COVID-19 Infection Can Lead to More Severe Pancreato-Biliary Disease

Patients with COVID-19 tend to have more severe pancreato-biliary disease and worse outcomes from post-endoscopic retrograde cholangiopancreatography (ERCP), according to study findings published in Digestive Diseases and Sciences.

Although viral infections are known to affect the hepato-pancreato-biliary system, there is a lack of data regarding this relationship for COVID-19. Researchers conducted an international, multicenter, retrospective cohort study (ClinicalTrials.gov Identifier: NCT05051358) to assess the pancreato-biliary disease severity and post-ERCP measures in patients with severe COVID-19 infection.

The study was conducted at 2 study centers with adults aged 18 years and older diagnosed with pancreato-biliary disease requiring ERCP. The analysis was conducted based on the status of COVID-19 infection prior to procedure, with patients testing either positive or negative 3 days before ERCP. The researchers conducted the Student’s t-test, chi-square test, or the Fisher’s exact test when necessary. 

Of the 175 participants recruited for the study, 95 tested positive and 80 tested negative for COVID-19. The average Computed Tomography Severity Index (CTSI) score, which measures pancreatic inflammation, was higher by 3.2 points among patients testing positive for COVID-19 (P <.00001). Participants that tested positive for COVID-19 had a greater number of severe pancreato-biliary disease cases (n=41) compared with participants who tested negative for COVID-19 (n=2; P <.00001). 

There were no significant differences in ERCP success and adverse event rate between the COVID-positive and -negative groups. Additionally, there were no significant differences in clinical success rate, defined by the resolution of the indication for endoscopic treatment in patients who tested positive (84.6%) or negative (92.3%) for COVID-19.

The average length of stay at the hospital post-ERCP was increased among patients who tested positive for COVID-19 (29.7 days) compared with patients testing negative for COVID-19 (8.3 days; P <.00001). The mortality rate was also increased among patients testing positive (n=18 [19%]) compared with those testing negative (n=6 [7.5%]) for COVID-19, although patients testing positive had a decreased malignancy rate (n=7 [7.3%] vs n=17 [21%], respectively; P =.0455).

“This study shows that there was 100% technical success of ERCP, regardless of COVID-19 status, which is different than what prior studies have reported,” study authors noted.

Study limitations include the retrospective design and the small sample size. 

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.

This article originally appeared on Gastroenterology Advisor