hadil Said (Wexham Park Hospital, Slough, UK); Heba Ali (Western Health and Social Care Trust, Altnagelvin. Northern Ireland); Harriet Whewell (The Royal Gwent Hospital, Newport,UK); Harry VM Spiers (Addenbrooke’s Hospital, Cambridge, UK); Henry D De’Ath (Frimley Park Hospital, Camberley, UK); Hu Ying Charmaine Chan (Southampton University Hospital, Southampton); Imran Bhatti (Royal Derby Hospital, Derby, UK); Islam Noaman (Royal Infirmary of Edinburgh, Edinburgh, UK); İsmail Sert (University of Health Sciences Tepecik Training and Research Hospital, Department of General Surgery, İzmir, Turkey); James A Gossage (Kings college hospital, London); Jack Martin (Addenbrooke’s hospital, Cambridge); James Blackwell (Nottingham city hospital, Nottingham, UK); James Williams (Bristol Royal Infirmary, Bristol, UK); Jasmine Grace Moore (Dumfries and Galloway Royal Infirmary, Dumfries, UK); Jenna Shepherd (Aberdeen Royal Infirmary, Aberdeen, UK); Jennifer Wheat (The University Hospital of Wales, Cardiff.); Jenny Cao (Addenbrooke’s Hospital, Cambridge); Jeremy Fenech (Mater Dei Hospital, Malta); John Leeds (Freeman Hospital, Newcastle Upon Tyne); Kofi Oppong (Freeman Hospital, Newcastle Upon Tyne); Anitha James (Wexham Park Hospital, Frimley, UK); Kai Hartshorn (University Hospital Coventry and Warwickshire, Coventry, UK); Kelsey Rowsell (Morriston Hospital, Swansea, UK); Ken Philip (Weston General Hospital, Bristol, UK); Khaled Abdelgalel (Warwick hospital, Warwick, UK); Kieran McGivern (Forth Valley Royal Hospital, Larbert, UK); Leo Richard Brown (Dumfries and Galloway Royal Infirmary, Dumfries, UK); Louise Howse (University Hospital Lewisham, Lewisham, UK); Louise M Finch (Manchester Royal Infirmary, Manchester, UK); Louise Silva (University Hospital of Wales, Cardiff, UK); Maitreyi Patel (Princess Alexandra Hospital, Harlow, UK); Mandeep Kaur (Royal Sussex County Hospital, Brighton, UK); Marcus Quinn (Southmead Hospital, Bristol, UK); Marwa Ahmed Jama (Northern General Hospital, Sheffield, UK); Rajiv Lahiri (Royal Surrey County Hospital, Essex, UK); James Hopkins (Southmead Hospital, Bristol, UK); Mohamed abousamra (Altnagelvin Area Hospital, Londonderry,UK); Mohamed Issa (Arrowe Park Hospital, Wirral, UK); Mohammed Hammoda (Morriston Hospital, Swansea,UK); Muhammad Ali Qadeer (Department of Gastroenterology, Dr. Ziauddin University Hospital, Clifton Karachi, Pakistan); Momin Eltayeb (St James Hospital, Leeds,UK); Muneeb Zafar (Dumfries and Galloway Royal Infirmary, Dumfries, UK); Mishal Shahid (Musgrove Park, Taunton, UK); Nanda Bandlamudi (Royal Derby Hospital, Derby, UK); Nnaemeka Chidumije (Heartlands hospital, Birmingham); Navneet Tiwari (Freeman Hospital, Newcastle Upon Tyne, UK); Obi Nwogwugwu (Bristol Royal Infirmary, Bristol, UK); Olivia Spence (Northern General hospital, Sheffield, UK); Paul Bassett (Stats consultancy LTD, UK); Paula Ghaneh (The Royal Liverpool Hospital, Liverpool, UK); Paula Strong (The University Hospital of Wales, Cardiff, UK); Peter Szatmary (The Royal Liverpool Hospital, Liverpool, UK); Riadh Salem (Wexham park, Frimley Health, UK); Rupaly Pande (Queen Elizabeth Hospital, Birmingham); Qazi R Muhammad (University Hospital Coventry and Warwickshire, Coventry, UK); Quentin M Nunes (Aintree Hospital, Liverpool, UK); Qurrat Al Ain Atif (Royal Sussex county hospital, Brighton, UK); Robert Sutton (The Royal Liverpool Hospital, Liverpool, UK); Robert Young (Arrowe Park Hospital, Wirral, UK); Roland Taylor (St James University Hospital, Leeds, UK); Sam Tingle (Freeman Hospital, Newcastle Upon Tyne, UK); Sarunas Dailidenas (Klaipeda University Hospital, Klaipeda, Lithuania); Sudin Daniel (Doncaster Royal Infirmary, Doncaster, UK); Sapna Gupta (Royal Gwent Hospital); Santhalingam Jegatheeswaran (Manchester Royal Infirmary, Manchester, UK); Sattam Halaseh (Weston General Hospital, Bristol, UK); Shehryar Noor (Aberdeen Royal Infirmary, Aberdeen, UK); Simon J McCluney (Whittington Hospital, London, UK); Sophie Allen (East surrey hospital, Surrey, UK); Stephanie Goh (Addenbrooke’s hospital, Cambridge, UK); Steven Brown (James cook university hospital, Middlesbrough, UK); Stuart Cowie (James cook university hospital, Middlesbrough, UK); Tayfun Kaya (University of Health Sciences Tepecik Training and Research Hospital, Department of General Surgery, İzmir, Turkey); Thomas Tolley (The Royal Gwent Hospital, Newport, Wales); Tamer Ghorab (Western Health and Social Care Trust; Altnagelvin. Northern Ireland. UK); Victoria Morrison-Jones (Southampton General hospital, Southampton, UK); John Moir (Freeman Hospital, Newcastle Upon Tyne);Ahmed M S M Marzouk (Altnagelvin hosital, Londonderry, Northern Ireland)

    • Contributors All authors: manuscript preparation, study concept and critical review. CV: manuscript preparation and critical review.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

    • Provenance and peer review Not commissioned; internally peer reviewed.