Oleksandr Rotar, Igor Khomiak, Oleh Polanskyy, Yury Muskovsky, Sitlana Railianu, Michael Fishbach
Objective COVID-19 primarily affects the respiratory tract, but reports of acute pancreatitis occurrence in patients with COVID 19 suggest possibility of direct injury of pancreatic gland by this virus. Methods We present observation of patient with acute necrotizing pancreatitis and concomitant COVID-19. SARSCoV2 infection was diagnosed 5 days before initiation of ANP with bilateral pneumonia. He was admitted with persistent multi-organ failures and injuries over 50% of pancreas. Results Biochemical changes included prolonged prothrombin and partial thromboplastin time, elevated fibrinogen and D-dimer concentration, hypertriglyceridemia with normal amount of platelets. Diffuse erosive hemorrhage from pancreas occurred on 6th day from onset as result of coagulopathy and several laparotomic interventions were necessary for control of it. Despite intensive therapy this patient died due to progressed ARDS. Conclusion Development of ANP in patients COVID-19 carries risk of erosive hemorrhage from pancreas due to coagulopathy. Precise monitoring of coagulation and fibrinolytic activity in such patients is indicated.
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