ABSTRACT
Background: Pancreatic involvement in patients with Coronavirus 2019 (COVID-19) has been reported in the literature. The pancreatic injury in COVID-19 patients might be a result of the direct cytopathic effect of viral replication or indirectly related to the immune response to the viral infection. Methods:Westudied 183 patients diagnosed with symptomatic SARS-CoV-2 and admitted to COVID-19 facilities in Qatar. We included only the patients with documented positive SARS-COV-2 PCR and measured lipase levels. The cohort was categorized into two groups based on the serum lipase level. The cutoff was the elevation of the serum lipase more than three times the upper limit of normal. Patients with lipase levels below the cutoff were included in the first group, and those with lipase levels above the cutoff were included in the second group. The primary outcome was mortality. The secondary outcomes were disease severity on presentation and markers of disease progression. Markers of disease progression (Table 1) included the development of acute respiratory distress syndrome (ARDS), shock, multi-organ failure, the requirement for ICU admission, mechanical ventilation, continuous renal replacement therapy (CRRT), and extracorporeal membrane oxygenation (ECMO). Results: Our study population had a mean age of 49 and a mean BMI of 28. There was a male predominance in the study sample (more than 91%), reflecting the country's demographics. There was no statistically significant difference between the two groups in the mean age, BMI, gender distribution, or patients' reported symptoms. There was an increased prevalence of diabetes mellitus (DM) and hypertension (HTN) in our study population (45.4% and 44.8%). Apart from the increased prevalence of chronic liver disease in the second group, there was no statistically significant difference in the prevalence of comorbidities (e.g., DM, HTN) between the two groups (Table 1). The second group showed a statistically significant increase in mean creatinine, troponin, procalcitonin, ferritin, and amylase compared to the first group. On the other hand, the mean hemoglobin, sodium and albumin were lower (Table 2). Interestingly, more patients in the second group received tocilizumab and oseltamivir (Table 1). The mortality rate in our study population was 15.3%, with a higher mortality rate in the second group (Table 1). Almost 50% of the patients developed ARDS. Multiple markers of disease progression, including the development of ARDS, shock, and multi-organ failure;requirement for ICU, mechanical ventilation, and CRRT were increased in the second group compared to the first group. Also, the mean length of stay was higher in the second group (Table 1). Conclusion: Based on our study, hospitalized patients with COVID-19 who had higher lipase levels had a higher mortality rate and higher risk for disease progression. (Table Presented)
ABSTRACT
Climate change has emerged as a global issue that poses a serious threat to life in this world such as a shortage of food and clean drinking water due to global warming, erratic weather patterns, melting glaciers, droughts, etc. This issue has been in the limelight for more than 4 decades and world bodies including the WHO have been quite active in holding international conferences, seminars, and workshops to impress upon the member countries to take concrete steps to mitigate environmental degradation and save future generations from the devastating effects of climate change. While the climate change issue has been highlighted to a great extent, its impact on health has not received appreciable attention of the world community. The initiative of Inter-Academy Partnership (IAP) to address this issue is, therefore, a laudable scientific endeavor. Pakistan, one of the developing countries in South Asia is among the 5 most-affected countries due to climate change. Climate change has resulted in erratic weather patterns, reduction in the availability of clean water per capita, melting of glaciers, desertification of fertile cultivable land, flooding, land sliding, and drought leading to food insecurity. Besides having a drastic effect on the economy, the health of people is also getting adversely affected. According to the United Nations, more than 44% of Pakistani children under the age of 5 years suffer from stunted growth due to malnutrition. Such stunting impairs normal brain and body development. This has been one of the most alarming consequences of poverty and food insecurity. Other ill-effects of climate change (such as unseasonal rains and “smog”) on health include the spread of water and vector-borne diseases such as malaria, dengue, zika virus, typhoid, cholera, asthma, hay fever, allergies, respiratory diseases, and chronic diseases like diabetes, cardiovascular disease, renal disease, obesity, cancers, anxiety, and depression. Moreover, infectious diseases such as hepatitis B and C, COVID-19 are also spreading due to a compromised immune system. It is hoped that the world during the post-pandemic period would be more conscious of the mitigation steps to be taken to prevent future generations from the ill-effects of climate change. The UN Secretary-General, Antonio Guterres in his recently enunciated guiding principles urged the world leaders in the post-pandemic period “to rescue businesses that can create new jobs and enterprises through a clean and green transition based on the decarbonization of the economy and shift fiscal power from grey to green to initiate the resilience of people and communities in a way that is fair and leaves no one behind”. In other words, the world needs a “climate-smart” stimulus to provide a safe and healthy environment to future generations. © Pakistan Academy of Sciences.