HYPERLIPASEMIA IS ASSOCIATED WITH INCREASED MORTALITY IN COVID-19 HOSPITALIZED PATIENTS: A RETROSPECTIVE STUDY

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)